Key Takeaways
- Experts say cognitive decline can be challenging to distinguish from normal aging, but can be assessed by physicians using specific tests.
- Certain symptoms, such as short-term memory loss and difficulty completing familiar tasks, warrant consulting a doctor.
- Early detection and diagnosis of Alzheimer’s and dementia are crucial for accessing FDA-approved treatments.
Ever since President Joe Biden’s June debate with Donald Trump, many Americans have wondered if his halting gait, slow responses, and difficulty staying on topic might indicate cognitive decline.
Experts say it can be hard to distinguish cognitive decline from normal slowing due to aging. However, neurologists and psychologists can help determine this through in-person assessments based on questions and lab tests.
“It may be nothing at all, it may be a treatable condition such as an infection, or it could be early signs of dementia or Alzheimer’s disease,” Jason Krellman, PhD, a neuropsychologist at Columbia University Irving Medical Center in New York, told Verywell.
A condition like urinary tract infection (UTI) or ministroke can also lead to memory impairment or confusion in older adults, but proper treatment can often resolve these cognitive issues.
Krellman said it’s important to speak to your doctor if you’re worried about cognitive function in yourself or a loved one. A healthcare provider can conduct a cognitive assessment.
What Are the Signs of Cognitive Impairment?
Memory loss that disrupts daily life could be a symptom of dementia or Alzheimer’s disease, saidMaria C. Carrillo, PhD, Alzheimer’s Association chief science officer and medical affairs lead.
“Some memory changes can be a normal part of the aging process, but when changes start to interfere with daily living or stray drastically from the person’s normal behavior, it’s best to get it checked,” Carrillo told Verywell.
These are the 10 warning signs of Alzheimer’s disease or dementia that warrant a discussion with your doctor, according to the Alzheimer’s Association:
- Short-term memory loss: This can include forgetting recently learned information like important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids like notes.
- Challenges in planning or solving problems: This could manifest in an inability to follow a familiar recipe or difficulty keeping track of monthly bills.
- Difficulty completing regular daily tasks. Common issues include not remembering how to drive to a familiar location, inability to organize a grocery list, or forgetting the rules of a favorite game. Something that used to feel mundane, like recording a TV show, might be confusing.
- Confusion about time and place. People living with Alzheimer’s or dementia can lose track of dates, seasons, and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes, they may forget where they are or how they got there.
- Trouble understanding visual images and spatial relationships. Some people may experience vision changes, which can lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.
- New problems with words while speaking or writing. This can include having trouble following or joining a conversation, stopping in the middle of a conversation, and having no idea how to continue. There may also be struggles with vocabulary and trouble naming a familiar object or using the wrong words (e.g., calling a “watch” a “hand-clock”).
- Misplacing things and losing the ability to retrace steps. This involves putting things in unusual places or losing things without being able to retrace steps to find them again.
- Decreased or poor judgment. Individuals living with dementia may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.
- Withdrawal from work or social activities. A person living with Alzheimer’s or other dementia may experience changes in the ability to hold or follow a conversation. As a result, they may withdraw from hobbies, social activities, or other engagements.
- Changes in mood or personality. Symptoms can include becoming confused, suspicious, depressed, fearful, or anxious. Someone may also become irritable if a routine is disrupted.
“Now more than ever, early detection and diagnosis of Alzheimer’s and other dementia is critically important,” Carrillo said. “There are now FDA-approved treatments targeting the early stages of Alzheimer’s, and more are in development. Early and accurate diagnosis will help determine eligibility for current and future treatments.”
What Cognitive Testing Entails
When it comes to testing for cognitive decline, many people start by contacting their primary care physician about their memory or thinking concerns, and primary care doctors often oversee the diagnostic process themselves, Carrillo told Verywell.
Your doctor will evaluate your overall health and identify any conditions that could affect how well your brain is working. When talking to your primary care physician about cognitive problems, ask how familiar they are with diagnosing dementia and whether there are circumstances in which they would refer you to a specialist.
A specialist, such as a neurologist, can evaluate memory and thinking issues and diagnose dementia. Some people with unclear symptoms, including those under age 65, may require evaluation by two or more specialists who combine their findings to reach a diagnosis. These might include a psychiatrist, psychologist, or geriatrician.
Carillo said there is no single test that can determine if a person is living with Alzheimer’s or dementia. Physicians use physical assessments, diagnostic tools, and medical history to make an assessment. This can include:
- A physical examination and review of any current medications
- A depression screen and mood assessment
- A neurological exam. This involves testing reflexes, eye movement, speech, sensation, coordination, and muscle tone. It may or may not involve brain imaging.
- Cognitive, functional, and behavioral tests to evaluate memory and problem-solving abilities. These tests vary in length and difficulty. Specific test examples include Ascertain Dementia 8 (AD8), Functional Activities Questionnaire (FAQ), Mini-Cog, Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA) and Neuropsychiatric Inventory Questionnaire (NPI-Q)
- Blood tests and/or cerebrospinal fluid tests to look for abnormal clumps of amyloid and tau proteins, which may be early indicators of Alzheimer’s
What This Means For You
If you or a loved one are experiencing signs of cognitive impairment, such as memory loss or difficulty completing daily tasks, it’s important to consult a healthcare provider. Early assessment and diagnosis can lead to better management of symptoms and access to treatments.
