Trouble reading? Try these workarounds

Once you learn how to read, it's easy to take the skill for granted. Like breathing or walking, we don't give the ability much thought unless it begins to deteriorate. But trouble reading can develop at any age for a variety of reasons, including difficulty concentrating, mild cognitive impairment, and physical changes.

Mental roadblocks can cause trouble reading

Fuzzy thinking and difficulty concentrating can get in the way of reading. "If your attention isn't focused on the sentence you're reading, you're not likely to register enough of the sentence to understand what your eyes just passed over," notes Dr. Joel Salinas, a neurologist at Harvard-affiliated Massachusetts General Hospital.

You might experience fuzzy thinking or difficulty concentrating because of

• a lack of sleep
• stress
• nutrient deficiency
• a medication that makes it harder to concentrate
• reading or learning disabilities.

Sometimes age-related cognitive changes affect reading skills. Reading requires attention, short-term memory, and recall, which decline a little as we get older. "It's normal when you're older that your reading might be slower or that you have to occasionally read a sentence more than once to get its meaning. Your ability to read and retain information may take more effort," Dr. Salinas explains.

Mild cognitive impairment can cause trouble reading

Mild cognitive impairment (MCI) may also be behind a decline in reading skills. MCI can make it harder to understand or retain what you're reading.

MCI is a noticeable change in thinking and memory skills, but not enough that it becomes a huge barrier to your ability to take care of yourself and accomplish your daily tasks. You may miss some appointments, lose things often, have more difficulty recalling names or words you'd like to use, or have a harder time finding familiar places and keeping track of important dates.

Physical challenges can cause trouble reading

Physical changes, such as accidents or chronic disease, can also affect your ability to read. Examples include:

• Poor vision. Maybe you have double vision, or you can't see up close, or maybe it's hard to read in a room that isn't well lighted.
• Arthritis. "Osteoarthritis at the base of the thumb, wrist, or fingers is common with age and can affect your ability to hold a book," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
• Neuropathy (pain or numbness in the extremities). This may result from diabetes or back pain, and can make it uncomfortable to hold reading material for extended periods.
• Traumatic brain injury. A concussion that you suffer from a sports injury, fall, or car accident might create difficulties concentrating or seeing (such as blurry vision).
• Shaky hands from essential tremor, multiple sclerosis, or other conditions may keep you from holding a book still enough to read the words.

When to seek help

Talk to your doctor when you notice trouble reading. Start with your primary care doctor, who can perform a mini evaluation or send you to a neuropsychologist for a thorough evaluation. "Neuropsychologists can test for how fast you read, how much you understand, and what you recall from what you read," Dr. Salinas says.

When physical changes are the problem, treating the underlying condition can help you read better. For instance, maybe you just need a new pair of glasses.

Try these workarounds

Sometimes using a few simple strategies can make reading easier. If you have pain or tremors, Dr. Shmerling recommends propping up a book on a pillow or book holder. If you find it's hard to flip pages, try an electronic reading device like an iPad or Kindle. With an electronic device, the page stays steady, and it's just a tap to turn the page. For vision challenges, electronic reading devices and large-print books can help greatly.

When attention is the challenge, Dr. Salinas suggests reading in a quiet space, reading out loud, mouthing the words as you read, listening to the audiobook recording while you read, or using a sheet of paper to reveal one line of text at a time so you don't skip ahead.

The important thing is to try. "There are solutions that work for most obstacles to reading," says Dr. Shmerling, "and for most people, it's a great way to keep up with what's happening in the world and to keep the mind working."