Detecting memory issues early: When to seek help
The first step in addressing memory concerns is to visit a primary care physician
As people age, occasional forgetfulness is common, but when memory lapses become more noticeable, they may signal mild cognitive impairment (MCI) - a condition that falls between normal aging and early dementia.
While MCI does not usually disrupt daily life, early detection can make a difference in managing cognitive decline.
"It's not unusual to be forgetful at times as you age, but if memory issues are more noticeable, it's always best to get checked out and undergo a cognitive test," said Sara Weisenbach, a neuropsychologist with Harvard-affiliated McLean Hospital.
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"There are ways to slow the progression of cognitive decline or treat issues that could be causing memory lapses, but the sooner you can identify a problem, the better the outcome."
Consulting a Doctor
The first step in addressing memory concerns is to visit a primary care physician. This can be done during an annual wellness check-up, where the doctor will review symptoms, health history, and potential genetic links to dementia.
Weisenbach warns against relying on online cognitive tests as they are often inaccurate. Instead, she recommends in-office cognitive screenings, which take five to 15 minutes and may involve:
- Repeating a list of words immediately and after a short delay
- Recalling personal details, such as addresses or birthdays
- Naming objects in a picture
- Answering questions about recent events
- Drawing a clock to assess spatial awareness
"The results might indicate a potential problem, but they usually are not sufficient for a formal MCI diagnosis," said Weisenbach.
Further Assessments and Imaging
If initial screenings suggest cognitive impairment, brain imaging tests such as an MRI scan may be recommended to detect structural changes or blood flow issues. A PET scan can check for amyloid plaque buildup, a key indicator of Alzheimer's disease.
Doctors may also refer patients to a neurologist or neuropsychologist for a more in-depth evaluation. This assessment, which can last several hours, examines cognitive function, including:
- Difficulty finding words while speaking
- Frequent misplacement of personal items like keys and phones
- Struggling to recall conversations from the previous day
"All this information can help determine if the issues are a sudden phenomenon or have worsened over time," said Weisenbach.
"A neuropsychologist can also help determine which cognitive skills are strong and which ones are more challenging."
Test results are also assessed in the context of medication side effects, anxiety, depression, or grief, as these factors can influence cognitive performance.
Establishing a Baseline for Future Monitoring
Even if a neuropsychological evaluation does not confirm MCI, doctors can still identify and address any underlying issues affecting cognitive function. "This initial screening also provides a baseline for future reference in case other memory issues arise or your situation worsens over time," said Weisenbach.
In cases where results are inconclusive, patients may be monitored for 12 to 18 months before undergoing another evaluation.
