Alzheimer's Archive

Many cases of memory loss aren't related to dementia, but stem from other, treatable conditions.

You've been forgetting things lately — your keys, or maybe names. Sometimes you struggle to find the right word in conversations or repeat yourself to others. You may worry: are these signs of dementia?

If this sounds like you, you're not alone. Many people find their way into Dr. Tammy Hshieh's office wondering the same thing. But most of the time, it's not dementia causing their problems, says Dr. Hshieh, a geriatrician at Harvard-affiliated Brigham and Women's Hospital and Dana-Farber Cancer Institute and assistant professor of medicine at Harvard Medical School.

The shift from this condition to dementia is not necessarily inevitable.

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Will I get dementia? That common question takes on urgency if you have mild cognitive impairment (MCI), a slight but noticeable change in memory and thinking skills. But the progression from MCI to dementia is not automatic. 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.

What are the causes of MCI?

MCI is not dementia (see "What is dementia?"), but it's not normal thinking, either. It often stems from disease or treatments for disease, including

Two common classes of drugs have been linked to dementia. Fortunately, there are alternatives to both.

If you're worried about developing dementia, you've probably memorized the list of things you should do to minimize your risk—eating a healthy diet, exercising regularly, getting adequate sleep, and keeping your mind and soul engaged. In addition, some of the drugs you may be taking to help you accomplish those things could increase your risk of dementia. In two separate large population studies, both benzodiazepines (a category that includes medications for anxiety and sleeping pills) and anticholinergics (a group that encompasses medications for allergies and colds, depression, high blood pressure, and incontinence) were associated with an increased risk of dementia in people who used them for longer than a few months. In both cases, the effect increased with the dose of the drug and the duration of use.

These findings didn't come entirely as a surprise to doctors who treat older people. The Beer's List published by the American Geriatrics Society has long recognized benzodiazepines, antihistamines, and tricyclic antidepressants as potentially inappropriate for older adults, given their side effects. Such drugs are on the list because they share troubling side effects—confusion, clouded thinking, and memory lapses—that can lead to falls, fractures, and auto accidents.

Stress management may reduce health problems linked to stress, which include cognitive problems and a higher risk for Alzheimer's disease and dementia.

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It's not uncommon to feel disorganized and forgetful when you're under a lot of stress. But over the long term, stress may actually change your brain in ways that affect your memory.

Studies in both animals and people show pretty clearly that stress can affect how the brain functions, says Dr. Kerry Ressler, chief scientific officer at McLean Hospital and professor of psychiatry at Harvard Medical School. Scientists have seen changes in how the brain processes information when people experience either real-life stress or stress manufactured in a research setting. (For the latter, researchers might challenge subjects to perform a difficult task, such as counting backward from the number 1,073 by 13s while being graded.) Either type of stress seems to interfere with cognition, attention, and memory, he says.