Are Your Memory Lapses the Result of Mild Cognitive Impairment or Something Else?

Memory lapses, confusion, and difficulty with decision-making are red flags that cause worry—sometimes needlessly.

When you start to have trouble remembering names or you have a moment of confusion doing something you’ve done a thousand times, it’s easy for your worst fears to surface. You may feel you’re on the path to Alzheimer’s disease or some other form of dementia.

But it’s important to remember that changes in cognition can have many causes, some of which are temporary. Some are treatable if the underlying cause is related to medication use or a manageable condition, such as thyroid disease. The first classification for a noticeable change in thinking skills and memory is called mild cognitive impairment (MCI). It can be a state in which you live for many years, a precursor to dementia, or a temporary condition brought on by a range of factors.

“Not all MCI is caused by Alzheimer’s,” says Deborah Blacker, MD, a psychiatrist with Massachusetts General Hospital. “Some MCI is a bad day. Someone may just be going through a bad patch.” She notes that bereavement, for example, can contribute to difficulty concentrating and short-term memory problems.

Factors Affecting Thinking

Your ability to concentrate, make decisions, recall new or old information, and be at your sharpest can be compromised by countless factors. Of course, changes related to Alzheimer’s disease or Lewy body dementia can result in irreversible changes in brain function. But it’s important to understand the many other reasons why you may have fuzzy thinking or be unable to recall information that always seemed to be readily accessible.

Among the more common—as well as some unlikely—causes of MCI are:

Insufficient sleep: One night of poor sleep can affect memory and attention the next day, and years of sleep problems can have longer lasting impacts.

Thyroid disease: Your thyroid, that little butterfly-shaped gland in your neck, releases a hormone that affects every part of your body—including your brain. An overactive or underactive thyroid may lead to problems with memory or concentration.

Menopause: Many women complain of fuzzy thinking and memory problems during and after menopause, and research suggests the changing hormone levels in the brain at this time may be at least partly to blame.

Smoking: Cigarettes are most strongly associated with harming lung and heart health, but smoking can reduce healthy blood flow to the brain. Without plenty of oxygenated blood, brain cells suffer, as does brain function.

Anxiety and depression: These are often overlooked, because they are emotional disorders. You may not associate impaired thinking or memory with these conditions, but the severity of the impairment can actually mirror the severity of the depression or anxiety.

Stress: Prolonged stress can increase the brain’s production of cortisol, which can affect your synapses—the bridges between brain cells.

Other Major Factors

Prescription drugs come with many potential side effects. You may be more likely to notice physical symptoms, such as headaches and nausea, but anti-anxiety drugs and antidepressants are among several medications commonly associated with cognitive changes. Others include sleep aids, incontinence medications, and even antihistamines for allergy control. If you take a prescription drug and notice that your memory or thinking skills seem impaired, talk with your doctor. You may be able to take a lower dose or switch to a different medication that won’t cause those side effects. You and your doctor should review your medications regularly, but especially if you are noticing cognitive changes that could be drug side effects.

Neurological conditions can also have profound effects on brain function. Parkinson’s disease (PD), for example, affects muscle control, as well as cognition over time. Though PD is a chronic condition, there are medications and treatments that can help slow the progression of the disease.

Brain tumors, the accumulation of tau and amyloid proteins, and fluid buildup all can impair your thinking and memory. Some of these developments are also treatable. But you won’t know what’s treatable and what isn’t if you don’t seek out an evaluation of your brain health.

“Sleep apnea, especially in this era when so many people are overweight or obese, is a serious problem that can affect brain function, but it’s modifiable,” Dr. Arnold says. “There are many other medical, neurological, and neuropsychiatric conditions that have MCI as part of their syndrome.”

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