When to Start Fretting About Forgetfulness

By Frederic Golden

You forget where you put your keys, often misplace your glasses and certainly can't remember names as well as you used to. At bedtime, you stare haplessly into the bathroom mirror, wondering whether you've already brushed your teeth. Once you showed up for a dinner date at the wrong restaurant. What's happening? Should you regard these lapses as a sign of more serious memory problems, maybe even Alzheimer's?

Forget it. Mental slips like these are a normal part of mid-life. Even teenagers, capable of reeling off entire CDs of rock lyrics, occasionally blank out--though one might be suspicious of instances involving chores requested by parents or teachers. Unless your forgetfulness is accompanied by deeper failures in reasoning and logic, it's nothing to fret about. After all, if being absentminded were a sign of mental disarray, you'd have to write off Einstein, who bungled simple arithmetic even while working on relativity.

You should feel concern if memory loss becomes a consistent pattern--forgetting what you've just said or done, repeatedly missing appointments, telling old jokes again and again or unwittingly making phone calls to the same people about the same subjects. Or if these flubs are followed by changes in behavior, such as irritability, depression or irrational suspicions (your house has been broken into, your spouse is cheating on you, people are out to get you).

Even then, don't jump to hasty conclusions. In middle age, many things can cause memory loss or mental fuzziness, to say nothing of confused thinking--menopause, for example, whose effects can be eased with estrogen-replacement therapy. Also, keep in mind (remember?) that age takes a very normal toll on what psychologists call processing speed--the rapidity with which you can summon up the names of people and places. Our brains, in any case, have evolved with a certain built-in forgetfulness, lest they become hopelessly cluttered with useless information.

In older people too, memory problems may be the result of poor diet, vitamin deficiencies or glandular imbalances (all reversible with treatment) rather than the classic types of dementia associated with old age. Even if a physician ultimately diagnoses Alzheimer's disease--which is done by eliminating other possibilities rather than by a direct test, because none is available other than a brain biopsy--the news needn't be as bleak as it once might have seemed.

The mind-robbing disease is still incurable, and the drugs that are currently available only ease certain symptoms like anxiety, confusion and insomnia or slightly slow down its relentless progression. Still, Alzheimer's assault on the brain varies enormously from person to person. Even five or 10 years after a diagnosis, some people have only modest memory loss while retaining old skills like the ability to play golf or sail a boat--or, for that matter, to recall long-ago happenings. Alzheimer's, moreover, is one of the hottest areas of scientific research. Already scientists have identified some of the genes involved in the growth of the nerve-cell-killing plaques in the brain that are widely suspected to be at the root of the disease. These discoveries make it quite likely that we'll start seeing the first effective therapies for Alzheimer's in the next few years.

--By Frederic Golden