In the video 10 Causes of Memory Loss in Aging posted on the YouTube channel Better Health While Aging, board-certified geriatrician Dr. Leslie Kernisan (MD MPH) explains the common causes of memory and cognitive issues in older adults, and what healthcare providers should address during an initial evaluation.
Below is a summary of Dr. Leslie Kernisan’s insights:
Misconceptions About Memory Loss and Aging
I understand why people have concerns about memory loss because there are two common misconceptions about memory loss and aging, not only in the community but even among doctors.
The first misconception is: “Memory loss or cognitive issues are part of normal aging.” It’s commonly believed that short-term memory declines as you get older, or that it’s normal to experience difficulty with thinking as you age. This is completely incorrect. It’s a misconception.
The second misconception is: “There’s nothing that can be done because memory loss can’t be cured or reversed.” Some people may think there is no help because they’ve heard that memory loss could be a sign of Alzheimer’s or another form of dementia, and these diseases are incurable. But this is also wrong. Both of these ideas are misconceptions you shouldn’t believe.
10 Common Causes of Memory Loss and Cognitive Issues in Older Adults
Before I introduce the causes, I want to emphasize a very important point when talking about memory loss and cognitive issues in older adults. When an older adult’s memory or cognitive abilities aren’t functioning properly, and we call this cognitive decline, in most cases, the cause will be due to multiple factors working together.
So, it’s often not just one cause that leads to all the problems. Most older adults are dealing with several issues at once that affect the brain’s ability to perform optimally.
So, as we explore these 10 causes, keep in mind that we’re not just looking for one single cause, but rather considering factors that could contribute to or worsen the condition.
Now, I’ll share the 10 causes that I most often think of when an older adult begins experiencing memory or cognitive issues:
- Medication Side Effects: Many common medications can affect brain function. If you’re concerned about memory or cognitive abilities, it’s important to identify these medications and reduce or stop their use if possible.
- Metabolic Imbalances: Abnormal blood chemistry, such as low sodium, calcium, or glucose levels, can impair brain function and cause confusion in older adults.
- Hormonal Issues: Low hormone levels, especially thyroid hormones, can affect memory and cognition. Issues with estrogen and other sex hormones can also have an impact, particularly in middle-aged adults.
- Vitamin Deficiencies: A deficiency in vitamin B12 is a common cause of memory problems in older adults. Other B vitamins can also contribute to similar issues.
- Delirium: Delirium is a severe decline in mental function due to significant stress on the body. Older adults who become frail may experience delirium, even without a serious illness. It’s important to recognize that delirium can cause a normally functioning person to act as though they have a mental disorder, resembling someone with Alzheimer’s or another form of dementia.
- Mental Health Disorders: Most severe mental health disorders can lead to memory, thinking, or concentration problems.
- Depression: Depression can affect memory and focus. Some older adults even develop a form of depression known as psychotic depression, where they may become delusional or exhibit very unusual behavior due to depression.
- Anxiety: Anxiety is also quite common among older adults. While it may not cause overt delusions, it can make it difficult to concentrate or sometimes affect memory, especially if anxiety interferes with sleep.
- Substance Abuse and/or Withdrawal: Substance abuse, such as alcohol, drugs, or even prescription medications like sedatives or painkillers, can impact the brain. The brain may become impaired and not function well if the person is intoxicated or under the influence. Prolonged excessive use of substances can also lead to chronic damage to brain cells.
- Brain Cell Damage from Trauma: A common form of brain damage is from vascular injury, meaning damage to the blood vessels in the brain. Like the blood vessels in the body and heart, the brain has its own network of blood vessels. The brain needs oxygen from these vessels, so if the blood vessels are damaged, it can harm brain cells, potentially causing memory loss and cognitive problems. If it’s a large blood vessel affected, it could result in a major stroke.
- Neurodegenerative Diseases: This is a very common cause as people age. If they are fortunate enough to live long enough, they may begin to experience neurodegenerative diseases. These diseases accumulate in the brain and slowly damage and kill neurons over time, often over many years. Common neurodegenerative diseases include Alzheimer’s and Parkinson’s disease.
- Infections: Acute infections, such as viral, bacterial, parasitic, or fungal infections, or chronic infections that last for weeks or months, can directly affect brain cells.
That’s the list of 10 causes I often consider when looking at memory or cognitive issues in older adults. I also want to acknowledge another cause that is not typically considered, nor frequently evaluated in geriatrics, but it has been brought up and I think it’s reasonable to include it: toxins. Toxins, such as heavy metals, air pollution, water pollution, or pesticides, are another potential cause that could affect brain function as people age.