You’re rushing off to run errands and can’t find your car keys—for what feels like the tenth time this week. You walk into the kitchen for something but draw a blank about what you wanted. The name of the movie you just saw is on the tip of your tongue.
Is this normal forgetfulness or a sign of something more serious, like the onset of dementia? It’s a common question, underscoring a common fear, for many, especially when you hit your 50s or 60s.
Relax, say experts. Memory lapses can be frustrating, but they’re usually not cause for concern. While some abilities may diminish over time, dementia in your middle years is uncommon.
Less than 10% of people with Alzheimer’s developed the disease before 65, according to the National Institute on Aging. The Alzheimer’s Association estimates that currently about 200,000 people out of 5.7 million with Alzheimer’s have an early-onset form of the disease—that’s less than 5%. And while the risk doubles every five years after 65, studies show that dementia rates actually fell over the past decade.
The bottom line: Despite what you may have heard, dementia is not an inevitable part of aging. And there are steps you can take to lower your risk of developing the disease later in life.
This is the most common fear
The primary difference between age-related memory loss and dementia is that the former isn’t disabling, according to Amy Ehrlich, associate chief of geriatrics at Montefiore Health System in New York City.
“It’s very typical as you age that you have trouble remembering a name, then it will just pop into your head,” says Ehrlich. “That is not a sign of impending dementia.”
Whether forgetfulness is an early sign of dementia is the most common fear she hears from patients, Ehrlich adds.
Dementia is actually an umbrella term for several cognitive disorders. Alzheimer’s disease is the most common type of dementia, contributing to about 60% to 70% of cases.
Other prevalent forms of the disease include vascular dementia, caused by poor blood flow to the brain from heart disease or stroke; and Lewy Body dementia, which happens when abnormal microscopic deposits damage brain cells over time. Media mogul Ted Turner recently disclosed he’s been diagnosed with Lewy Body dementia. Actor Robin Williams also had this form of the disease.
The National Institutes of Health points out that as you age, your experiences and knowledge keep your brain working, developing and learning. Different parts of the brain perform different complex functions, such as concentration, language, motor skills, social cognition and more, often simultaneously.
Your memory may be less sharp now for a host of reasons, including depression, anxiety or other mental health issues. Effects of some medications can also interfere with memory, as can alcohol and other substances. In addition, several scientific studies have linked sleep apnea with mild cognitive impairment.
These issues are very treatable following a thorough physical and mental evaluation which assesses memory, mood, and function. Symptoms usually improve once the underlying problem is addressed.
Recognizing the true signs of dementia
During your 50s and 60s, you may have some trouble recalling information, but retain your ability to think things through. Your intelligence remains stable. as does the ability to learn new things.
When Ehrlich screens patients for possible signs of dementia, she looks at whether they can still learn new technology, like using a universal remote or the latest-model smart phone. She asks, “It may take you a little longer, but can you learn a new task?”
Multitasking may be more challenging at a certain age, but getting older mostly doesn’t interfere with remembering facts and concepts, a process called semantic memory. The American Psychological Association says semantic memory typically remains steady or just slightly declines with age.
Another type of memory, episodic memory, affects the ability to remember a lunch date or the author of the book you just read. So forgetting where you left your reading glasses doesn’t mean you’re sliding into the abyss.
Then too, some women in their early 50s experience so-called “menopause brain,” marked by forgetfulness and distraction. Ehrlich says this is perfectly normal and disappears when hormones settle down.
If you’re worried about memory loss or other cognitive changes over time, by all means get evaluated by a physician, Ehrlich advises.
Doctors use a risk scale for cognitive impairment based on criteria like education, number of medications, family history, health threats like heart disease or diabetes, depression and other factors. It’s an easy and inexpensive means to determine who should be referred for further testing and early intervention.
Most of the time it’s nothing, but early screening can rule out other causes. If there is mild impairment, prompt treatment with drugs can slow progression and extend physical health.
What you can do to lower your risk
There’s a lot you can do to help reduce your dementia risk later in life, especially managing conditions like high blood pressure and diabetes.
“We want people to be physically active, doing ongoing exercise, and enjoying social interaction, so keeping oneself engaged in the world and using your brain is important, and using your body is critical,” Ehrlich said.
What about the so-called super-foods and brain training games that are supposed to improve cognition and memory?
There isn’t any good data on brain games and only extremely limited clinical information on foods which may improve brain health, Ehrlich explained.
“I’ve lived through the high-dose vitamin E, which we found out had cardiovascular side effects; we learned that ginko has other interactions with drugs,” she said. “So I tell people to eat a more plant-based, balanced diet, in general following the current nutrition guidelines. There is no magic cure for this.”
In other words, you can stop worrying about those misplaced car keys. But if you forget what they’re used for or get lost on a familiar drive, that could be a sign of something more serious.
Here are steps you can take to help your memory now:
- Socialize and engage in community activities.
- Exercise. Brisk walking helps maintain brain function.
- Write it down. Keep to do lists and grocery lists on paper or your smartphone.
- Establish a routine. Put your keys, glasses, wallet or purse in the same spot every time you come home.
- Avoid distractions. If it is hard to concentrate, turn off the radio while driving, focus on one task at a time and give conversations your full attention. Take any medications at the same time daily.
- Have a dedicated spot for bill paying and writing payment dates on a wall calendar or use the calendar and reminders features on your phone.
- Maintain good vision and hearing to ensure full engagement in life.
An earlier version of this story misstated the incidence of early-onset dementia. The article has been updated to correct the error.