One of the questions most often asked is: “Are those actions normal or not normal for my mother?” Change in our cognitive processing is normal as we age. Our thinking slows down, and we may need extra time to respond, but that is normal as we age. Normal age-related declines are subtle and mostly affect the speed of thinking and concentration, often called mild cognitive impairment (MCI). These signs may be more noticeable during middle age (40s, 50s, and early 60s), however, only when those signs become significant and impair normal daily functions should they be of concern.
Forgetting where you last placed your glasses is normal when you can retrace your steps and remember where they were placed. Unable to remember a person’s name shortly after meeting them is also not unusual as we age. Many of us get a little more forgetful as we age. Most will need a bit longer to remember things, get distracted more easily, or struggle to multi-task as well as we once did.
Our ability to process slows down and may need additional time and aids in remembering things. Cognitive changes are normal, at times a nuisance, and can be very frustrating. It is important to realize these changes may be the result of normal aging and are not signs of dementia. These are signs of normal cognitive decline as we age and typically do not impact our ability to perform daily activities like driving, dressing, cooking, and shopping.
However, placing keys in the refrigerator and a carton of milk in the pantry may be a sign of dementia. Forgetting the name of a family member or close friend, unable to recall a recent phone call, or not recognizing your location are signs of more severe cognitive impairment bordering on dementia.
Dementia impacts daily life and the ability to carry out everyday tasks. Often it is difficult to determine exactly when a person should be concerned with the cognitive changes they may be experiencing. Symptoms vary from person to person. What is normal for one person may not be normal for another and determining the level of decline is often a challenge. Dementia is not a normal aging of the brain and professional testing will help determine if the decline is or is not within normal levels for that age.
The table below is a sample of symptoms between normal and not normal and should be used as a guide to determine if more comprehensive evaluations should be performed. Always include your healthcare provider to ensure the best options are presented and discussed.
| Action | |
| Normal | Not normal |
| Balance | |
| Stumbles or trips that are recovered quickly | Repeated falls and loss of balance |
| Walking slowly or needing support to walk | Shuffling or uneven gait |
| Language | |
| Having a bit of trouble finding the right word sometimes | Having frequent problems finding the right word or referring to objects as ‘that thing’ |
| Needing to concentrate harder to keep up with a conversation | Having trouble following or joining a conversation |
| Losing the thread if distracted or many people speaking at once | Regularly losing the thread of what someone is saying |
| Orientation | |
| Getting confused about the day or the week but figuring it out later | Losing track of the date, season, and the passage of time |
| Making a wrong turn going to a familiar place | Forgetting how to get to a familiar place and not being able to retrace steps or remembering even if reminded. |
| Going into a room and forgetting why you went there, but quickly remembering again | Getting lost or not knowing where you are in a familiar place |
| Personality, mood, and behavior | |
| Sometimes being weary of work, family, and social obligations | Becoming withdrawn and losing interest in work, socializing or hobbies |
| Sometimes feeling a bit low or anxious | Getting unusually sad, anxious, frightened, or low in self-confidence |
| Developing specific routines and becoming irritable when a routine is disrupted | Becoming irritable or upset at home, work, with friends, or in familiar places |
| Needing more time to plan and organize activities | Unable to plan or organize activities |
| Occasional short temper or non-interest | Loss of temper or complete apathy |
| Eating less but still enjoying food as before | Loss of appetite or changes in eating habits |
| Occasionally forgetting personal hygiene (shaving, showering, brushing teeth) | Lack of personal hygiene |
| Planning, problem-solving, and decision-making | |
| Being a bit slower to react or think things through | Getting very confused when planning or thinking things through |
| Taking longer to complete tasks | Unable to complete tasks or distracted to the point of forgetting the task altogether |
| Getting less able to juggle multiple tasks, especially when distracted | Having a lot of difficulty concentrating |
| Making an occasional bad decision | Frequently poor judgment when dealing with money or assessing risks |
| Forgetting the name of familiar item | Not recognizing an item or unable to determine function of item |
| Occasionally making a mistake when doing family finances | Having trouble keeping track of monthly bills |
| Wearing mismatched clothes like uncoordinated colors or patterns | Wearing inappropriate clothing or incomplete clothing |
| ‘Short-term’ memory and learning new information | |
| Sometimes forgetting people’s names or appointments, but remembering them later | Forgetting the names of close friends or family, or forgetting recent events – for example, visitors you had that day |
| Repeating a story, especially from your past | Repeating a story you just related to someone |
| Occasionally forgetting something you were told | Asking for the same information over and over – for example, “Where are we going today?” |
| Misplacing things from time to time – for example, your mobile phone, glasses or the TV remote – but retracing steps to find them | Putting objects in unusual places – for example, putting your house keys in the bathroom cabinet |
| Visual perceptual skills | |
| Vision changes related to cataracts or other changes in the eyes, such as misty or cloudy vision, sensitivity to light, poor night vision | Problems interpreting visual information – having difficulty judging distances on stairs, misinterpreting patterns, such as a carpet or reflection, can’t recognize common items |