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What’s Normal Brain Aging?

Updated: Jun 1, 2023

Sakura LBJ. Artjamming Central, 2016.

Sometimes dementia has a way of creeping up on us. Like a thief in the night. At first we aren’t sure what’s even happening.

Thief in the night

Our elderly loved one may be a bit vague about day to day events, like who came over, or what they had for dinner. They may seem a bit different - more short-tempered, anxious or unexpectedly aggressive. Maybe you notice that you’re the one who's getting frustrated when they ask you what day it is for the fifth or sixth time that evening.

It’s hard to know for sure if mom is actually losing memory or misplacing things, or if she just didn’t hear. The other confusing thing is that there are good and bad days, like maybe mom can’t find her purse one day, and the next day she impresses you by remembering the names of every grandkid, even the ones you had forgotten yourself.

And then of course we tell ourselves we are overthinking, imagining things, exaggerating. We might even feel a little embarrassed or guilty, because we often forget things too. We brush it off. Because we aren’t sure what’s happening. And of course we don’t want it to be happening. Because that would be bad. Devastating even.

Mild cognitive impairment

Dementia shows up in many different ways. There is almost always a stage called mild cognitive impairment (MCI), which can often be hard to distinguish from normal aging. What’s “normal” can of course vary a lot across different individuals. Beyond forgetting things and perhaps names, you may notice them forgetting whole conversations or events like a birthday celebration.

We may be reluctant to act when we begin noticing memory or behavior changes in our elderly loved one in part because we believe “There’s no cure for Alzheimer’s.” But that doesn’t mean that there is no way to help them.

Mild cognitive impairment (MCI) is often be hard to distinguish from normal aging

People with MCI are estimated to have a 20% chance of progressing to dementia over a three year period of time. Alzheimer’s disease is the most common form of dementia, accounting for about 2 out 3 cases, but it often coexists with other causes of memory loss or confusion. It’s important to rule out other potential health issues like thyroid or vitamin B12 deficiency. And to proactively address potential problems with hearing or vision that could be contributing to their confusion.

Gale et al. Am J of Med, 2018.

What can I do?

It’s perfectly normal to question your observations, and to want to keep them to yourself. But at some point it’s worth having a conversation with your loved one. Chances are that if you have noticed, they have too - and things have a way of getting bigger and scarier when we avoid them.

We can create a safe space to allow our loved one to feel unconditionally loved and accepted.

There is absolutely no rush, so choose a calm moment when you know you won’t be interrupted. Begin by telling her that you love and support her no matter what. Then gently remind her of a recent episode when you felt concerned about her memory or behavior. Be genuinely curious about her reflection on that episode, allowing plenty of time and space. If she genuinely is not worried or doesn’t remember, it’s okay to reassure her that you are glad she isn’t troubled by what happened, and that you are available if she ever wants to talk.

Canva graphic, 2022

You don’t want your loved one to feel that you are watching and judging her, because this may make her anxious or defensive. If you notice more lapses, try to help as tactfully as possible. It may take some more time for her to be ready to take the step of talking to the doctor, or maybe you could offer to go with her to her next checkup appointment.

Memory loss is a terrifying and traumatic experience. You cannot force her to get help without causing her more trauma. What we can do is to create a safe and supportive environment, so that she can feel unconditionally loved and accepted. And sometimes the best thing we can do is to acknowledge how hard it is for ourselves to be in uncertainty about the future, especially with someone we hold dear.



Website - Cleveland Clinic Health Library provides resources to help educate the public on common health conditions.

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