I've been asked many times by concerned friends and clients if forgetting words and events at their age is normal, and by "their age", I mean anywhere after age 55.
With so many people dealing with ageing parents who are developing or already living with some form of dementia, it's no wonder they are concerned about meeting the same fate themselves. And why wouldn't they be? Experiencing memory loss can be frightening for a high-functioning professional in a busy job, or for someone who has been caring for a loved one with dementia. But memory loss can be caused by many things and doesn't necessarily mean you're heading down the road to cognitive impairment.
What Causes Memory Impairment?
First of all, forgetting why you walked into a room or that you were supposed to meet a client at 2pm is normal, and we've all experienced those situations. It's also normal for those memory blips to occur more frequently as you get older. Usually, this temporary forgetfulness is no more than a function of being distracted. All of my seminar attendees have been told to stop multitasking, with my finger wagging in their face like a mom talking to a 2-yr old. Yeah, I do that. No apologies.
But what's going on in your brain when these memory lapses start to affect your daily life? In addition to the embarrassment of committing a social faux pas when you miss an appointment or forget someone's name, this could be a sign that something's amiss upstairs and warrants investigation by your doctor.
Determining the cause of memory loss isn't always easy because there are many possible reasons for a relatively sudden change in the ability to hold on to names, facts, words, etc. The usual suspects are dementia and Alzheimer's Disease (AD), but many other things can factor into the situation, so before you start thinking about dementia and AD, consult with your doctor about the other treatable possibilities. Let's take a look at the some of the common culprits that can be easily addressed (mostly):
Vitamin B12 Deficiency
This is one of the key vitamins for brain function. In addition to the general support of cells in the central nervous system (brain and spinal cord), it's important for DNA repair and red blood cell formation, both of which are essential for energy production. Because humans don't produce B12 like we do with Vitamin D, we must get it from the foods we eat or via supplements. B12 deficiency tends to be more prevalent in the older population when it can become harder for the body to absorb, and because of the symptoms of B12 deficiency at that stage of life it can be easily mistaken for the onset of dementia. The list of symptoms includes forgetfulness, confusion and general cognitive impairment, but most commonly, people experience mental and physical fatigue. Check out these great reviews on the effects of B12 deficiency:
The good news is that these dementia-mimicking symptoms are easily and quickly treatable. If your doctor has confirmed low levels of B12, an initial bolus injection followed by a regular dietary supplement should have you feeling supercharged and back to normal within a day or two!
Chronic Stress and/or Anxiety
Stress is a significant contributing factor to memory impairment, and I don't mean the kind of stress you feel as you're driving in gridlock traffic – I’m talking about the kind of ongoing stress that affects your daily life. Think demanding boss, work overload, three kids in 20 different sports activities...you get the idea. The list of stuff that causes stress in our lives is too long to add here but it's important to be aware of how it can affect your memory. Daily chronic stress encountered by being overworked most definitely has an impact on memory retrieval as our brains simply weren't built to do too many things at once. Add general anxiety into the equation and you're now trying to manage and cope with unnerving thoughts at the same time. When your brain starts to prioritize these anxious thoughts (as it will) it becomes incredibly distracting and difficult to focus. The anxiety then builds as you realize you're forgetting other important things. In severe cases, this can lead to confusion, difficulty concentrating and brain fog.
So, why does your memory falter in these situations? Well, when stress becomes chronic it results in the elevation of a hormone called cortisol, which binds to a region in the brain called the hippocampus. In addition to its role in memory formation and long-term storage, the hippocampus is also involved in modulating stress responses, and high levels of cortisol are actually harmful and can interfere with the formation of new memories. Additionally, dividing your attention makes it impossible to focus on an immediate task, especially if anxiety pushes you into fight or flight mode. This response results in the release of additional hormones including adrenaline, catecholamines - and more cortisol. Your body will attempt to normalize and recover from this response, but if it occurs repeatedly (such as during chronic stress), you'll eventually become exhausted. Literally, being stressed and anxious is exhausting to both your brain and body.
You may not be able to quit your stressful job (maybe give it some thought), but exploring some strategies for reducing stress and/or anxiety in your life could be one way to take the pressure off your hippocampus so it can do its job. Consider taking a course on mindfulness or incorporating yoga into your daily routine, and be sure to take a restorative vacation at least once a year. This will help re-set the cortisol levels and get your memory back on track.
And please remember to be kind to yourself. Accepting rather than judging your negative experiences and thoughts is vitally important to your wellbeing. Acceptance will help lessen the negative emotions that result from stress and anxiety. You don't have to be perfect, just be yourself. For further reading on acceptance, visit:
Sleep Deprivation
It's no secret that stress can lead to sleep deprivation, so be sure you've crossed that off your list before considering other causes for memory loss. Additionally, if you're a woman approaching menopause, you might be experiencing disrupted sleep due to night sweats. Hormone replacement therapy, including Bioidenticals, has come a long way and is worth investigating.
It's generally accepted that sleep is important for many biological reasons, including memory consolidation, which is initiated by – yep – your hippocampus again. It's a busy little bunch of neurons. Research suggests that sleep not only allows your brain to rest, reorganize itself and regulate your immune system but to also convert short-term memories into long-term memories. Without sufficient sleep on a regular basis, your brain has trouble storing memories properly, which makes memory retrieval more difficult. 1
Chronic sleep deprivation is also widely known to be associated with a decline in several cognitive functions, particularly attention. A lack of focus makes it difficult to form memories and thereby further contributes to forgetfulness.
Looking more deeply into cellular functions within the brain, it's been a long-held belief that your brain has a drainage system (the glymphatic system) that functions predominantly during sleep. This works like a garbage disposal by removing toxins and cellular metabolic products from your brain. It's thought that without this, your brain would accumulate the proteins that are known to be present in people with Alzheimer's disease and certain other forms of dementia. However, although sleep deprivation is associated with AD and dementia, new research (as of April 2024) on mice is challenging previous evidence that waste removal happens during sleep by demonstrating that the process occurs more predominantly during wakefulness. 2
(I will certainly be keeping an eye on the literature for updates on this.)
Regardless of what your neurons are doing at night, we're certainly all aware of the physical effects of sleeplessness, especially if you've had to drive without enough sleep. Studies show that reaction times of drivers are considerably slower when sleep deprived, and are comparable to driving under the influence of alcohol. 3
It's clear then, that sleep is vital to many biological functions and without enough of it, you're definitely not 'yourself'. With this, I encourage you to get your beauty sleep, not simply for general health but for your beautiful brain as well.
Prescribed Medications
There are several medications that can interfere with memory, but I haven't listed them here because if you're currently taking any of them, I don't want you to stop because you think it might improve your memory. Stopping prescribed medications suddenly can be extremely dangerous, so if you have any concerns that your medication might be causing issues with your memory, please consult with your physician.
Now let's explore other (more serious) causes of memory loss:
Dementia is an umbrella term for describing several different reasons for cognitive impairment or dysfunction.
The Mayo Clinic describes Mild Cognitive Impairment (MCI) as "the stage between expected decline in memory and thinking that happens with age and the more serious decline of dementia". This is when you really start to notice that you're having more trouble remembering things like social appointments or you're finding it difficult to follow the train of a conversation or the plot of a movie you're watching. It's usually significant enough that your friends and family start to notice as well. MCI may or may not lead to more serious dementia, depending on the cause. Studies suggest that only 10 to 15% of people with MCI will develop dementia.
As your brain changes with age, certain cellular functions begin to decline and this is usually a slow, gradual process and is typically something that most people deal with easily. However, a more sudden change or unusual behavior are warning signs that something more serious is going on.
There are several types of dementia and more than one can exist in the same person at the same time (mixed dementia). The primary (but not sole) reason for common forms of dementia is the accumulation of certain proteins within and/or around the brain cells. These clusters act like cerebral traffic jams in neural pathways such that the information being sent along these pathways is no longer able to get to its destination and the memory recall or thought process cannot be completed. These clusters of proteins can form in most any region of the brain, but when they accumulate in the hippocampus and temporal lobes, where memories are processed and controlled, the ability to recall words and objects or to learn new things is naturally affected.
Here are three of the most common types of dementia that can involve memory loss:
Alzheimer's Disease is the most common form of dementia and you've probably heard about the hallmark 'plaques and tangles' that are associated with the disease. These, in short, are the accumulation of amyloid-beta and tau proteins in the brain. When the size of these cerebral traffic jams becomes analogous to the size of 5-car pile-up on a highway, not only does communication between cells and even between brain regions get blocked, it also prevents the small blood vessels from delivering all-important nutrients to the affected area. The unfortunate result is that cells begin to die and brain areas begin to shrink.
Lewy Body Dementia is caused by an accumulation of proteins referred to as Lewy Bodies (named after Dr Freidrich Heinrich Lewy). These proteins accumulate within individual brain cells. Although progressive loss of memory, language and reasoning are common symptoms, Lewy body dementia can share similarities with Parkinson's Disease, depending on where the Lewy bodies have formed in the brain. When formed in the frontal cortex, the area responsible for thinking and reasoning, the patient is typically diagnosed with Lewy body dementia. However, when the protein deposits accumulate in an area of the brain responsible for movement, it's referred to as Parkinson's Disease dementia.
Vascular Dementia generally refers to damage of the small blood vessels in the brain, disrupting blood flow to small regions of brain tissue and thereby preventing the affected brain cells from functioning properly. Blood delivers vital nutrients to brain cells, including oxygen and glucose. When deprived of these nutrients, cells die. In small numbers the affected brain regions are insignificant to overall brain function, but as the affected regions begin to accumulate in number and size, cognitive function is impacted because more and more neurons are deprived of the oxygen and nutrients they need to perform their daily tasks. Vascular dementia can develop as the result of a stroke, but not always. There are a range of conditions that disrupt blood flow to and within the brain.
For further reading on all forms of dementia, visit The Alzheimer Society of Canada
Finally - The Good News
Age-related memory loss and mild cognitive impairment can be slowed by building up a 'cognitive reserve' as early as possible and by reducing the many known risk factors for dementia. Building a cognitive reserve involves keeping your brain sharp by continually learning new things and remaining socially active. So why not start now?
To help stave off the onset of dementia, avoiding the common risk factors is something that you can start doing immediately. The following is a list of behaviors and factors known to be associated with dementia:
· Untreated hearing loss
· Untreated cardiovascular disease
· Smoking
· Excessive alcohol consumption
· Social isolation
· Chronic stress
· Head injuries
Here are some tips to help improve your memory and/or delay memory loss:
· Think before you Google. Try your best to remember something before just letting your fingers do the thinking.
· Make handwritten notes versus typing, when possible. It recruits more regions of the brain thereby linking areas for a stronger association.
· Increase your vocabulary by challenging yourself to learn a new word every day. There are a ton of vocabulary apps out there. You know the saying … Use it or lose it!
· Keep doing those brain games – but not the same one every day. Mix it up so that you're continually challenging yourself.
I'd like to leave you with this encouragement: You have the ability to change your own brain. So go be your best self. Right now.
If you want to learn more about memory, you can sign up for my seminar called
"Five Steps to a Better Memory". It's gonna be awesome!
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