Resource Guide for Family Caregivers
Memory/cognitive changes with aging

Contrary to many myths and stereotypes, significant memory loss is not the norm for older people. Research has found that barring illness or disease, people’s memory and cognitive abilities can remain healthy and strong well into old age. In fact, long-term memory seems to remain intact with advancing age.

Nevertheless, a number of normal, age-related memory changes do occur. These include:

Slower thinking

The speed of learning and recall (remembering) tends to decrease, so it may require more time to learn new things and/or retrieve information. Short-term memory doesn't necessarily fade with age; it just takes longer to function.

…the more concerned an older adult is about memory loss, the less likely they are to have Alzheimer’s disease.

Difficulty in paying attention

Many memory changes are due to problems of attention, not retention. Reduction in the ability to concentrate as a person ages makes it harder to remember. Distractions are more difficult to ignore and interruptions may cause forgetfulness.

More memory cues required for recall

As people age, more memory aids or cues are needed. A cue can be a word, picture, smell, rhyme, or anything associated with information or events to be remembered.

Despite the evidence that normal aging does not result in major cognitive or memory losses, an unspoken fear among many older persons is that forgetting things may signal a disease such as Alzheimer's disease. Most older people do not get Alzheimer’s; only five to eight percent of the population over age 65 are likely to get the disease.

As a general rule, the more concerned an older adult is about memory loss, the less likely they are to have Alzheimer’s disease. Individuals with Alzheimer’s disease are often unaware of their own loss of function.

 

 Or is it Alzheimer’s?

Ten Warning Signs7 

1. Recent memory loss that affects job performance

It’s normal to occasionally forget assignments, colleagues’ names or a business associate’s telephone number, but generally remember them later. Those with a dementia, such as Alzheimer’s disease, may forget things more often, and not remember them later. They may repeatedly ask the same questions, not remembering either the answer, or that they already asked the question.

2. Difficulty performing familiar tasks

Busy people can be distracted from time to time and leave the carrots on the stove, only remembering to serve them at the end of the meal. People with Alzheimer’s disease could prepare a meal, forget to serve it, and even forget they ever made it.

3. Problems with language

Everyone has trouble finding the right word sometimes, but can finish the sentence with another appropriate word. A person with Alzheimer’s disease may forget simple words, or substitute inappropriate words, making their sentence incomprehensible.

4. Disorientation of time and place

It’s normal to forget the day of  the week or your destination for a moment. But people with Alzheimer’s disease can become lost on their own street or in a familiar shopping mall, not knowing where they are, how they got there or how to get home.

5. Poor or decreased judgment

People can become so immersed in an activity or telephone conversation that they temporarily forget the child they’re watching. A person with Alzheimer’s disease could entirely forget the child under their care and leave the house to visit a neighbor. Or, the person may make unsafe decisions, such as forgetting to make sure traffic was clear before crossing the street.

6. Problems with abstract thinking (e.g., balancing a cheque book)

People who normally balance their cheque books may be momentarily disconcerted when the task is more complicated than usual, but will eventually figure out the solution. Someone with Alzheimer’s disease could pay bills twice or forget to pay them altogether, or even forget completely what the numbers are and what needs to be done with them.

7. Misplacing things

Anyone can misplace their wallet or keys, but eventually find them by reconstructing where they could have left them. A person with Alzheimer’s disease may put things in inappropriate places - an iron in the freezer, or a wristwatch in the sugar bowl - and not be able to retrieve them.

8. Changes in personality

People's personalities ordinarily are generally stable in adulthood, though certain character traits strengthen or mellow. But a person with Alzheimer’s disease can change drastically, becoming extremely irritable, suspicious or fearful.

If, after reviewing these warning signs, you or your family suspects dementia, a physician specializing in working with older people should be contacted.

9. Changes in mood or behaviour

Everyone has a bad day once in a while, or may become sad or moody from time to time. Some with Alzheimer’s disease can exhibit rapid mood swings for no apparent reason: e.g., from calm to tears to anger to calm in a few minutes.

10. Loss of initiative

It’s normal to tire of house work, business activities or social obligation, but most people regain their initiative. The person with Alzheimer’s disease may become very passive and require cues and prompting to get them involved in activities. 

If, after reviewing these warning signs you or your family suspects dementia a physician specializing in working with older people should be contacted (see Section 8 on assessments). It may be that the hunch is wrong and that the memory changes may be caused by temporary and treatable conditions. Moreover, five per cent of dementias are at least partly reversible, especially if detected early. Over-medication, adverse drug reactions and interactions, vitamin B deficiency and thyroid gland disorders can all be causes of reversible forms of dementia.

Even if the dementia cannot be reversed, some symptoms, such as tearfulness, sleeping problems and anxiety, often can be treated. A diagnosis prompts the family to plan for the future while their family member can still be part of the planning.

6 Adapted from: About dementia: Age-related memory changes, via: www.alzla.org/dementia/aging.html
7 Adapted from: About dementia: Is it Alzheimer’s? Ten Warning signs. Via: www.alzla.org/dementia/signs.html