As we get older, we worry that forgetfulness may signal the onset of Alzheimer’s disease or dementia. But experts say that memory problems may be due to other causes such as aging, medical conditions, emotional issues, and even medications.

According to the National Institute on Aging, forgetfulness is a normal part of aging. The brain undergoes many changes that can make it harder to learn a new skill or easier to forget where we placed keys or glasses.

Certain medical conditions, such as kidney or liver disorders, can also trigger memory loss. Head injuries or concussions, as well as imbibing too much alcohol, can cause forgetfulness. Emotional problems such as depression, stress and anxiety can leave people feeling confused and disoriented so they may appear to be forgetful. Lapses of memory caused by physical or emotional factors tend to go away with proper treatment.

Assessing Memory Lapses

However, the differences between normal aging or temporary memory loss compared to Alzheimer’s disease are distinct in their pervasiveness. For example, older people may make a bad decision once in a while. A person with Alzheimer’s disease has poor judgment most of the time, according to the National Institute on Aging.

While we all may miss paying a monthly bill from time to time, those afflicted with Alzheimer’s have trouble paying bills at all. Normal forgetfulness means that at times we cannot recall a name or word, but more serious memory loss means trouble carrying on a conversation.

Sometimes forgetfulness is caused by mild cognitive impairment or MCI. Approximately 15% to 20% of people over the age of 65 have MCI. People with this condition, especially MCI involving memory problems, are more likely to develop Alzheimer’s disease or other dementias than people who do not have MCI, according to Harvard Health. However, MCI does not always lead to dementia, as many folks fear and believe. In fact, MCI is not always permanent.

“It depends on the underlying cause,” says Dr. Joel Salinas, a neurologist at Harvard-affiliated Massachusetts General Hospital. MCI is not dementia, but it is not normal thinking either. The most common causes stem from actual disease or treatments for disease, including:

*Degenerative brain disease, such as Alzheimer’s disease.

*Stroke or other vascular disease.

*Traumatic brain injury.

*A medication side effect.

*An underlying health problem such as sleep deprivation, depression, or anxiety

Proven Treatments For Mild Cognitive Impairment

The American Academy of Neurology (AAN) recently published new guidelines for the treatment of MCI and notes that about 15% of the time MCI cases progress into full blown dementia. Dr. Salinas adds that when the cause is a neurodegenerative disease, the numbers of those who progress into dementia will be higher. What’s unclear is how long, if ever, this progression takes.

“If the cause is Alzheimer’s disease, it may take two to five years,” he says. “But I’ve seen patients stay in the MCI stage for many years, even when we presume it was a neurodegenerative disease.”

Dr. Salinas says that MCI can often be reversed if a general health condition such as sleep deprivation is causing the decline. By treating the underlying cause, cognition dramatically improves.

Since there are no pills to slow the worsening of memory problems, treatment can be challenging. However, the AAN has found encouraging evidence linking exercise with better memory in people with MCI. Exercising can offer both mental and social stimulation while improving blood flow to the brain. This increased blood flow may also release molecules that can repair brain cells and make connections between them. New AAN guidelines recommend exercising at least twice a week. Cognitive tasks like operating a computer or playing video games can also sharpen your brain’s response time and improve attention span.

In 2015, the famous FINGER trial, a randomized controlled study, found less cognitive decline over two years in older adults who maintained a combination of habits, such as eating a healthy diet, exercising regularly, and taking part in social events.

Dr. Salinas advises people with MCI to emulate the healthy habits of older adults studied in the FINGER trial along with adding mentally stimulating activities like a taking up new hobby or learning a new language.

There are no guarantees, but the evidence does suggest that these steps may delay or even prevent progression to dementia.

“The people who spend the most time cognitively stable are often the ones who stick to healthy lifestyle recommendations,” Salinas says.