Forgetting: Is It Aging or Alzheimer's?

Medical director William Uffner explains what symptoms should cause concern.


Everyone forgets their keys occasionally, gets lost sometimes, or just can't quite remember the name of someone they were introduced to in the past. Young people usually shrug off these temporary bouts of memory loss. But older people may wonder if it could be the beginning of mild cognitive impairment or even Alzheimer's disease. U.S. News asked William Uffner, medical director of the Friends Hospital Older Adult Program in Philadelphia, how to tell when memory loss is a normal sign of aging or something more serious. Excerpts:

How do you know what's normal (like forgetting your keys) and when things are growing more serious?

The brain is unable to recognize when something is wrong with it. People generally are not aware when they have crossed over from a mild memory problem into dementia. More often, it is going to be a family member or an associate or someone else who makes the realization that a person isn't appropriately functioning and managing their affairs anymore. The individual themselves is likely to call the bank and say the bank made a mistake. That's a sign of true cognitive decline. What signs should family members be on the lookout for?

Most people over the age of 55 will tell you that their memory is not as good as it used to be. Everyone has had the experience of going up the stairs to their bedroom and thinking, "What did I come up here for?" As you age, you may begin to worry more about that. But this does not represent a problem. It's when a person has memory problems that are very severe [that] you need to worry, when they can't make use of information and turn that information into a useful course of actions. Also, when they start to show problems with their judgment and when they repeatedly make mistakes. It's OK to get lost, because young people get lost. It's not OK when you get lost and you can't assemble a plan to get back to where you should be. If you make a date on the phone to pick them up for lunch the next day, someone with normal memory problems is aware of their memory problem and will find a way to keep their schedule by taking notes. Someone with Alzheimer's disease will open the door and be angry and say, "What do you mean we spoke on the phone? You're crazy." They also display difficulty in utilizing a familiar object which they would have previously recognized and difficulty in using things. A person who can no longer figure out how to operate the microwave or set their alarm clock even though it's the same device they used to be able to manipulate appropriately is a sign of a real problem. If you are diagnosed with cognitive decline, will you be able to keep your job?

Most people who are beginning to experience these kinds of problems elect to retire, because work is difficult and stressful for them. And usually you are talking about people in their 70s. These are uncommon problems before the age of 70. Of those who haven't elected to retire, there is likely to be problem with their work productivity and they may be asked to leave. Hopefully employers are sensitive. If you have mild cognitive decline, you may be able to keep working. It depends on the nature of the work that you do. Most people with mild cognitive impairment may have trouble learning new tasks and retaining new information, but they don't overall show problems with their judgment, so they should be able to remain productive during that time. I recently saw someone who had really moderate Alzheimer's disease still going into the job that he had for 50 years where he was the supervisor. What can baby boomers do to try to prevent cognitive decline?

Make sure you have good nutrition, good rest, stay physically active, and engage in a lot of activities. Having a good social life, support groups, and your family nearby will help any individual to age more gracefully. The one thing that can be done if a person has early Alzheimer's is learning new tasks can help to preserve function. Really novel tasks like learning a new language or eating breakfast with your left hand instead of your right hand can stretch the brain's limitation, which can help to slow the decline down. But if you have always done the New York Times crossword puzzle, then that is not a novel or new activity for you—even if it is intellectual stimulation. What are some signs of normal aging that you don't need to worry about?

Slowness in learning new information. That's the chief change that, in and of itself, you don't need to worry about. You can read about how a diagnosis of Alzheimer's disease affected retirement plans for two seniors here and here.

Alzheimer's disease
senior health
brain health