When memory loss strikes in an older adult, Alzheimer’s Disease is often one of the first thoughts that come to mind. While Alzheimer’s is the most common form of dementia, there is always the possibility that memory loss could not be related to dementia at all. There are other medical conditions, besides Alzheimer’s, that can cause memory loss:
1. Delirium
Delirium is associated with impaired memory, orientation, attention, and concentration. Lots of things can cause delirium but it is often seen in older adults during times of illness or if taking a lot of medication.
It would not be uncommon for an elderly person to develop something as simple as a urinary tract infection (UTI) and then develop the symptoms listed above. You can also expect for the symptom to improve significantly with the treatment of the underlying cause. The onset is usually quick in presentation for delirium whereas Alzheimer’s typically has a slower progression of significant symptoms.
2. Depression
Memory loss can be a major complaint about those suffering from a depressive disorder. When depression presents in this way it is often referred to as “pseudodementia” or “dementia of depression”.
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When a person has depression, they may experience impaired concentration and memory along with a slowing of their thoughts and movements. In older adults, special testing may be necessary to try to determine if memory loss is the result of Alzheimer’s Dementia or depression.
A study by Harvard Medical School researched the relationship between depression and how your brain functions.
What they discovered was a significant link between worsening depression symptoms and declining cognition over two to seven years that was influenced by Alzheimer’s disease pathology, as measured by PET imaging of brain amyloid.
“Our findings offer evidence that in healthy older adults, depression symptoms together with brain amyloid may be associated with early changes in memory and in thinking,” explained Jennifer Gatchel, HMS assistant professor of psychiatry and a geriatric psychiatrist at Mass General and lead author of the study.
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“Depression symptoms themselves may be among the early changes in the preclinical stages of dementia syndromes. Just as importantly, these stages represent a clinical window of opportunity for closely monitoring at-risk individuals and for potentially introducing interventions to prevent or slow cognitive decline,” Gatchel said.
Mass General researchers also learned from their extensive work that not all older adults with depression symptoms and cortical amyloid will experience failing cognition.
Other risk factors investigated by the authors that could modify the relationship between depression and cognition include brain metabolism and volume of the hippocampus, the part of the brain associated with learning and forming of new memories.
3. Vitamin deficiencies
Part of the physical workup for someone presenting with memory loss should include a complete blood count and a vitamin B12 level due to the fact that B12 deficiency can present with mental sluggishness and fatigue.
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4. Low thyroid
Having a low level of thyroid hormone can often cause poor concentration, slower thought processing, impaired short-term memory, and slower movements. In rarer cases, thyroid disorders can lead to confusion and disorientation.
Reduced thyroid function, called hypothyroidism, slows the metabolism, leading to weight gain, while elevated thyroid activity, called hyperthyroidism, speeds up the metabolism, leading to weight loss. While the effects on body weight are often the most visible, changes to thyroid function impact all metabolically active tissues, including the most energetically demanding organ- the brain.
The brain is highly sensitive to levels of thyroid hormone. Insufficient thyroid hormone during development can result in mental retardation. In adults, clinical hypothyroidism is a cause of cognitive impairment which can be reversible upon the restoration of thyroid hormone levels
5. Sexually transmitted diseases
Those who are HIV positive can have substantial memory impairment, slow thought processes, impaired concentration and attention, and an overall decrease in the ability to organize the thoughts and actions required to function from day to day.
It is important to remember that even though Black Americans make up 12 percent of the U.S. population, they make up 44 percent of new HIV diagnoses. Also, syphilis, if not treated, can lead to severe illness with forgetfulness, impairment in judgment, and personality changes that can closely resemble dementia.
While it can be difficult to tell at first glance if your loved one’s memory deficit is Alzheimer’s Disease, the one thing that is important to remember is that the first step should include a medical workup to rule out any other causes of dementia, including the issues above.
This is generally started with your primary care physician and you can be referred to specialists as needed based upon the findings. It is also common to send those with memory deficits such as for testing with a psychologist who can help determine the cause of memory impairment.
Dr. Nicole Washington is a board-certified psychiatrist, speaker, author and host of The C-Suite Confidant, a biweekly podcast covering topics pertinent to mental wellness for the high performer. She enjoys discussing and providing education on all things mental wellness in hopes of decreasing the stigma associated with mental health issues.
