Will I Lose My Memory?

Neither Alzheimer’s nor other forms of dementia follow a single trajectory. Some patients progress rapidly, while others remain vibrant, active and socially engaged for years. 

Even if you’re not concerned about your brain health, it’s a good idea to get a cognitive evaluation, so you have a baseline against which to measure changes you or others notice. 

At age 50, I did an online assessment through AARP’s Staying Sharp platform that allows me to compare myself to other women my age with a similar level of education. I did well but didn’t get perfect marks in every area. The key benefit is that I can redo the test and track any changes over time. 

You can also do a cognitive assessment in a doctor’s office, as part of the annual wellness visits paid for by Medicare. If you or your doctor is concerned, the doctor can check for other conditions that could be causing symptoms that mimic early dementia and that are treatable — such as thyroid disease, vitamin B12 deficiency, depression and sleep apnea. Your doctor or pharmacist should review your prescriptions; some common prescription drugs, as well as over-the-counter sleep aids, may have side effects that cause confusion, impact memory or worsen the symptoms of existing cognitive problems. 

Your doctor might also schedule a more thorough assessment with a specialist, who may perform an MRI, CT or PET scan that could reveal tumors, strokes or other problems that can cause dementia.

Many people I’ve spoken to feel that because there is no medical cure for dementia, there is little point in getting an early diagnosis. But undiagnosed cognitive impairment or dementia can be a source of ongoing stress and uncertainty, disrupting work and relationships. And a diagnosis can bring important benefits. Jason Karlawish, M.D., codirector of the Penn Memory Center and author of The Problem of Alzheimer’s, shared with me that early diagnosis helps people to understand the changes they’re experiencing, potentially begin treatments that might help with symptoms or even participate in clinical trials of new therapies. Critically, it allows people to make informed decisions about the future and put a plan in place. 

Many people live alone and don’t have natural caregiver networks. A diagnosis, Jason said, is a catalyst for the discussions we need to have: “Who will help me in the coming months and years, to make sure I remain safe, social, engaged?”

It’s important to bear in mind that you don’t lose capacity the day you’re diagnosed. Many people continue to live meaningful lives for years following a diagnosis. I met Terrie Montgomery on Zoom in 2022, seven years after she learned that she had early-onset Alzheimer’s. Terrie told me she first became concerned when she noticed she was forgetting passwords at work. Then one day, while driving, she found herself at a railroad crossing. For a moment she just didn’t know what to do and she panicked. After her diagnosis, Terrie became an advocate — along with two other African Americans living with dementia, she cofounded Black Dementia Minds (under the umbrella of the National Council of Dementia Minds). She remained active in spite of her doctor’s attitude. 

“The doctor told me it was terminal, there was no cure,” she said. “There was nothing like, ‘You can live with this disease.’ But just because you get this diagnosis doesn’t mean you’re going to die tomorrow. You have to live. And I wanted to live.” 

Terrie said that if she were a doctor delivering a dementia diagnosis, she would say, “You’ve got Alzheimer’s. But we have resources. We’ve come so far. Walk out of here thinking about the things you can do. Get in touch with a support team. Start doing things you’ve put off. Start living.”

Whether we feel perfectly sharp or are concerned about how we’re functioning, there is actually a lot we can do to support our brain health and lower our risk of dementia by 15 to 33 percent. Adopting healthy habits even late in life can make a difference. So while we await the development of more effective medical treatments, let’s take action where we can: Establish our cognitive baseline, learn to recognize concerning signs, adopt habits that can improve brain health and talk to our doctors if we’re concerned.

W. W. Norton & Company

This article is adapted with permission from AARP’s The Second Fifty: Answers to the 7 Big Questions of Midlife and Beyond by Debra Whitman (W.W. Norton & Company, September 2024), a guide to aging well in a changing America. One hundred percent of AARP’s royalties from the sale of this book support the charitable work of AARP Foundation.

Find The ­Second Fifty at aarp.org/Bulletin50 or wherever books are sold.