Ending Embarrassment: Forgetfulness

Key Takeaways:

• When a lapse in memory is followed by recall, that’s part of the normal aging process.
• When lapses start impacting once automatic routines, that’s when a conversation with a doctor should take place.

Where you left your car keys, your glasses, or the remote for the TV. Where you parked your car in a parking lot. Someone’s name. One of the eight billion passwords you need to log into various accounts. 

Regardless of age, these are all things we have the tendency to forget from time to time. And it’s normal to forget things more frequently as we age.

One of the questions I hear most often from patients and their families is some version of: “Is this normal aging, or is it something more?”

It’s a fair question and an important one. Here’s how we think about it.

Everyone forgets things. That’s not the problem.

Every one of us has memory lapses: forgetting what time it is, losing track of the date, blanking on an acquaintance’s name. On its own, that’s not a red flag.

The key feature with normal cognitive aging is that the information comes back. You forget a name, and a few minutes or a couple of hours later, it surfaces again. You forget an appointment, but once reminded, you’re oriented right away. 

That pattern — lapse, then recall — is what we typically see with normal aging.

What Alzheimer’s looks like instead

With Alzheimer’s disease, those lapses behave differently. They’re more persistent. You don’t reorient to the day or the time on your own. You forget the names of people close to you, and that memory doesn’t resurface later.

It also starts showing up in tasks that used to be automatic: struggling with a recipe you’ve made for years, getting lost in a part of town you know well, or having trouble putting together a simple grocery list.

The distinction we’re looking for isn’t whether someone forgets; it’s whether the information comes back and whether it’s starting to interfere with everyday tasks. 

Those are the nuances that help us tell normal aging apart from Alzheimer’s disease.

When to bring it up

If you’re noticing memory changes in yourself or a loved one, don’t wait for the “official” moment to raise it. Start with a conversation with your family doctor. 

They can help sort out whether what you’re seeing is consistent with normal aging or if it warrants a referral for a closer look. 

If it’s the latter, we’re here to help you figure out what’s next.

What happens at your first visit to the Memory Health Clinic

If you or your family doctor decides it’s worth exploring further, here’s what an initial evaluation at our Memory Health Clinic typically involves:

We use a multidisciplinary approach, meaning several specialists evaluate you on the same day rather than sending you back and forth between appointments. 

Your care team usually includes a physician — a neurologist, geriatrician, or geriatric psychiatrist — along with a neuropsychologist, a PhD-trained specialist in cognitive assessment.

The visit generally breaks down into two parts:

• The first hour is spent with the physician and neuropsychologist together, gathering your history and doing an initial exam.
• The second hour is dedicated to cognitive testing, which gives us a detailed picture of how different aspects of your thinking — memory, language, attention, and problem-solving — are functioning.

We also typically order brain imaging, ideally an MRI, since it offers the best resolution for spotting changes associated with Alzheimer’s, other forms of dementia, and contributing factors like strokes or vascular disease.

Why we review every case as a team

What sets our program apart, beyond the multidisciplinary visit itself, is what happens after: we meet weekly as a full team to go through every patient together. 

That means input from radiologists and every specialist involved before we finalize a treatment plan.

We then bring you back for a feedback appointment to walk through everything as a group.

Not every moment of forgetfulness is a sign of something bad

As I mentioned previously, not every bout of forgetfulness is a symptom of Alzheimer’s disease or dementia. 

Those things happen to all of us, and they’re part of being human.

But if those things that once were automatic stop coming back, please talk to your doctor. The earlier we can intervene, the better the chance we have of slowing disease progression.