What’s the Difference Between Forgetfulness, Age-Related Memory Loss, and Dementia?

February 14, 2023

Forgetting your car keys. Forgetting why you walked into a room. Not being able to remember the name of somebody you’ve known for 20 years.

Sound familiar? I get calls from patients after these incidents all the time. “Why is my memory getting worse?” they ask. Often, they think they have dementia.

They’re right to be concerned. Dementia is a horrible disease that robs people of their quality of life, turning them into a shell of who they once were. Everybody wants to avoid it. And because there really aren’t any good treatments for it, it causes a lot of worry.

So, could you have dementia, or is it something else? What’s the difference between forgetfulness and dementia?

The Difference Between Forgetfulness, Memory Loss, and Dementia

We can classify memory problems into three broad categories: forgetfulness, memory loss, and dementia.

General forgetfulness is very normal. It can be influenced by stress, by how well you slept the night before, even by how much caffeine you consumed that day. It varies over time and depending on circumstances.

Age-related memory loss is an expected, slow, gradual decline over the years.

Dementia is something else entirely. Dementia affects your life to a much greater degree, and it’s harder to spot on your own. Really, the big difference between forgetfulness and dementia is that dementia is a pathologic problem.

Everybody loses about 10% of their memory as they age. That’s a normal part of getting older, and we call that age-related memory loss.

For people who start out with really fantastic memories, that 10% loss might not be so obvious. For other people who start with a poor memory as a baseline, it’s much more noticeable when they lose that 10%. Nobody begins at the same point, which is why our approach in evaluating memory loss has to be individualized.

Dementia is difficult to notice in yourself. So, if you notice memory lapses in yourself, it’s most often just normal age-related memory loss. As a physician, I’m more worried when a family member tells me a patient’s memory is suffering while the patient claims they’re fine.

Normal memory loss also doesn’t hinder your lifestyle or career. If you’re still able to hold down a job and maintain relationships in your personal life despite being forgetful, that falls under the category of normal memory loss.

It’s forgetting the big things — like showing up for work or for events in your personal life — that marks the difference between forgetfulness and dementia.

Infographic: What’s the Difference Between Forgetfulness, Age-Related Memory Loss, and Dementia?

Dementia

Dementia isn’t a normal result of aging. It’s a progressive, nonstop, pathologic disease process. With dementia, there are actual physiological changes going on in the brain that inhibit a person’s ability to form new memories.

If a person suspects their parent or older relative has dementia and mentions it to them or to a doctor, the patient often responds with, “I can remember things from 60 years ago in perfect detail! I don’t have dementia.” But that’s not what dementia is. Dementia is the pathologic inability to make new memories, so the person’s short-term memory is what we’re watching.

A telling sign of dementia would be getting lost in familiar territory — maybe while driving home from work or from a friend’s house. Or, maybe a person forgets they started cooking dinner on the stove and starts a small fire in their home.

While we know certain signs to look for to identify it, we don’t truly understand dementia. There’s an enormous amount of dementia research going on right now, trying to shed light on this disease. Though we don’t yet know how or why it develops, we do know that dementia causes physiologic changes in the brain. And we also know that you can take certain steps to lower your risk of dementia, like exercising.

What to Do if You’re Concerned

If you’ve asked yourself the question, Why is my memory getting worse?, then you probably also want to know how to tell the difference between forgetfulness and dementia.

Fortunately, there are easy steps you can take if you’re concerned.

Track Your Memory Over Time

Several apps and websites now allow you to track your memory over time. My favorite is Lumosity, where you can take quizzes that assign you scores to gauge how your memory is doing. It also offers helpful tips you can use to improve your memory, because your memory is like a muscle that you can work on and even strengthen.

Exercise Your Memory

If you’re worried about memory loss, another step you can take during the day is to exercise something called your executive function.

Executive function is what separates us from apes. It’s your brain’s ability to process things, like planning, multitasking, and doing mental math. Normal, everyday tasks can give your executive function a workout. Any task that involves not just recall but synthesizing information can help:

  • Balancing your checkbook
  • Working out a tip amount in your head
  • Mentally mapping your driving routes instead of relying on GPS
  • Solving crossword puzzles or sudokus

All of these and more give your executive function that beneficial exercise.

If you’re concerned about memory loss, holding onto your executive function through simple but intentional practice is one of the best things you can do.

Talk to Your Doctor

If you have any kind of ongoing health worry, you should always talk with your physician. This goes for memory loss and dementia, too.

Your doctor may do a mini mental status exam, which tests your brain’s executive function. It’s a simple test that asks you to perform a task that involves your executive function, like drawing out a clock face showing a specific time.

Drawing an analog clock works well because there’s so much going on in the request. You have to know the difference between the minute and hour (and perhaps second) hands, and where they’re located relative to each other. Then, you have to use your motor skills to physically draw out the clock yourself.

The task uses many different parts of your brain, and your executive function has to synthesize all that data. If you can do all that, your chances of having dementia are very low.

Besides the mini mental status test, your doctor will need other information about how your memory has been working. I recommend bringing a trusted friend or family member who knows you well to your appointment. They can offer the additional input that only a third party can provide.

Ask Someone Close to You

If you’re worried you can’t tell the difference between forgetfulness and dementia on your own, talk to the people you see every day. Have they noticed any ongoing issues with your memory? They’ll have an outside perspective separated from personal anxiety. If they aren’t concerned, you usually don’t need to be either.

Forgetfulness, Memory Loss, and Dementia: Final Thoughts

One of the top benefits I’ve appreciated of practicing membership-based medicine is the opportunity to get to know my patients. That way, when someone comes to me with a concern about their memory, I already have a baseline of knowledge to start from and can evaluate them in an individualized way.

If you’re concerned about your memory, don’t hesitate to speak with your doctor. They’ll be able to talk to you about the difference between forgetfulness and dementia, and help identify what you’re dealing with. That’s why we’re here!

Dr. Jonathon Schmidt

Dr. Schmidt is a board-certified family medicine physician with undergraduate degrees in Microbiology and medicine from Southern Illinois University and the University of Illinois. He completed his residency at St. Joseph Regional Medical Center in South Bend, IN and has a passion for putting his patients first in his practice. In his free time, Dr. Schmidt enjoys spending time with his family and participating in outdoor activities such as water sports and woodworking.

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