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Worried About Your Memory? Here Are 5 Questions to Ask a Cognitive Neurologist

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Worried About Your Memory? Here Are 5 Questions to Ask a Cognitive Neurologist

As we age, it’s normal to have concerns about our cognitive health, especially for those who have a family history of Alzheimer’s disease or other forms of dementia. Nicholas Frost, MD, PhD, and Christine Cliatt Brown, MD, neurologists at University of Utah Health, answer some common questions about our cognitive health as we age: 

1. How can I tell if my forgetfulness is normal or something I should worry about?

If you misplace your car keys on occasion or forgot about an appointment, that doesn’t definitively mean you are experiencing cognitive decline. Forgetfulness is a normal part of being a human, especially as we age. However, if your memory lapses have become common enough that the people around you have expressed concerns over it, or you regularly experience the following, schedule a chat with your primary care physician:

  • Getting lost in familiar areas
  • Repeating the same questions
  • Forgetting basic words
  • Having trouble completing basic, familiar tasks
  • Frequently misplacing items

“Our brain is the biggest it will ever be when we are in our 40s, and it gets a little smaller every year after that, so it’s common to notice some changes,” Frost says. “The people who end up coming to our clinic with concerns are people who have noticed a change in themselves and have had family members or friends say that they have noticed a change.”

2. Could stress, lack of sleep, or some other health issue be affecting my memory?

Absolutely. Several factors and conditions can affect your memory, and they don’t necessarily mean you are experiencing cognitive decline. These include:

  • Going through a stressful time
  • Mental health conditions like depression and anxiety
  • Side effects of certain medications
  • Head injuries
  • Substance abuse disorder
  • Nutritional deficiencies or dehydration
  • Having trouble sleeping
  • Thyroid imbalances

“Anyone going through a stressful life event, whether that’s emotional stress or something physically stressful like an illness, is likely to suffer some cognitive difficulties,” Cliatt Brown says. “What I would be worried about is, once things have settled and your situation is less stressful, if things are still getting worse instead of getting better.”

3. What are some lifestyle habits that can help keep my brain sharp?

“We know that about half of dementia cases are preventable,” Frost says. “There are many things that you can do throughout your life to help prevent dementia, and a lot of those are just about being a healthy person in general.”

Frost and Cliatt Brown recommend the following healthy lifestyle habits to their patients:

  • Stay physically active by getting at least 30 minutes of aerobic exercise per day.
  • Eat a healthy diet, such as the Mediterranean or MIND diets, which include leafy greens, whole grains, healthy fats, and low-fat animal proteins, such as fish or poultry.
  • Get enough sleep each night.
  • Limit alcohol and avoid smoking.
  • Manage controllable risk factors that can increase the risk of dementia, such as diabetes, high blood pressure, high cholesterol, and sleep apnea.
  • Wear your eyeglasses or hearing aids if you need them.
  • Stay social, whether that be with family members, friends, neighbors, religious organization groups, or volunteering.
  • Partake in a variety of activities you enjoy that also challenge you mentally, such as puzzles, reading, art, board games, or knitting.

“You want to make sure you’re exercising your brain and not just your body,” Cliatt Brown says. “Your brain staying sharp is a ‘use it or lose it’ kind of thing, so you want to give your brain a variety of things to do.”

4. What can I expect during a cognitive screening?

If you have concerns, you don’t need to go straight to a cognitive neurologist. Your primary care physician can get you started with a basic cognitive screening, which usually consists of a written test that only takes a few minutes to complete. If you struggle with the test, that may point to an issue with your cognitive function, and you may be referred to a neurologist for further testing.

Brain imaging tests, such as an MRI or CT scan, can rule out serious conditions like stroke. A PET scan of the brain is a specialized test that can help determine the cause of someone’s cognitive decline by pointing toward Alzheimer’s, frontotemporal dementia, or other diseases.

Individuals who have started experiencing symptoms of cognitive decline could also have a simple blood draw done that detects certain biomarkers associated with Alzheimer’s. ARUP Laboratories, University of Utah’s laboratory services partner, has a blood test available that looks for tau proteins in the blood. The presence of tau proteins is a key indicator that a person has Alzheimer’s. This test should not be done on a person without cognitive decline, as there is a higher risk of false positives in people with normal cognition.

5. I have a family history of Alzheimer’s disease. What are some early warning signs I should look for?

“Especially in people age 65 and older, the most common early symptoms of Alzheimer’s are going to relate to memory, like not remembering recent conversations and events,” Cliatt Brown explains. “Another concern would be losing skills you had mastered cognitively. For example, if you’ve always done a lot of woodworking and now you can’t build a simple chair that should be really easy for you, that’s a concerning sign.”

Remember, if you’re ever worried about your cognitive health, don’t hesitate to reach out to your primary care physician. They will help you start the process of digging deeper.

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