As we age, it’s natural for many things to slow down. We don’t move as quickly as we once did and it can take a little longer to learn new things. Our brains are amazing organs, but over time they can start to slow down a little too.
Normal brain changes, or cognitive changes, are often seen with age. This can include minor trouble with multi-tasking or infrequent issues with memory (like sometimes forgetting to take your medication with breakfast).*
But there are times when cognitive changes are not a normal part of aging. Cognitive decline not associated with normal aging consists of changes in memory or cognitive function that are frequent enough to be noticed by others. Today we’re going to explore what cognitive decline is, what signs and symptoms to look for, and what you can expect if you go see your healthcare provider for cognitive decline concerns (either for you or a loved one).
What is Cognitive Decline?
Cognitive decline not associated with normal aging is often called mild cognitive impairment (MCI). According to the Alzheimer’s Association, mild cognitive impairment causes changes in memory that are serious enough to raise concern from others but do not cause serious impairment when it comes to day to day life.
MCI is a term often used to describe memory, language, or problem solving changes that are more serious than would be expected with age.
What Causes Mild Cognitive Impairment?
While there is no single cause for MCI, age is the biggest risk factor. Cognitive changes can affect up to 20% of people over 65 years old. Other MCI risk factors according to the National Institute of Aging include having diabetes or a history of stroke. A history of depression is another MCI risk factor.
According to the Mayo Clinic lifestyle factors such as smoking, lack of physical exercise, and lack of mental or social stimulation are risks for cognitive decline and MCI. There are also certain genes that can increase someone’s risk for MCI, the most prevalent one is called APOE e4.
It’s also important to remember not everyone who has MCI will go on to develop dementia or Alzheimer’s Disease. Having MCI does increase your risk, but most people do not develop dementia later in life. Only 10-15% of people with cognitive decline will develop dementia.
What Are The Symptoms of Cognitive Decline?
Cognitive decline can impact both memory and the ability to carry out certain tasks. The Center for Disease Control and Prevention (CDC) states common symptoms of cognitive decline and MCI include:
- Memory loss. This doesn’t mean forgetting where you put your keys or forgetting you had an appointment from time to time. Memory loss due to cognitive decline refers to forgetting new information, trouble remembering words, or getting lost driving home from a familiar place.
- Repeating the same question or telling the same story many times. People with cognitive decline often forget they’ve asked a question or told a certain person the same story.
- Having trouble recognizing familiar faces or places such as not realizing you’re talking to your neighbor of 30 years or to your grandchild.
- Trouble with quick thinking or problem solving, for example in a time of emergency.
- Mood changes including depression, sadness, or anxiety. Cognitive decline can be scary and stressful, often causing mood swings or changes.
- Trouble completing tasks that involve a lot of steps like cooking a meal or paying bills.
Not everyone with cognitive decline will have every symptom. Another thing to remember is occasionally forgetting names or faces is not necessarily something to be worried about. If someone has MCI they will have these symptoms more times than not and they will occur often enough for other people to notice.
Since spotting the signs can sometimes be challenging, even if you’re unsure if you or a loved one have symptoms of MCI, it’s a good idea to talk to your healthcare provider.
Is There a Cognitive Decline Test?
If you make an appointment to see your healthcare provider for cognitive decline, you may be wondering what will happen during your visit. Since memory changes and confusion can be due to many things, your healthcare provider will likely check many areas of your health.
This includes discussing your medical history and reviewing any chronic illnesses or diseases such as heart disease, diabetes, or mental health concerns.
Reviewing your current medications is also part of your medical history. Many medications can cause memory changes, especially if they’re combined with other medications. Sometimes stopping or changing a medication can help reduce cognitive decline.
In addition to your medical history and medications, you may have lab work done to check for any medical conditions. This may include checking your thyroid function or vitamin B12 level as both of these can cause symptoms of cognitive decline.* If you’d like to know if you have the APOE a4 gene mutation, you can be tested for this as well.
Lab work can help identify other causes of memory changes including:
- Infection
- Liver function changes
- Electrolyte changes (like sodium, potassium, and magnesium)
- Heavy metal in the blood
- Changes in blood sugar
- Inflammation
Additional tests your healthcare team may recommend to check cognitive decline include imaging tests like a brain MRI or CT scan to take pictures of the brain. These tests can look for any signs of a stroke or other diagnoses that may be responsible for memory changes.
During your visit, they may ask you a series of questions or ask you to perform a few tasks. This is part of a mental status exam, where your healthcare provider tests your memory and ability to perform tasks. This can include asking you to remember a set of three words or numbers to repeat later in the visit or drawing a clock face on a piece of paper.
While there is no definitive test for MCI, your healthcare provider can make sure there aren’t other health issues causing your memory changes.
What Can I Do if I Spot Signs of Cognitive Decline?
If you notice signs of cognitive decline in yourself or a loved one and feel lost about what to do — you are not alone. Memory changes can feel scary and overwhelming, but the good news is there are many things you can do.
In addition to seeing your healthcare provider or offering to take a loved one to see theirs, there are many things you can do at home to help lower your risk for MCI or potentially improve current symptoms.
Maintaining a healthy weight, eating nutrient-rich foods, and exercising regularly can all help boost brain function. Getting enough sleep each night and quitting smoking are both important for brain health. Since depression can be a risk factor, if you currently struggle with depression, anxiety, or other mental health concerns, working with your healthcare team to address them can help reduce your MCI risk.
Learning new skills and doing activities with others may help improve forgetfulness or memory changes. Think of your brain as a muscle that needs to be exercised too. Puzzles, games, and completing complex tasks help keep your mind active. If you aren’t into puzzles or games, try and find some hobbies that take mental focus like painting, flower arranging, or tackling a new cookbook with fun recipes.
While it can be more challenging than when you were younger, finding time to hang out with friends, family members, or neighbors can help with cognitive function. It may not seem like it, but engaging in social time and having conversations with many people over dinner or happy hour takes a lot of mental focus — and this will help keep your mind sharp.
If you find yourself forgetting things or missing appointments, using organizational tools can help keep you on track. Placing a large calendar on the fridge or having your to-do list taped to your bathroom mirror so you see it each morning can help you stay on top of your schedule.
If you take several medications (or even just one!) using a pill organizer will help keep all of your pills in one place. You can even buy ones that have them broken down by time of day or meal so you don’t have to wonder if you took your pills with breakfast.
And remember the old saying ‘it takes a village?’ This doesn’t only apply to babies and children. So don’t hesitate to lean on those around you that know you and love you. They may have some ideas, tools, or tricks of their own to stay on top of their mind and memory. You are not a burden to them and they will likely be honored if you asked for their help or advice.
