Spotting memory loss in a loved one

You know a lot about the health of your loved ones. But would you recognize if a loved one had memory loss? It's not always easy. "You're less likely to notice cognitive changes if you're with a family member every day. It's more obvious when you see the person infrequently," says Dana Kelly, a neuropsychologist who specializes in dementia disorders at Harvard-affiliated Massachusetts General Hospital.

Normal vs. abnormal memory changes

Age does a number on the memory. Normal age-related changes make it harder to focus and recall details. "The complaints I hear often are that people sometimes forget why they walked into a room or can't remember the name of an acquaintance. Those aren't red flags for cognitive disorders," Kelly says.

More concerning examples of memory loss, she says, are frequently forgetting

• a close family member's name
• important conversations
• words for everyday objects
• bills that are due
• medication times or doses
• routes home from familiar destinations.

Under the radar

It can be hard to detect a potentially serious type of memory loss in a loved one. You might not be in a position to observe certain changes; for example, you may not realize that a family member "is having trouble at work, making frequent financial mistakes, falling for financial scams, or taking medications incorrectly," Kelly says. And no one wants to believe that a loved one has cognitive decline, so we might ignore certain signs.

To sharpen your ability to detect memory loss in a loved one, Kelly suggests noting incidents that happen consistently or those that seem uncharacteristic for your loved one. It may help to track the incidents on a calendar to find patterns.

What does it mean?

Memory loss symptoms don't automatically mean that your loved one has dementia. "Memory problems could come from other health-related issues, such as chronic stress, medication side effects, or an underlying health problem such as sleep apnea," Kelly points out. Those conditions can be treated, potentially reversing memory loss.

But sometimes memory loss is a sign of either mild cognitive impairment (MCI) or full-blown dementia, such as Alzheimer's disease or vascular dementia (caused by reduced blood flow to the brain from plaque in the arteries).

Beyond memory loss, dementia symptoms can include problems producing speech or understanding language, mood or personality changes, unusual behavior (such as wearing too many clothes), and difficulty with the type of mental abilities called executive function — multitasking, organizing, decision making, problem solving, and planning.

When you suspect memory loss

Talking to loved ones about memory loss can be difficult. Try to be gentle and respectful. "Tell them you've noticed they seem more forgetful than usual, less organized than they once were, or less able to get sentences out. Explain that you just want to know if they're okay and that you want to help," Kelly advises.

If your loved one has also noticed those changes, you can talk about how to proceed.

But brace for the possibility that your loved one might feel angry that you're pointing out mistakes, and that it may feel like an attack on intelligence or sanity. How do you respond? Kelly recommends making these points:

• Not all memory loss is permanent.
• A doctor can help uncover other causes, which might be reversible.
• A brain check-up as we age is as normal as a heart or vision check-up.

Being proactive

The first step in evaluating a possible memory problem is a visit to your loved one's primary care provider. It can help if you and other family members are present. "Share your observations from the last month, year, or years," Kelly says. "If there seems to have been a change over time, the health care provider may administer a five-minute screening test."

Based on the results, the clinician may recommend either keeping an eye on symptoms or getting more tests, such as blood work and brain scans (CT or MRI).

The provider may also refer your loved one to a neuropsychologist (who diagnoses cognitive disorders) or a neurologist (who treats brain disorders). Those experts may order cognition tests.

What comes next?

If there's a diagnosis of MCI or dementia, your assistance will be crucial. "Give your loved one space to process the diagnosis, and ask how you can support them," Kelly says.

She also recommends

• making a plan for the future, especially financially, if the condition is progressive
• evaluating if your loved one needs help managing medications, driving, cooking, cleaning, or running errands
• seeking support from friends, family, or support groups.

"A diagnosis can feel isolating," Kelly says. "Remind your loved one that this is the time to lean on family and friends, and that staying socially connected, not isolated, will help get you both through this."