What to Know About Cognitive Decline in Older Adults

Medically Reviewed by Jennifer Robinson, MD on May 01, 2023
3 min read

Cognitive decline in older adults refers to the concern of or difficulty with a person’s thinking, memory, concentration, and other brain functions beyond what is typically expected due to aging.

Cognitive decline, also known as cognitive impairment, can come on suddenly or gradually, and it can be permanent or temporary. It can be scary for the person experiencing the symptoms as well as their family and friends.

If you’re worried about an older person’s cognitive abilities, there often are some underlying health issues affecting the mind’s function.‌ Those need to be detected and treated if at all possible. It’s recommended that you seek help from your doctor. 

Your brain, like the rest of your body, changes as you grow older. It's common to notice increasing forgetfulness as you age. It may take longer to think of a word or to recall a person's name. But consistent or increasing concern about your mental performance may suggest cognitive impairment. Some of the most common signs include:

  • ‌Forgetting things more often
  • Forgetting important appointments or social engagements
  • Losing your train of thought or a thread of conversations, books, or movies
  • Feeling increasingly overwhelmed by making decisions, planning steps to accomplish a task, or understanding instructions
  • Experiencing difficulty finding your way around familiar environments
  • Becoming more impulsive or showing increasingly poor judgment
  • Your family and friends notice changes

Challenges with memory, thinking, or other brain processes are often due to more than one cause. Some of the most common causes of cognitive decline in older adults include:

Medication. Sedatives, tranquilizers, and anticholinergic medications are the most common types of medicine that interfere with proper brain function. Anticholinergic drugs block the chemical (neurotransmitter) released by nerve cells to send signals to other cells. This can affect muscle contractions in the body as well as learning and memory in the brain.

Blood chemistry.Kidney or liver dysfunction can cause different types of imbalances in your blood chemistry, sometimes affecting brain function. Unusual blood sodium levels, calcium, and glucose can also affect your blood chemistry, causing cognitive decline.

Problems with hormones. Imbalances in estrogen and other sex hormones may impact cognitive function.

Vitamin deficiency. Low levels of vitamin B12, other B vitamins, and folate often affect brain function.

Delirium. Delirium is a condition that includes confused thinking and reduced awareness of one’s surroundings. It is widespread in hospitalized older adults and can also occur due to infection or other health problems in older people who are not hospitalized.

Psychiatric conditions. Most psychiatric conditions can cause problems with memory, thinking, or concentration. Depression and anxiety, bipolar disorder, schizophrenia, or other forms of major mental illness are the most common contributing factors.

Substance abuse. Overuse of certain substances (such as alcohol, drugs, or even prescription drugs) can impair brain function.‌

Injury. Two main types of injury can cause cognitive decline. For instance, strokes can cause vascular damage to neurons. Head injuries can also create temporary or long-term cognitive decline.

Neurodegenerative conditions. The most common conditions that cause cognitive decline include Alzheimer's disease, Lewy-Body disease, Parkinson's disease, and frontotemporal degeneration (damage and loss of nerve cells in the brain).

Toxins. Other potential causes of cognitive decline are toxins like heavy metals, air pollutants, contaminants in your drinking water, and pesticides.

Also keep in mind that other medical conditions and lifestyle decisions may cause an older adult to be at a greater risk of experiencing cognitive change, including:

  • ‌Diabetes
  • Smoking
  • High blood pressure
  • High cholesterol
  • Being overweight
  • Depression
  • Lack of physical exercise
  • Low education level
  • Lack of mental engagement or socially stimulating activities

Certain activities can assist older adults in adapting as they age and increasing their capacity to learn. For instance, doing activities like complex memory tests may help mental abilities like vocabulary improve.

Stay socially active. Research indicates that social activities can help prevent cognitive decline by challenging people to communicate and stimulating the mind.

Keep learning. Reading books and magazines, playing board games, going to museums, and playing musical instruments all help reduce the risk of cognitive decline.

Exercise. Exercise helps by improving your mood, reducing stress, and reducing other risk factors that can lead to cognitive decline.

Eating a healthy diet. Eating a nutritious diet may help prevent cognitive decline by providing your body with nutrients that can reduce the risk of high blood pressure, type 2 diabetes, and high cholesterol.

If you are concerned about cognitive impairments like memory loss, do not try to diagnose yourself. Your doctor can provide everything from assessment and counseling to treatment.