Duke geriatrician Heidi White, MD, discusses the effects of aging on memory.

When are the memory lapses we often call “senior moments” warning signs of a more serious condition? Because the speed at which we process information slows with age, most such incidents are not a cause for concern.

Forgetfulness can, however, reflect conditions that require evaluation and treatment, such as physical illness, depression, and hearing loss. More rarely, memory loss is indicative of a disease called dementia. The most common cause of dementia is Alzheimer’s disease, but many other potential causes must be considered.

A general internist or family physician can often uncover problems that may be contributing to memory loss. Additional consultation with neurologic or geriatric specialists may be useful when the exact diagnosis remains unclear or the patient and family desire a second opinion.

A variety of research studies (including several at Duke currently seeking participants) seek to better understand the causes of dementia, diagnose it earlier, and develop more effective treatments. In the meantime, thanks to the complex but clearly proven connection between mental and physical health, you can enhance your mental functioning by taking steps to make your overall lifestyle healthier and more active.

Handling "Senior Moments"

“Senior moment” has become a catchphrase for the over-50 crowd to describe those embarrassing moments when a word does not come to mind in conversation or the name of a friend or acquaintance is forgotten. These slips were once written off as simple memory lapses, but now we attach more significance to them. Are they warning signs of a more serious condition?

As a geriatrician at Duke University Medical Center, I see a wide variety of individuals who are concerned about their memory. I believe it is important for older adults and their families to not only recognize changes in memory, but to seek explanations from knowledgeable professionals and adopt lifestyle habits that will promote good cognitive (i.e., reason, judgment, perception) and memory function.

Usually, all that is necessary to recover from these "senior moments" is patience. After all, the speed at which we process information is one aspect of brain function that normally slows with age. With a little time, the word or name can be retrieved.

Dementia: One Risk Factor Among Many

Illness and persistent pain can have a negative impact on memory and thinking. Depression is a common illness that often goes unrecognized in older adults, but can definitely produce impairments in memory, attention, and concentration. Sensory deficits such as hearing loss can also contribute to those senior moments when important information is simply missed.

Memory loss may be indicative of a disease called dementia. Dementia is a general term used to describe memory and thinking problems that interfere with activities the individual was previously capable of doing. These may include managing medications, balancing the checkbook, paying bills on time, grocery shopping, and driving a vehicle.

When to See a Doctor

If you're concerned about your senior moments, it's important to discuss your symptoms with a physician. I suggest that you start with your primary care physician. A general internist or family physician can do a lot to uncover problems that may be contributing to memory loss. A review of your current prescription and non-prescription medications is essential, because many medications can affect memory and overall brain function.

Often, your primary care physician will be able to diagnosis the reason for your memory difficulties. However, specialists may be useful when the exact diagnosis remains unclear or the patient and family desire a second opinion.

There are three types of specialty physicians who evaluate memory problems: neurologists, psychiatrists, and geriatricians. Within the Duke University Health System, patients with memory loss can be seen by a neurologist at the Memory Disorders Clinic (919-668-7600) or by a geriatrician at the Geriatric Evaluation and Treatment Clinic (919-620-4070).

Current Research Could Improve Care

Several studies are under way at Duke and many other leading medical centers to understand the changes that accompany or cause dementia, develop effective treatments, and uncover means of preventing further decline.

Research studies regarding memory loss available through Duke University Health System can be accessed at dukehealth.org/clinicaltrials. Local and national clinical research trial information can be accessed through the Alzheimer’s Disease Association at clinicaltrials.gov and through the National Institutes of Health at alz.org/alzheimers_disease_clinical_trials_index.asp.

My colleagues in the field of geriatric medicine and I are optimistic that, through continued research, we will uncover ways of preventing serious memory loss and develop safe and effective treatments.

In the meantime, it's worth keeping in mind that, for most older adults, senior moments are simply momentary annoyances that do not represent anything more serious. And because a growing body of research proves the close connection between mental and physical health, you can enhance your mental function by taking steps to make your overall lifestyle healthier and more active.

Tips to Support, Enhance Memory

Even when memory loss is not indicative of dementia, other illness, or medication effects, it can still be troublesome. Here are some ideas to help keep your memory as sharp as possible.

Simple changes that help you stay organized can greatly improve your daily function and decrease the anxiety that occurs when items are misplaced or events missed. For example:

• Keep a calendar and write down all important information
• Always put your keys in the same place
• Schedule bill payment and other important tasks
• Make lists and check off tasks that have been accomplished

Medication regimens for age-related conditions can become complex. Using a weekly medication box can help you stay organized. If you're on multiple medications, have your drug regimen reviewed by your physician or a geriatrician to make sure your medications are not interacting in ways that could damage your health or impair your mental function.

Remaining active both physically and mentally provides needed brain stimulation and helps reduce anxiety and stress. Anxiety and stress put added strain on memory function but may be avoidable and treatable with interventions including stress management techniques and psychotherapy.

Grief and loneliness are common as loved ones die and living circumstances change. Social relationships and social activities help older adults deal with these common feelings so that they don't become overwhelming and lead to more serious problems.

Healthy habits help. Decreasing the use of alcoholic beverages can improve memory function. Adequate rest and sleep are important for good memory, attention, and concentration.

Although many vitamins and herbs are promoted as memory aids, there is little data to support such claims and they may interact with prescription medications. So be sure to discuss the use of such products with your primary care physician before embarking on a course of treatment.