Yellow stickies on your computer monitor. Alerts in your calendar. A checklist reading “Keys? Charger? Reusable grocery bags? Small child?” on the inside of your door so you can’t miss it as you rush out for the day.
Thank the goddess for those little tricks that prompt us to do, bring, buy, show up at, or otherwise attend to one of the hundreds of items on our daily lists. Life is complicated and if you’re also responsible for kids or aging parents, you’re gonna need every ding, note, and piece of string tied around your finger to keep it all straight.
And even with all that, it’s normal space on some stuff. “I’ve had plenty of 30-year-old women say they have dementia, when really they’re 30-year-old moms with three kids and a full-time job,” says Stephanie Faubion, M.D., director of the Mayo Clinic Center for Women’s Health and medical director of The North American Menopause Society. Dr. Faubion likens our brains to a browser with too many tabs open—the computer is simply slower to respond.
Too-busy people also tend to try and multitask, which actually isn’t a thing, she says. “Multitasking is a myth—you have to do what you’re doing and then move on to the next thing.” If you don’t remember agreeing to drive your daughter to meet her squad at Starbucks, for example, which she asked while you were cooking and replying to a text, it has nothing do with memory. “You’re basically not concentrating—your attention is just not there.”
Still, it can be a little alarming the first time you wander to the fridge, open it, and forget what you were there for. You might jump to worst-case scenarios, like that you’re on the fast track to Alzheimer’s Disease. Whether or not your memory issues are cause for concern starts with your age. “If it’s a midlife woman going through menopause, it’s almost never true dementia. If I’m seeing a 75-year-old who is having memory concerns, that’s more worrisome to me,” says Dr. Faubion.
That’s because the risk of dementia and other conditions that can contribute to memory loss increases as you get older, says neurologist Ronald Petersen, M.D., Ph.D., director of the Mayo Clinic Alzheimer's Disease Research Center and the Mayo Clinic Study of Aging. “Age itself doesn’t determine anything, but it does kind of set the stage,” he says. A little falling off on things like recall of names after around age 50 is normal, but if it’s anything more than that, “we do want to look at whatever else is going on in your life,” says Dr. Petersen.
Here are some of the things that could be causing your memory glitches—and bear in mind that there may be several things going on, even if one is dominant, says Dr. Petersen:
1. You are stressed or anxious.
Hello! That would be the woman doing 700 things at the same time, or someone who has a lot of long-term external pressures, such as financial trouble or a loved one who’s not well. “When you have too many balls in the air or are burning the candle at both ends, cortisol levels run high,” says Dr. Petersen. This stress hormone that keeps you revved and ready also affects the hippocampus and other parts of the brain that are involved in memory. Similarly, anxiety—persistent worry about something that may or may not happen in the future—feels like stress to your body, and so has the same effect on your brain. “When your anxiety level is high, you can’t focus on anything and your attention is going to be impaired—it’s going to feel like you have a memory disorder because you can’t concentrate on anything,” says Dr. Faubion.
2. You’re feeling depressed.
The jury is out as to whether depression is a cause of memory loss or a symptom of it, but either way, research shows a link between depression and cognitive impairments, including memory issues. Even people who only have a symptom or two can have issues: One study that looked at people who were not clinically depressed found that the more symptoms of depression they had, the more memory issues they reported. And struggling with depression from a young age, another study found, is associated with poorer memory in midlife. And wouldn’t you know it? Certain older antidepressants are also associated with memory loss. Fortunately, newer medications in the SSRI category “have less of a deleterious effect on memory,” says Dr. Petersen.
3. You’re a woman in or around menopause
Among the many joys of perimenopause (the period of time leading up to menopause) and the transition itself may be a small but significant cognitive impairment, according to research, that may be independent of age. Theories abound, but “the bottom line is that we don’t really know exactly why this happens,” says Dr. Faubion.
The sorta kinda good news? Research has suggested that things go back to pre-menopause levels once you’re through the ups and downs of the transition. That said, this is far from certain, especially if you have other factors, such as poverty or HIV. “Women, especially women of color, with multiple risk factors may be more vulnerable to longer-lasting memory problems,” says Dr. Faubion. “Some of the women who were of highest risk in terms of socio-cultural stressors, with and without HIV, didn’t look better on the other side of menopause,” she says.
What’s more, perimenopause often brings on mood changes, such as anxiety and depression, and sleep problems, sometimes caused by symptoms like hot flashes. These can all affect memory. Which brings us to…
4. You’re not sleeping well or enough
Whatever the reason you’re not getting enough good quality sleep, poor shuteye can affect your memory in a big way, says Dr. Petersen. During the deeper stages of sleep, certain proteins are cleared out of the brain, says he says. “But if you never get to the stages of sleep when these housekeeping activities are thought to be taking place, perhaps toxic substances can build up in the brain,” Dr. says, and affect the way these nerves work. Talk to your doctor about possible sleep disorders such as restless leg syndrome or sleep apnea for which you can be treated—improving sleep can boost your alertness throughout the day, which helps memory, says Dr. Petersen.
5. Maybe your medications are fogging your mind
Certain medications are known to affect memory. And in the nothing-is-simple department, some of these meds are ones you’d take to help with anxiety, depression, disrupted sleep, or other problems that may keep you up at night—conditions that if left untreated can contribute to memory issues. Benzodiazepines (often taken for anxiety) are known to affect memory, as are a class of drugs called “anticholinergics,” which show up in treatments for stress urinary incontinence, over-the-counter sleep aids, and allergy treatments like Benadryl. Tricyclic antidepressants and certain opioids also deal your memory a blow.
6. You could be drinking or partying too much
Abusing alcohol or any substance (such as opioids) that can slow your central nervous system may affect memory as well, says Dr. Petersen. “I don’t want to overstate this, but clearly if someone is aging and vulnerable, two or three cocktails a night probably will catch up with you,” he says. Scientists have known for years that there is evidence of brain shrinkage in people with alcohol use disorder.
7. Perhaps you have a thyroid issue
Hypothyroidism (which is when your thyroid gland does not produce enough thyroid hormone) not only causes forgetfulness and brain fog, but research has shown that the condition can result in shrinkage of the hippocampus, an area of the brain involved with both long and short term memory. And hyperthyroidism (the gland cranks out too much thyroid hormone) can interfere with cognitive function, and a review of the literature has found that “studies with a larger sample size have shown statistically significant evidence of hyperthyroidism increasing the risk of dementia,” in older patients. “Thyroid hormones are so important for the energy metabolism of individual cells,” including those in the brain, says Dr Petersen. similarly in the brain.
8. You might have a B12 or folate deficiency
One of the known treatable causes of dementia is a vitamin B12 deficiency, says Dr. Faubion, found in foods like salmon, liver and milk. The vitamin supports nerve health, so “we may check for vitamin B12 deficiency after the age 50 to make sure people are not deficient,” she adds. That said, taking B12 pills (or another B vitamin, folate, a deficiency of which may also be associated with cognitive impairment) does not help to improve memory unless you’re deficient, says Dr. Petersen, which means taking extra B12 or folate isn’t going to make you sharper.
When to see a doctor about memory loss
It’s wise to know the signs that something more serious is going on, because the sooner you seek treatment, the better.
Here’s when Drs. Petersen and Faubion suggest making an appointment.
If memory problems bother you. “That warrants a conversation with your physician,” says Dr. Petersen, if only to make you feel better about normal aging.
If you’re forgetting routine things, such as which medications you take, or things that you want to do, like a standing girls’ get-together. “It happens every so often, but if it happens tonight and then a week from now and then three weeks from now,” it’s something to look at.
If you tell the same story over and over in a short span of time. “I’m talking about the same conversation in a loop in one sitting,” says Dr. Faubion, rather than your aunt who, every time you see her, gleefully recounts how you yelled at the tree when you were a little girl because it wouldn’t move out of the way. If, once reminded, the person remembers telling you and doesn’t do it again, and the repetition is not getting more frequent, it’s probably fine.
If the memory loss comes on suddenly or after a medical procedure. “One common thing I hear is, ‘Dad was fine, until he had his prostate surgery,’” says Dr. Petersen. Sometimes everything goes well and the person is fully recovered from an illness or procedure, but perhaps a few months later his family notices memory slippage. “That to me is a notable event. It could be that when the person’s system was stressed, it may have unmasked something that was likely developing.”
If those around you are noticing your slips. “Most of the time it’s not the patient who notices, it’s the family, saying things like, ‘Mom isn’t right anymore,’” says Dr. Faubion. This doesn’t necessarily mean you have dementia, adds Dr. Petersen, but that it is time to get yourself evaluated.
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