As you get older, you may experience a gradual loss of some thinking abilities. A significant changes may indicate another health condition.
Your mind is central to your identity. The sharpness of your thinking, your ability to communicate and connect with others, and the rich trove of memories you’ve collected over a lifetime all have enormous value.
As you get older, you may notice changes in some of your thinking skills, including cognitive decline. Cognitive decline is the gradual loss of thinking abilities such as:
- learning
- remembering
- paying attention
- reasoning
For some peopleTrusted Source, a small amount of cognitive decline occurs with age. But more significant changes can be a sign of a cognitive disorder. Injury, illness, and health habits can influence how much and how fast your cognitive abilities change over time.
This article explores how your cognitive abilities can change later in life. It also provides some practical guidance to help you keep your brain healthy as you age.
Cognitive decline looks different from person to person. That may be because people vary in their health profiles, life circumstances, and capabilities. Still, some patterns have emerged from the research.
People with mild cognitive decline might:
- have trouble finding the right words to express themselves, especially when compared with others of the same age
- lose or misplace things
- forget appointments and scheduled events
- become overwhelmed by complex tasks and projects
Keep in mind that typical forgetfulness is not the sameTrusted Source as cognitive decline. It’s not helpful to assume that regular forgetfulness is necessarily a sign of cognitive decline. Such worrying can affect your well-being.
A doctor can help you determine whether you’re experiencing typical signs of aging or symptoms of cognitive decline. They may assign you a brief self-screening test to check for symptoms of cognitive decline.
Self-Administered Gerocognitive Examination (SAGE) and other screening tests
There are several screen tests that you can use to check for signs of cognitive decline. These tests usually take about 3 to 15 minutes. They include:
- Self-Administered Gerocognitive Examination (SAGE)
- AD8 Dementia Screening Interview
- Quick Dementia Rating System (QDRS)
- Mini-Cog
SAGE is one of the most common screening tests. You can download the test online and complete it at home. You can also take it to a doctor’s office to complete.
SAGE differs from the other tests in that it is slightly more complex. A 2022 studyTrusted Source found that SAGE detected cognitive decline in people with MCI 6 months sooner than MMSE, another common test. According to a 2021 reviewTrusted Source, SAGE produces a correct result 79% of the time.
Note that these quick tests are not enough to diagnose cognitive decline or dementia on their own. If your score shows some decline, it may be a sign for a doctor to do a more thorough evaluation.
Neuropsychological tests
In an evaluation, doctors often use neuropsychological tests to see whether your thinking and memory skills are changing. Some of the most common tests are:
- Mini-Mental State Examination (MMSE)
- Montreal Cognitive Assessment (MoCA)
- Sahlgrenska Academy Self-Reposed Cognitive Impairment Questionnaire (SASCI-Q)
- Subjective Cognitive Decline Questionnaire (SCD-Q)
- Memory Complaint Questionnaire (MCQ)
- Everyday Cognition (ECog)
- Clinical Dementia Rating (CDR) Scale
- 6-Item Cognitive Impairment Test (6-CIT)
- Hong Kong Brief Cognitive Test (HKBC)
Some of these tests are relatively new. More research is needed to understand how well they predict or measure cognitive decline.
Other tests
A doctor might order a blood test to see if something else — like hypothyroidism or a B12 deficiency — may be causing a change in your thinking abilities.
Brain imaging, such as magnetic resonance imaging (MRI), may help a doctor determine whether something like a stroke or brain tumor is at the root of your symptoms.
Experimental tests
Researchers are also looking into blood or spinal fluid testsTrusted Source that look for proteins linked to Alzheimer’s disease. These proteins are called beta-amyloid and tau.
In studies, brain imagingTrusted Source like MRI and PET scans can show changes in some parts of the brain.
The above tests may be able to detect changes in your brain up to 20 yearsTrusted Source before symptoms appear. But they’re often too costly, invasive, or complex to use for screening purposes. There’s ongoing research into simpler and more cost-effective screening tests.
There are many reasons you may experience age-related changes in thinking and memory. Sometimes, another health condition may be the cause. Examples include:
- high blood pressure
- vascular (blood vessel) disease
- depression
- sleep deprivation
- diabetes
Sometimes, a neurological condition such as Alzheimer’s Disease or frontotemporal dementia is the underlying cause.
Your genes and family history also play a role in whether you will experience cognitive decline as you get older. Genes may be responsible for up to 60% to 70%Trusted Source of the various ways cognition declines due to aging.
Each person is different. Your health behaviors have some influence on your brain function as you age.
A 2020 analysisTrusted Source of the Health and Retirement Study, which involved around 29,000 participants, found that women first experienced cognitive impairment around age 73. Those women who went on to develop dementia did so at about 83 years old. Men, the study found, experienced cognitive decline near age 70 and dementia at 79 years.
It’s important to know that not everyone with cognitive decline will later have dementia.
The study also found that race and education level affect the age of onset.
For many Black and Latinx people in the United States, cognitive decline may begin 3 to 6 yearsTrusted Source earlier than for white people. Researchers think this disparity could be related to differences in healthcare access and accumulated stress (“weathering”) over a lifetime.
People with higher education levels tend to experience cognitive decline at a later age. This may be because they stay active mentally and have more social connections later in life, researchers said. They may also have greater access to healthcare and earlier treatment of medical problems.
Genes and family history are major risk factors for cognitive decline. But other factors may also lead to faster or more noticeable decline. These include:
- diabetes
- high blood pressure
- stroke
- smoking
- high cholesterol
- hearing loss
Some of these factors you can control, and some you can’t. Try working with a healthcare team to create a plan to stay healthy — mentally and physically.