forgetfulness

and Carola Felchner, science journalist

Ingrid Müller is a chemist and medical journalist. She was editor-in-chief of for twelve years. Since March 2014 she has been working as a freelance journalist and author for, among others, Focus Gesundheit, the health portal ellviva.de, the publishing house living crossmedia and the health channel of rtv.de.

More about the experts

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Forgetfulness is not uncommon: It is easy to forget the name of a friend or forget the milk while shopping. Individual memory failures are not yet a sign of illness. Even in old age, forgetfulness does not necessarily have to indicate dementia. There may be other reasons why memory content cannot be called up. Read more about the causes of forgetfulness and what you can do about memory lapses here.

Brief overview

Does forgetfulness mean dementia? No, some level of forgetfulness is normal. Only a noticeable and continuous decrease in memory can be a warning signal for a serious memory disorder such as dementia.
How much forgetfulness is normal? There is no general guide value here. If you forget something now and then, you usually don't have to worry. If the memory gaps accumulate and / or other symptoms occur (misplacing things, loss of orientation, etc.), you should see a doctor.
Causes of forgetfulness: i.a. Stress, exhaustion, certain medications, alcohol abuse, dementia (such as Alzheimer's), meningitis, epilepsy, sleep apnea, kidney or liver failure, heart failure, thyroid disease, anemia, mental disorders
Forgetfulness - what to do? In the case of existing forgetfulness and for prevention, memory training, stimulating hobbies, healthy eating, regular exercise and relaxation are recommended.
This is what the doctor does in the event of forgetfulness: Carrying out tests to clarify the cause precisely, then initiating suitable therapy (e.g. with medication).

How much forgetfulness is normal?

Many people immediately associate forgetfulness with the diagnosis “Alzheimer's” or “dementia” in general. But that's wrong - not everyone who is forgetful is also demented or otherwise ill. Everyone forgets something every now and then - young as well as older. This is not a weakness, but a necessary mechanism of the brain to protect itself from overstimulation. A certain “bogus” is therefore normal, as long as it is kept in moderation and not intensified.

It is also normal to be more forgetful in old age or to be unable to remember some things (exactly). Because over the years, the processes by which the brain stores and retrieves memory information also slow down. The cells then transmit the information more slowly, and memory deteriorates. That means: Even in older people, forgetfulness does not necessarily indicate dementia (like Alzheimer's). In the elderly in particular, for example, a lack of fluids is often the trigger for forgetfulness. Even with stress and exhaustion, your memory can let you down.

However, such memory gaps or even confusion should not increase noticeably. If that does happen, it can indicate a reduced memory performance that goes beyond "harmless" forgetfulness. Possible reasons for this are insufficient cerebral blood flow due to "calcified" arteries, depression, anxiety disorders, alcohol abuse - or even dementia.

When does forgetfulness become pathological?

It is difficult to say when forgetfulness will go beyond normal standards. Some people think they are forgetful if they forget their debit card pin. Others don't worry even if they misplace something every other day. It is therefore difficult to define "normal" precisely.

Basically, however, it can be said: changes in memory performance that last longer than six months and are also noticeable to third parties can be warning signals that should be clarified by a doctor. Such changes can be, for example:

You often forget appointments, names, passwords, etc.
Quite often everyday words and concepts no longer occur to you.
Occasionally you have the feeling that you are not familiar with places you know.
They often misplace things (keys, glasses, slippers, remote control, etc.).
Actually familiar actions such as ironing or changing a lightbulb are difficult for you.

The alarm bells should ring because they may be signs of advanced memory impairment:

Repeatedly asking the same question, although the person in question has already received the answer (several times).
Repeatedly telling the same story within a short period of time (e.g. an hour) to the same person
Problems with everyday activities and movements (e.g. cooking food but forgetting to bring it to the table)
Difficulty remembering events that happened just a few minutes ago
not just forgetting details or certain facts, but entire events

Orientation problems, even in familiar surroundings
little drive, social withdrawal

Forgetfulness: causes and possible diseases

Difficulty concentrating and forgetfulness can have many reasons. The most important are:

dementia

Dementia is an umbrella term for various diseases, all of which impair mental performance and the ability to think. Affected people have difficulty absorbing and reproducing new things. Orientation as well as speaking and arithmetic are also impaired. Ultimately, your entire personality also changes.

Important forms or causes of dementia:

Alzheimer's: The most common form of dementia is Alzheimer's disease. In those affected, brain cells progressively perish - it is not known exactly why. What is certain is that there is a lack of acetylcholine (a neurotransmitter) in the brain of those affected. In addition, protein deposits form in the brain, which could be responsible for cell death.
Vascular dementia: Vascular dementia is the second most common type of dementia. It is based on circulatory disorders in the brain. Small strokes are responsible for this. The memory can be retained significantly longer in vascular dementia than in Alzheimer's disease - forgetfulness therefore only occurs later in the course of the disease.
Lewy body dementia: In Lewy body dementia, protein deposits form in the brain - as in Alzheimer's disease. Therefore, both forms of dementia show similar symptoms. Typical of Lewy body dementia, however, are visual hallucinations and strong fluctuations in mental performance and alertness over the course of the day.
Frontotemporal dementia: In people with frontotemporal dementia (FTD), it is primarily the personality and interpersonal behavior that change - those affected behave conspicuously and unsocially. Your memory, on the other hand, is retained for a long time. In FTD, nerve cells die mainly in the frontal and temporal lobes of the brain.
Creutzfeldt-Jacob disease: Creutzfeldt-Jacob disease manifests itself in a rapidly progressing dementia - with disorders of attention, memory, concentration and memory. In addition to dementia, there are motor disorders (such as muscle twitching). The cause is the deposition of atypical protein fragments (prions) in the brain.
Veitstanz: This is the old name for the hereditary nerve disease Huntington's disease. In addition to other symptoms, those affected also develop progressive dementia.
Parkinson's disease: About a third of all people with Parkinson's disease (paralysis) also develop dementia in the later course of the disease. Doctors speak of Parkinson's dementia here.
HIV / AIDS: If the HIV disease is advanced, the brain can also be affected. The result is what is known as HIV encephalopathy, which is associated with dementia symptoms (HIV dementia or AIDS dementia).

Other diseases

Forgetfulness can also be related to other illnesses. Examples are:

Meningitis (meningitis): Forgetfulness, poor concentration, confusion and drowsiness up to a coma (rarely) can occur here. The most common causes are bacteria or viruses.
Inflammation of the brain (encephalitis): People with meningitis can also develop encephalitis in some cases. Symptoms include impaired consciousness, forgetfulness, or confusion.
Sleep apnea: People with sleep apnea experience repeated pauses in breathing during sleep. The night's rest is significantly impaired. Frequent consequences are tiredness, forgetfulness and poor concentration during the day.
Chronic Fatigue Syndrome (CFS): Also called chronic fatigue syndrome. Typical of the disease is severe mental (and physical) exhaustion with poor concentration, forgetfulness or irritability.
Thyroid disorders: Both overactive (hypertyhreosis) and underactive (hypothyroidism) can be associated with forgetfulness, orientation difficulties and memory problems.
Acute kidney failure: It can manifest itself through memory disorders, poor concentration and forgetfulness, among other things. The same applies to chronic kidney failure (chronic kidney failure).
Liver failure: Liver failure (for example as a result of cirrhosis or hepatitis) can damage the brain. Symptoms are forgetfulness, poor concentration and even loss of consciousness (hepatic coma).
Severe heart failure: Many people with severe heart failure have forgetfulness, memory problems, and thinking problems.
Pronounced anemia: Anemia, mainly caused by an iron deficiency (iron deficiency anemia), can limit mental performance. Forgetfulness and memory problems are some of the possible signs. Vitamin B12 deficiency anemia can also trigger forgetfulness, poor concentration and fatigue.
Epilepsy: Not only the typical convulsions, but also poor concentration, forgetfulness and perception difficulties can occur in connection with epilepsy.
Brain trauma: Traumatic brain injuries can damage nerve cells, so that mental performance can be impaired as a result.

Mental disorders

Depression can also affect memory: Among other things, it can lead to a loss of mental performance, forgetfulness, poor concentration and memory problems.

Anxiety disorders can also affect the brain and trigger forgetfulness - possibly also due to certain drugs that are taken against the pathological fear.

Other causes of forgetfulness

There are other factors that can negatively affect memory. Some of them are:

Alcohol abuse
Cancer therapies, especially chemotherapy (so-called "chemobrain")
various medications (e.g. sedatives)
stress
sleep disorders
Tiredness, exhaustion
Lack of fluid and food (especially in the elderly)

Forgetfulness: What Can You Do By Yourself?

You can prevent forgetfulness by maintaining a lifestyle that is as healthy as possible. These include:

Eat a balanced diet.
Make sure you get regular exercise.
Don't drink too much or too often alcohol. Even better: do without it altogether!
Relax regularly, especially if you are stressed or have trouble sleeping. Relaxation techniques such as yoga, autogenic training or progressive muscle relaxation according to Jacobson are helpful.
Exercise your brain regularly. Find hobbies that challenge you mentally (e.g. reading, playing a musical instrument or chess).
Meet friends! Social contact with other people also seems to be good for the brain.

Memory training

A person has around 100 billion nerve cells, of which only a small fraction is used. However, those who do not regularly use their gray cells risk that they wither and lose performance. Forgetfulness or poor concentration can result. With age, the number of nerve cells decreases anyway without any action!

Memory training has not been proven to protect against dementia, but your gray cells are still happy when they are challenged. With a bit of training, you can quickly and effectively increase your memory - the memory for numbers, terms, people or images can be improved in this way.

People who already suffer from dementia can also benefit from brain jogging. However, normal forms of memory training are less suitable for people with dementia. Because dementia robs those affected from the opportunity to memorize something, to build up and improve memory. Here it is more helpful if the patients activate their memories that are stored in long-term memory.

Important: The exercises must be fun for those affected and give them a sense of achievement! These do not primarily help against forgetfulness, but strengthen self-esteem, which can suffer from forgetfulness!

Forgetfulness: what does the doctor do?

If there is any suspicion that your forgetfulness may be due to a serious memory disorder, various examinations and tests can help. If the suspicion is confirmed, the doctor will suggest an appropriate treatment.

diagnosis

First of all, the doctor will collect information about your medical history during the conversation (anamnesis). Possible questions are, for example:

How often does your memory let you down?
Since when has the forgetfulness existed?
Do you have the impression that your forgetfulness is increasing?
Can you no longer remember things that used to be no problem for you?
Are you no longer able to carry out familiar work processes correctly?
Do you take any medications? If yes, which?

Dementia tests

If the doctor suspects that you may develop dementia, neuropsychological dementia tests can help. During these tests, the doctor observes, among other things, how focused you are doing certain tasks and whether you have difficulty concentrating.

The watch test is particularly well-known: the doctor presents you with a piece of paper with an empty circle on it. In this circle you should then enter the digits of a clock and draw the hour and minute hands in such a way that they show a specific time. People with dementia often fail to do this.

Further investigations

A physical exam is also routinely done, including blood pressure measurements. In order to find out more about the condition and performance of the nervous system, the doctor will, among other things, test the muscle and pupillary reflexes (as part of a neurological examination). Further examinations depend in part on what the doctor suspects is the cause of the symptoms.

Imaging examinations can be particularly helpful: if computed tomography (CT) or magnetic resonance imaging (magnetic resonance imaging, MRI) can be used to determine a shrinkage of the brain, this suggests dementia as the cause of forgetfulness. If liver disease or kidney failure is suspected, the doctor will do an abdominal ultrasound, among other things.

A measurement of the heart currents (EKG) provides information about the heart rhythm and heart rate. This is important, for example, if a heart failure is suspected. A measurement of the brain waves (EEG) allows an assessment of the brain activity.

An examination of the nerve water can also be helpful (liquor diagnostics). To do this, the doctor takes a sample of the nerve fluid from the spinal canal with a thin hollow needle (lumbar puncture).

If Parkinson's is suspected, in addition to the above-mentioned procedures, the doctor also carries out an L-Dopa test and a special form of computed tomography - Single Photon Emission Computed Tomography (SPECT).

Sleep apnea syndrome can be diagnosed with the help of sleep medical examinations in the sleep laboratory.

For example, blood tests can be useful if you suspect liver failure, kidney failure, thyroid disease, anemia, or alcohol and drug abuse. If the doctor suspects kidney failure, a urine test can also help. A laparoscopy will help clarify suspected liver diseases.

Psychological tests are used for mental disorders (depression, anxiety disorders) as the cause of forgetfulness.

therapy

Therapy for memory impairment depends on the cause.

There is no cure for dementia, but it can be treated with medication that slows it down. These include, for example, the so-called acetylcholinesterase inhibitors. Other substances are said to be able to improve the brain performance of dementia patients. For example, there are indications that a certain extract from ginkgo leaves (EGb 761) has a positive effect on the cognition of patients with mild to moderate Alzheimer's dementia or vascular dementia and non-psychotic behavioral symptoms.

Forgetfulness: when do you need to see a doctor?

Have you forgotten the milk while shopping or have you misplaced your glasses again? You don't have to worry about that right away. Not every mental dropout means you need to see a doctor right away. There can also be harmless causes such as stress, tiredness, lack of fluids or sleep disorders behind the forgetfulness.

However, if your memory strikes frequently (see the warning signs and alarms listed above), you should see a doctor to clarify the cause of your forgetfulness. Information from people close to you is often helpful in recognizing the onset of dementia.

However, there is no general statement as to when you should consult a doctor if you are forgetful. In any case, the first point of contact should be your family doctor. If necessary, he will refer you to a specialist (neurologist). There are also specialized reminder hours for people who suffer from (possibly pathological) forgetfulness.

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