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The Aging Brain: Signs of Normal Cognitive Aging vs. Concerning Decline

Our brains are just like any other organ and experience some decline in performance as over time. Even in the best case scenario, we all experience a degree of cognitive decline as we age. The goal is to avoid an accelerated decline that leads to dementia or Alzheimer’s Disease in our later years. Healthy lifestyles that include regular physical activity, good nutrition, and an active social life can help delay or even prevent dementia and Alzheimer’s (see my previous post on 10 ways you can improve your brain health).

confused woman holding her head

So how can you tell the difference between ‘normal’ cognitive decline and something that is reason for concern? In general, normal (healthy) aging means being able to maintain independence in daily activities such as:

  • operating common appliances

  • balancing your checkbook, paying bills and managing finances

  • managing medications

  • driving safely

  • grocery shopping and preparing meals

  • keeping track of appointments and your daily schedule

  • able to remember recent events

Many of my clients worry that their occasional forgetfulness is a sign of something more deleterious. Usually, this is just normal aging. However, if your memory begins to significantly disrupt your daily life, you should speak with your healthcare provider about it. The following table provides a comparison of normal aging versus signs of cognitive impairment (with thanks to Dr. Ritabelle Fernandes at UH School of Medicine).

Normal Aging

Early Signs and Symptoms of Cognitive Impairment

Sometimes forgetting names or appointments but remembering them later.

Memory loss that disrupts daily life.

Making occasional errors when balancing a checkbook.

Challenges in planning or solving problems.

Needing occasional help to use the settings on a microwave or to record a TV show.

Difficulty completing familiar tasks at home, at work, or at leisure.

Confused about the day of the week but recalling it later.

Confusion with time or place.

Vision changes related to cataracts.

Trouble understanding visual images and spatial relationships.

Sometimes having trouble finding the right word.

New problems with words in speaking or writing.

Misplacing things from time to time and retracing steps to find them.

Misplacing things and losing the ability to retrace steps.

Making a bad decision once in a while.

Decreased or poor judgment.

Sometimes feeling weary of work, family and social obligations.

Withdrawal from work or social activities.

Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Changes in mood and personality.

If you are 65 or older and live in the United States, Medicare Part B covers an annual memory screening with your healthcare provider. The screening can check for conditions including dementia, depression, anxiety or delirium. Based on your results, your doctor can work with you on a plan.

AARP members or those registered on can take the free cognitive assessment to see how they perform that day on certain aspects of cognition, including reasoning, memory and attention. You can take the assessment every 30 days.

If you or a loved one notice significant changes in memory, thinking, or behavior, it's essential to seek professional advice promptly. Early detection allows for timely intervention and management. Consult a healthcare provider for a comprehensive evaluation and personalized recommendations. 

Even if you are diagnosed with mild cognitive impairment, all is not lost. You can delay and possibly reverse further decline through lifestyle modifications and specific exercise strategies aimed at increasing executive functioning, memory, attention, and processing speed. Remember, taking proactive steps to address cognitive health can lead to better outcomes and an improved quality of life for both individuals and their families.

It is never too early or too late to start living a brain healthy lifestyle. 

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