Memory loss, a possible symptom of dementia such as Alzheimer’s disease, is usually associated with old age. But as a geriatric psychiatrist and head of a memory center, I am seeing more patients age 50 to 65 who complain of increasing memory lapses and other cognitive issues.
These people are in the prime of their lives, and the very thought of having dementia is causing them to panic. They are particularly fearful of Alzheimer’s, the most common form of dementia, knowing it is incurable and difficult to detect early on.
Everyone needs to take a deep breath.
While possible signs of cognitive decline or dementia certainly warrant careful assessment, in patients of this age, such symptoms are more likely the result of a relatively benign and eminently more treatable 21st-century ailment that one might simply refer to as brain fog.
More often than not, what these patients actually are suffering from is normal age-associated declines in cognitive skills, along with some combination of other factors such as depression, drug side effects, substance abuse, sleep disorders or adult attention deficit disorder.
Here are a few examples, using experiences from my own practice:
The overtaxed brain
A patient I’ll call Marion is a successful business owner who arrived at the memory center with an anxious look. She reported having memory problems and said that because she was only 55 years old, she worried she was going “senile” like her grandfather, or possibly had a dementia such as Alzheimer’s.
Marion told me that she was under severe stress to keep her small business afloat. This was compounded by sleepless nights, crying jags and regular doses of a sedative prescribed by a doctor. Over the past 12 months, Marion had noticed increased memory lapses such as forgetting to pay vendors, missing appointments, and on one occasion being so preoccupied that she got lost driving to a regular customer. Increasingly, she felt as if she couldn’t concentrate while reading.
It was clear to me that Marion was panicking over something she didn’t understand. I explained that processing speed and other skills of the typical brain begin to slow down in middle age, and that she was taxing them even more with several common cognitive lodestones: overwhelming stress and depressed moods that distracted her and lessened her interest in daily tasks; lack of sleep; and a medication that can disrupt memory formation. These reversible factors, I told her, were likely behind her memory lapses.
I also explained that “senile” is an antiquated term that simply means old. In a previous era, where “old” was equated with losing one’s memory or some other degenerative process, “senile” became synonymous with dementia. It’s a term doctors no longer use.
Marion still warranted a comprehensive work-up to clarify the diagnosis and find a solution. Neuropsychological tests revealed an interesting finding: Her memory, along with most other cognitive skills, tested nearly perfect for her age, but her attention skills were poor.
A likely diagnosis of adult ADD was confirmed when she responded beautifully to a trial of the stimulant methylphenidate—a drug identical to one prescribed for children with ADD. This medication, along with psychotherapy, improved her thinking and mood and shooed away remaining concerns about her memory.