My aged parents keep forgetting things. Should I worry?

Our body undergoes several changes as we age, and our brain is no different. Given this fact, some amount of cognitive difficulty and forgetfulness often arises as a person ages. However, there’s a difference between normal age-related memory loss and memory loss associated with Alzheimer’s disease and other types of dementia.

Memory loss due to the process of aging doesn’t prevent an individual from living a full and productive life. For example, an elderly person may forget where they put their glasses or keys  or may forget the name of a person they haven’t seen in a while. Often such changes in memory don’t disrupt daily functioning which includes their ability to work, live independently or maintain a social life.

When memory loss is a sign of dementia 

Not all memory problems are a part of aging. Usually when an individual shows signs of dementia, other cognitive functions apart from memory are affected - learning, orientation, language, comprehension, planning, problem-solving and judgement. You may want to seek help if your parent is:

• frequently and increasingly forgetting things such as names, things and events

• having difficulty recalling recent events and incidents eg., forgetting what they had for breakfast that day.

• not able to recall familiar names or events completely. Eg.,. forgetting the name of a grandchild or remembering going to a relative's house but can't remember which relative they visited

• unable to recall names/places/events even after being provided with cues 

• forgetting common words when speaking or greeting

• showing sudden changes in behavior and mood or exhibits increasing anxiety

• having difficulty in performing their daily activities due to forgetting 

• misplacing items in inappropriate places, such as putting a wallet in a kitchen drawer or fridge

• having difficulty finding the way or gets lost while walking or driving in a familiar place

• becoming less able to navigate a place or follow directions

• having difficulty making decisions  

The existence of two or more of these signs could be an indication of a memory loss due to dementia. 

What to do if the signs indicate dementia

Dementia is a progressive and degenerative brain disease affecting cognition especially memory. Early detection and prevention are effective in reducing the risk and delaying the onset of dementia by a few years. If you notice that the signs of forgetfulness in your aged parents indicate dementia, then consult a psychiatrist or neurologist to evaluate the situation.

Forgetfulness can also be caused due to diabetes, hypertension, cholesterol, depression, anxiety, vitamin B deficiency and hypothyroidism.  Research evidence shows that these conditions can also potentially increase the risk for dementia. 

The risk for severe memory loss can either be prevented or reduced by:

• Keeping a check on potential risk factors such as diabetes, hypertension, cholesterol, hypothyroidism and deficiency of vitamin B.

• Modifying the lifestyle including reducing stress and avoiding smoking and/or reducing the intake of alcohol.

• Engaging in activities that can preserve or even improve brain functioning and cognition. For eg. solving word or number puzzles, playing board games like chess, enhancing a hobby etc.

• Increasing physical activity helps in increasing blood circulation to and from the brain. It also helps in keeping diabetes, hypertension and cholesterol under control

• Maintaining a healthy diet that includes fruits, vegetables and a diet rich in Vitamin B

Based on the inputs from Dr P T Sivakumar, professor, geriatric psychiatric unit, NIMHANS