Investigating memory loss
Memory lapses could be signs of aging or something else.
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
It can be scary not knowing if sudden memory lapses or other cognitive changes are just a natural aspect of aging or an early sign of mild cognitive impairment (MCI). MCI falls between the cognitive decline associated with aging and the more serious signs of dementia. With MCI, some changes are noticeable but usually do not impede the ability to carry out daily functions.
"It's not unusual to be forgetful at times as you age, but if memory issues are more noticeable, it's always best to get checked out and undergo a cognitive test," says Sara Weisenbach, a neuropsychologist with Harvard-affiliated McLean Hospital. "There are ways to slow the progression of cognitive decline or treat issues that could be causing memory lapses, but the sooner you can identify a problem, the better the outcome."
See your doctor
Your first step is to see your primary care physician to discuss your symptoms, review your overall health and concerns, and assess any family history of dementia. An ideal time for this may be at an annual wellness visit. (Don't rely on results of online cognitive tests, as many are unreliable and may not offer an accurate evaluation, says Weisenbach.)
Before your visit, make a list of your specific cognitive concerns to share with your doctor. Also, bring a family member or friend to your appointment. Their support can help ease your nerves, and they can provide their own observations. An in-office cognitive screening test lasts from five to 15 minutes. The test might include
- repeating a list of words immediately and then again after a short delay
- recalling personal information like addresses or birthdays
- naming objects in a picture
- answering questions about recent events
- drawing a clock to assess spatial orientation.
"The results might indicate a potential problem, but they usually are not sufficient for a formal MCI diagnosis," says Weisenbach.
Senior moments or red flags?It can be difficult to gauge when memory issues need medical attention. But you probably should consult your doctor if you experience any of the following:
|
Additional testing
Based on your test results and your doctor's assessment, you may be advised to undergo further testing and evaluation. If the results hint at memory loss or another cognitive issue, or if your doctor needs more information, the next step might be blood tests, which can help to rule out reversible causes of cognitive impairment, such as low vitamin B12, iron deficiency, or an underactive thyroid.
The doctor may also recommend one or more brain imaging studies. An MRI scan can look for structural changes in the brain, like loss of volume and changes in blood flow. A PET scan can look for amyloid plaque buildup in the brain, one of the hallmark signs of Alzheimer's disease.
Your doctor also may recommend a neuropsychological evaluation with a specialist like a neurologist or neuro-psychologist. This sit-down visit can last a few hours and explores your cognitive issues in more detail, such as when they began and the circumstances around them. For example, are you having trouble finding the right words when speaking? Do you regularly misplace your keys and phone? Can you not recall a conversation from the previous day?
"All this information can help determine if the issues are a sudden phenomenon or have worsened over time," says Weisenbach. "A neuropsychologist can also help determine which cognitive skills are strong and which ones are more challenging." Other factors are also considered when evaluating the test results. For instance, lower-than-expected scores can be influenced by medication side effects or mental health issues like depression, anxiety, or grief.
Even if the neuropsychological examination does not suggest MCI, your doctor or neuropsychologist can help address any issues that may be related to your mental lapses. "This initial screening also provides a baseline for future reference in case other memory issues arise or your situation worsens over time," says Weisenbach. "If the results from the tests are inconclusive, you might be monitored for 12 to 18 months and then re-evaluated."
Image: © RUNSTUDIO/Getty Images
About the Author
Matthew Solan, Executive Editor, Harvard Men's Health Watch
About the Reviewer
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
