As we age, it’s normal for our brains to change. But dementia — an umbrella term that’s used to describe loss of memory, language, and thinking abilities — isn’t a normal part of aging. Contrary to popular belief, dementia is not age-related. Dementia is a neurodegenerative condition that interferes with daily life.
Unlike dementia, typical age-related changes in thinking are subtle and generally affect speed, recall, and attention. However, seniors with severe symptoms and trouble completing day-to-day activities independently may be diagnosed with dementia.
Learn the differences between normal aging versus dementia, the links between memory and aging, and how to care for a loved one experiencing cognitive decline.
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For older adults, any lapse in memory, no matter how slight, can be alarming. However, brief periods of forgetfulness are a normal part of the aging process and usually do not indicate a dementia diagnosis. Old age dementia is not a condition in and of itself.
From birth to old age, a healthy brain goes through transformations that affect emotion, learning ability, and decision-making skills. As we age, brain cell communication and blood flow typically decrease, according to the National Institute on Aging.[01]
Certain parts of the brain shrink, including those important to complex mental activities and learning. And, inflammation — the body’s response to injury or disease — can also increase as people age, leading to mild cognitive impairment (MCI).
Because of these age-related brain changes, an impaired memory is normal for most adults.
Impaired memory function is the most widely seen cognitive change associated with aging. Memory itself is divided into four types:
Decline in episodic and semantic memory is most commonly associated with normal aging. Episodic memory starts declining in middle age, while semantic memory increases in middle age and declines in the late elderly stages. Decline in procedural and working memory is not typical of normal aging and could be a sign of dementia.[02]
After age 40, the average adult loses 5% brain volume each decade.[02] Older adults may be slower to find the right words or recall names, have difficulty with multitasking, and learn new skills slower than before.
Dementia is a general term for severe cognitive impairment, which goes beyond the mild cognitive decline expected from normal aging. People who have dementia have problems with memory, language, thinking, and problem-solving that worsen over time. These issues are significant enough that they gradually affect activities of daily living, behaviors, emotions, judgment, and communication.
After age 65, the risk of dementia doubles approximately every five years, and by age 85, the risk reaches nearly one-third.[03] Although age is an important risk factor for dementia, it is not a cause of it.
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Dementia comes in many forms and can be caused by a number of brain and central nervous system disorders. Two of the most common types of dementia are Alzheimer’s disease and vascular dementia. Other types of dementia include frontotemporal dementia, Lewy body dementia, Creutzfeldt-Jakob disease, and Huntington’s disease, with the last two being the rarest. Dementia patients can also experience more than one type of dementia at a time, with a diagnosis of mixed dementia.
See below for a comparison of the various types of dementia behaviors against normal aging behaviors.
Alzheimer’s disease is caused by changes in the brain, including abnormal buildups of certain proteins — known as amyloid plaques and tau tangles — and a loss of connections between nerve cells.[04] On the other hand, vascular dementia is caused by different conditions, such as strokes and hemorrhages, which interrupt the flow of blood and oxygen to the brain.[05]
Alzheimer’s disease and vascular dementia have similar symptoms. Take a look at this normal aging versus dementia chart to help you identify the differences between normal aging and two of the most common forms of dementia [06]:
| Common in normal aging adults | Common in Alzheimer’s disease and vascular dementia patients |
|---|---|
| Planning and decision making | Planning and decision making |
| Makes poor choices once in a while | Makes poor decisions more frequently, and seems to lack judgment in diverse settings |
| Finds it hard to multitask, but is able to focus on a single task | Struggles with staying focused on a single task |
| May miss an important deadline once or twice a year (for example, a monthly payment) | Struggles with all important deadlines such as monthly bills |
| Memory and learning | Memory and learning |
| Forgets things they were told a while ago | Forgets things they were recently told |
| Loses or misplaces things sometimes, but is able to eventually find them | Places important items, like keys, in unusual places |
| Takes longer to learn new tasks | Is unable to learn new tasks |
| Orientation | Orientation |
| Forgets which day it is, but remembers it later | Loses track of the date, season, or time of year |
| Gets lost in an unknown place, but eventually finds their way | Gets lost in familiar or easy-to-navigate places, such as a grocery store |
| Mood and behavior | Mood and behavior |
| Reluctant to participate in work, family, and social meetings sometimes | Complete loss of interest in work, friends, or hobbies |
| Feels down or anxious sometimes | Feels unusually sad, anxious, or frightened |
| Becomes irritable with routine changes, but can eventually cope | Gets easily upset at home, work, or with friends in places that usually feel comfortable or familiar |
| Language | Language |
| Forgets which word to use sometimes, but eventually remembers it | Has frequent problems finding the right word to use |
| Needs to concentrate harder to keep up with some conversations | Struggles to take part in regular conversations |
| Loses train of thought or gets confused in a conversation with many distractions | Is unable to follow what someone is saying even without distractions |
Frontotemporal dementia (FTD) is a progressive disorder caused by damage to the frontal and temporal lobes of the brain.[07] There are three types of FTD — behavioral variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and movement disorders.
Here is a breakdown of common FTD symptoms categorized by each type:
| Behavioral variant frontotemporal dementia (bvFTD) | Primary progressive aphasia (PPA) | Movement disorders |
|---|---|---|
| Finds it difficult to plan and sequence behaviors or events | Finds it difficult to use or understand some words | Loses mobility in hands or arms |
| Struggles to prioritize tasks or activities | Struggles with speaking: slurred speech, loss of words, or inability to speak | Experiences muscle stiffness |
| Repeats the same words over and over again | Aimlessly wanders | Has difficulty swallowing |
| Acts impulsive or inappropriate | Acts impulsive or inappropriate | Struggles with balance and walking |
| Shows apathy and lacks empathy | Experiences changes in appetite | Troubles with eye movements |
Note: Some of the above symptoms, like muscle stiffness and apathy, can be associated with normal aging. So, be sure to look for other signs as well if you suspect dementia, such as pronounced behavioral and physical changes.
Lewy body dementia, also known as DLB, is a type of dementia caused by Lewy body disease — a disease in which tiny clumps of proteins — known as Lewy bodies — form in the nerve cells of the brain.[08] These Lewy bodies typically form in areas of the brain that are involved in memory, thinking, and movement. They overwhelm the normal biological functions of brain cells, causing them to die.
Lewy bodies cause a range of symptoms, some of which overlap with Alzheimer’s disease and Parkinson’s disease, often causing misdiagnoses of Lewy body dementia. Approximately one in 10 people with dementia have Lewy body dementia, according to recent findings.[09]
The most common symptoms of Lewy body dementia include changes in cognition, movement, sleep, and behavior. Here is a chart of distinctive Lewy body dementia symptoms versus some Lewy body dementia symptoms that overlap with symptoms of normal aging:
| Symptoms distinct to Lewy body dementia | Symptoms of Lewy body dementia that overlap with normal aging |
|---|---|
| Visual hallucinations and delusions | Muscle stiffness |
| Unpredictable changes in concentration, attention, alertness, and wakefulness | Slowed movement |
| Smaller handwriting than usual | Difficulties with balance |
| REM sleep behavior disorder | Restless leg syndrome |
| Insomnia | Urinary incontinence |
| Sudden onset of depression, anxiety, or paranoia | Sensitivity to heat and cold |
Mild cognitive impairment (MCI) is an early stage of memory loss, between the expected cognitive decline of normal aging and the more serious decline of dementia. Older adults with mild cognitive impairment typically have more memory or thinking problems than the average person.[10]
Symptoms of MCI aren’t as severe as dementia symptoms and may include the following:
People with MCI do not typically experience personality and behavioral changes that are commonly associated with dementia and are able to take care of themselves and do their normal activities. However, MCI can signal a predisposition to developing full-blown dementia later on, so it’s important to act now on dementia prevention.
If you suspect that your loved one may have dementia or MCI, keep track of their symptoms so you can be prepared to talk to a doctor about them. To evaluate whether someone has dementia, doctors will typically follow a similar process:
A cognitive test is used to assess thinking and physical functioning, while brain scans can help identify strokes, tumors, or other problems that can lead to dementia. Furthermore, learning about your loved one’s mental health, genes, and amyloid protein presence can help doctors determine the cause of your loved one’s symptoms.
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A number of factors contribute to a person’s future risk for cognitive decline. Some risk factors — like age and genetics — aren’t in your control. But you do have some control over risk factors like exercise and diet. Whether or not your loved one is in a high-risk age or genetic group, you can help reduce future risk for dementia with the following lifestyle choices:
If symptoms or signs of dementia are increasing in your loved one, talk to their doctor. It’s important to note warning signs and symptoms, like those noted above, so you can determine next steps. Doctors may also help you identify underlying causes and navigate a potential diagnosis.
In the case of a dementia diagnosis, be sure to consider the best care options for your loved one. Depending on the stage of dementia, it may be time for in-home care or memory care. Speak to a Senior Living Advisor at A Place for Mom today — they’ll happily offer free advice and local solutions catered to your loved one’s unique needs.
National Institute on Aging. National Institute of Health. (2020, October 19). How the aging brain affects thinking.
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