Ask the Doc

Is my increasing forgetfulness a sign of Alzheimer’s?

By James Mastrianni, MD, PhD

Fact checked by Shannon Sparks

Q: I woke up this morning and saw that I had put the ice cream in the fridge. Am I on the road to developing Alzheimer’s disease?

A: It’s common for people to do things without paying attention. Your mind may be elsewhere, especially if there is a lot of stress in your life. If you experience one slip-up and have no other problems in your day-to-day with memory and cognitive functioning — then consider it a one-off, and don’t fret. However, if you’re misplacing personal items routinely, forgetting conversations that others are reminding you of, and especially if others are telling you that you are repeating yourself, these may be concerning.

Everybody starts to forget as they age. Typically, age-related memory problems involve retrieving previously learned information. You can still put information into your brain that will be there to retrieve later, but it may be a little harder to retrieve it than when you were in your 20s. A common example of this is not being able to find the word you want to use during conversation, but it comes to you later. Word-finding difficulty is common as you age, and can be a sign of an underlying memory disorder if it progresses to interfering with routine communication.

Alzheimer’s disease starts out with minor cognitive troubles that eventually progress, so differentiating subtle signs of cognitive impairment as solely related to aging and not the sign of future Alzheimer’s disease is sometimes difficult.

Q: How are more serious age-related memory issues different?

A: There are stages of memory impairment, typically starting with mild cognitive impairment (MCI) — memory and cognitive difficulties that are more severe than what is considered normal for age. In this stage, you function independently in your daily routine. You can pay your bills, clean the house, take your medications, and drive your car without trouble.

The difference with dementia is that the specific brain areas that allow us to lay down new memories start to fail. We can no longer store new information effectively in our brains for later retrieval. Also, ability to manage daily living activities start to break down. You may find that you can’t make meals anymore, or you lose your way driving to a familiar place, or you’re spending lots of time looking for personal items you misplaced. And you will forget that you’re forgetting. One of the difficult aspects of dementias is that they affect self-insight; those with dementia often don’t recognize that they’re having trouble with their memory. Friends and family members who know the person well typically recognize it first.

Q: What should you do if you’re worried — about yourself or a loved one?

A: Talk to (or encourage your loved one to talk to) a primary care physician or a neurologist, who can check for other health issues — such as thyroid disease, diabetes, sleep apnea, or cardiovascular disease — that can also result in memory or cognitive decline. They can also see if any medications may be impacting cognitive function.

There are no at-home tests to tell you if your memory problems are “normal” for you. A comprehensive evaluation by a memory specialist may include detailed neuropsychological testing in addition to advanced brain imaging, some of which can detect the presence of Alzheimer’s disease markers.  

The earlier you talk to a doctor about your memory concerns, the better. New therapies and diagnostic tools can have significant benefits early on.

James Mastrianni, MD, PhD, is a board-certified behavioral neurologist and director of the University of Chicago Medicine Center for Comprehensive Care and Research on Memory Disorders in Chicago.

Originally published in the Spring/Summer 2024 print issue.

Interview by Stephanie Bouchard

Stephanie Bouchard is a freelance journalist who writes about health and wellness, lifestyles, and pets.

www.stephaniebouchard.net