Is it dementia or something else?

You’ve been forgetting things lately — your keys, or maybe names. Sometimes you struggle to find the right word in conversations or repeat yourself to others. You may worry: are these signs of dementia?

If this sounds like you, you’re not alone. Many people find their way into Dr. Tammy Hshieh’s office wondering the same thing. But most of the time, it’s not dementia causing their problems, says Dr. Hshieh, a geriatrician at Harvard-affiliated Brigham and Women’s Hospital and Dana-Farber Cancer Institute and assistant professor of medicine at Harvard Medical School.

“While the number of people with dementia is increasing, simply because more people are living longer, I still see other reasons for memory problems, which is good news,” she says. “I love being able to tell someone it’s not something neurodegenerative that is going to get worse, but rather that it is something we can manage and do something about.”

Common reasons for memory problems

There are many possible reasons for a faltering memory, from mood disorders to the medications you take. Hshieh says that most often the underlying culprit is one of the following:

Depression, stress, or anxiety. When you are anxious, stressed, or depressed, it affects how your brain stores memories. First of all, you may be distracted, and thus less likely to recall information because you weren’t paying attention when you learned it. “People may have delayed recall problems, because their brains are not in the mood to process things or to take in new information,” says Dr. Hshieh.

In some instances, your brain may be less effective at storing memories when you are under extreme stress because the amygdala, the part of your brain that governs your survival instincts, may take center stage and divert energy from the part of the brain that handles higher-order tasks. This is why some people experience complete memory lapses surrounding a traumatic event.

Many of these mood-related issues have been worsened by the COVID-19 pandemic, says Dr. Hshieh.

“Initially we were telling older patients, ‘this is a sprint, you just need to get through this,’ but COVID-19 has become a marathon,” says Dr. Hshieh. “The social connections that people used to have are gone.” People may be exercising less and doing fewer things that are good for the brain, like getting out and engaging in activities. “On top of that, we’re seeing a lot of depression and anxiety and a lot of memory issues because of it,” she says.

Medication. A number of drugs can cause memory problems. One of the most common instigators of memory trouble is diphenhydramine, an antihistamine found in Benadryl and other common over-the-counter products such as Tylenol PM and Advil PM. Diphenhydramine acts on certain neurotransmitters in the brain directly related to memory, says Dr. Hshieh. “If you have arthritis and take a couple of Tylenol PMs at night, it may affect your cognition during the day.”

Another group of problematic medications are in a category called benzodiazepines. These include drugs such as lorazepam (Ativan), diazepam (Valium), and alprazolam (Xanax), which are commonly used to treat anxiety, insomnia, and seizure disorders.

“A woman may start taking these medications for anxiety or sleep problems in her 40s and 50s and is still on them as she gets older,” says Dr. Hshieh. “Many studies have shown that these medications do a number on the memory.” And memory problems that may not have been present when people initially started taking benzodiazepines may show up over time.

“Some people may just have one Xanax a day, but as they age their body processes these things differently,” she says. Metabolic changes that occur with age, including those that affect the liver and kidneys, make the drugs more potent by allowing them to linger in the body longer.

These aren’t the only problematic drugs. There are numerous others that may have a similar effect on your memory. So, if you are noticing changes, talk to your doctor about the medications you are taking.

Alcohol. Just as medication can affect your cognitive function, so can drinking alcohol, and it too may become increasingly problematic as you get older. As women age they may lose body weight, and that, in addition to natural metabolic changes, can exaggerate the effects of alcohol. Even one drink a day may be enough to cause memory problems, and lapses may become even more pronounced with increased use.

Insomnia. Poor sleep and memory problems are often linked. When you’re tired, not only are you less attentive, but your brain may be sluggish and less able to retrieve information quickly. In addition, sleep plays an important role in memory storage, according to the National Sleep Foundation. Experts think that memories are sorted and filed away when you sleep; insufficient or poor quality sleep impairs this process.

Medical problems. Less commonly, memory loss may be caused by underlying medical conditions, such as brain injuries, stroke, vitamin deficiencies, and thyroid problems. So, it’s also important to consider these causes with your doctor, says Dr. Hshieh.

Seeking treatmentMost memory problems unrelated to dementia are pretty treatable. Depression-related memory problems, for example, typically improve once you start taking an antidepressant, says Dr. Hshieh. Medication-related problems may also resolve fairly quickly once the triggering drug is stopped. “The hope is that the memory problems are temporary, and once you stop taking the medication you will see some improvement,” says Dr. Hshieh.However, while you can take some time to gather information if you’re noticing small memory problems, certain cognitive changes do require immediate attention. These include changes that come on suddenly or are accompanied by hallucinations, paranoia, or delusions, says Dr. Hshieh.”You should also see your doctor immediately if you are experiencing memory problems that are putting your safety at risk, such as leaving items on the stove, or ones that make you feel unsafe driving,” she says.But while memory lapses may seem scary, in many instances they have a benign and treatable cause.

What to do if you are experiencing problems

If you notice memory problems, don’t automatically assume the worst. Instead, start collecting information about the lapses you’re having, and ask others around you if they’ve noticed changes. The people who are close to you are often the first to see differences in your behavior or to notice patterns, says Dr. Hshieh.

Then take your concerns to your doctor. Be certain to bring a complete medication list and mention any other symptoms you may be experiencing. For example:

  • Have you had a harder time going to sleep or staying asleep at night?
  • Are you experiencing bladder accidents?
  • Have you had any falls lately?

“All of these things help your doctor fill in the picture of what may be going on,” says Dr. Hshieh.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

 “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” – Philippians 4:8

 “Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.” – Mark 11:24

 “Anxiety weighs down the heart, but a kind word cheers it up.” – Proverbs 12:25

 “Who of you by worrying can add a single hour to your life?” – Luke 12:25

 “For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.” – Jeremiah 29:11

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

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