Normal forgetfulness or dementia?

Understand the important differences between everyday memory loss and serious cognitive decline. 

“Watching my father slowly lose his mind was both heartbreaking and worrying,” says Gale, 57. “It started with him leaving home at night, thinking he needed to get to the airport for a work trip, even though he’d been retired for years. It ended with him having no idea who or where he was.”

“Thankfully, we had a carer to help, but it was agonising to know he was no longer able to bathe, feed, or dress himself. Every now and then, he’d have a flash of recognition and would grab my hand. But then it would pass, and he would get agitated and sometimes lash out at me.”

Having watched her father’s deterioration, Gale is now concerned that she might have early-onset dementia. “Every time I forget a word or don’t remember about an appointment, I’m convinced I too will no longer remember my adult son in a few years’ time. The idea keeps me awake at night.”

Knowing the difference

Everyone experiences moments of forgetfulness – whether it’s misplacing keys, forgetting someone’s name, or walking into a room and wondering why we’re there. Like Gale, these lapses might make you think: “Is this normal forgetfulness, or could it be a sign of dementia?” Understanding the distinction between these two conditions can give you peace of mind or encourage you to seek a medical opinion.

“Dementia is an umbrella term used to describe a range of neurological conditions that progress over time,” says Dr Katie Hamilton, a neuropsychologist at Mediclinic Morningside. “People with dementia slowly lose the ability to remember, rationalise, and even communicate to the point that it affects their daily life and activities.”

Alzheimer’s disease is the most common form of dementia, but there are many other types, including vascular dementia, which can happen after a stroke or long-term heart disease, and frontotemporal (FTD) disorders.

Normal age-related forgetfulness

As we age, our brains naturally undergo changes that can affect memory. “Normal forgetfulness might mean you slip up with appointments occasionally or struggle to recall a particular word or name that’s on the tip of your tongue,” says Dr Hamilton.

Generally, that information comes back to you once you’ve moved on to another task or topic. You also might forget specific details. For example, after reading a book, you might not recall details of the plot or characters. “Although these lapses in memory can be frustrating, they don’t impact how you work or look after yourself,” Dr Hamilton says.

Understanding dementia

Dementia, by contrast, is not a normal part of ageing. “People with dementia might find it hard to dress themselves, forget to maintain proper hygiene, and experience extreme mood swings,” says Dr Hamilton. “They might also show strange behaviour, such as oral obsessions and hoarding, getting lost in familiar places, or becoming suspicious of people they previously trusted.”

It’s also common for them to struggle with simple routines, such as following a recipe, paying their bills, or finding their way to familiar places. Not being able to name or identify everyday objects can also occur, often starting with difficulty with names, but can progress to using incorrect words. “Big shifts in personality, increased anxiety, depression, paranoia, or inappropriate behaviours are further signs of cognitive decline,” Dr Hamilton adds.

When to seek medical help

Normal forgetfulness is annoying but doesn’t prevent you from living independently. If you – or a loved one – have memory issues that interfere with work, socialising, and personal hygiene, you should talk to your doctor.

“Everyone occasionally makes mistakes, but people with dementia show a pattern of making poor decisions,” says Dr Hamilton. “Human error is on a spectrum, and when your occasional lapses start to interfere with your daily functioning or quality of life, it’s time to explore what could be behind them.”

Your GP can refer you to a neuropsychologist, neurologist, or geriatric specialist who will take a detailed history and conduct psychiatric evaluations and neurological exams.  They might recommend a CT or MRI scan to check that your symptoms aren’t due to a brain condition other than dementia, or to help differentiate the various types of dementia.

The only way to treat dementia is to manage the condition through ongoing medical care. If you’re diagnosed early, your doctor could prescribe medication that may improve your quality of life, giving you and your family more time to plan for the future.

Once diagnosed, treatment should focus on slowing down the disease. Your doctors will likely use medicines to help manage symptoms, therapy sessions, physical exercises guided by a physiotherapist, and help from neuropsychologists. All these treatments work together to help keep your cognitive abilities, physical movement, and wellbeing as healthy as possible for longer.

Social workers can also help by advising you on ways to protect yourself, helping your family understand how to support you, and finding ways to improve your quality of life.

If you are concerned about your – or a family member’s – brain health, find a doctor at www.mediclinic.co.za who can help.