Is It Normal Aging or Dementia? How to Tell the Difference

This morning I had a full-blown, 15-minute “Am I losing it?” panic.

I was reviewing my to-do list for the day: order birthday cupcakes, $ Store, call dermatologist.

I stared at it like it had been written by a stranger. What is a $ Store? Had I completely lost the ability to label a basic errand? Had I forgotten the word “ATM” and scrawled “$ Store” as some kind of substitute?

For the record, I was at least comforted in knowing there is no actual “money store” (and if there is, I’ve clearly been going to the wrong places).

Finally, it hit me. Dollar Store. I wanted to go to the Dollar Store next to McDonald’s.

Phew. Crisis averted. Brain still mostly operational.

But that little jolt of panic? That’s very real and very common as we get older. The moment you forget a name, lose your train of thought, or walk into a room with absolutely no idea why you’re there, the question creeps in:

Is this normal aging… or something more serious?

Aging is strange. At 25 you lose your keys because you were out partying. At 65, you lose your keys because you put them in the refrigerator next to the yogurt and somehow that felt logical at the time.

Today I'm detouring from my usual beat of sex and aging. Don't worry, that's not going anywhere. (A follow-up on how dementia affects sexual behavior and relationships is in the works.)

But dementia education has been a passion of mine since well before this blog existed. Early in my gerontology career, I conducted one of the first public opinion polls on Alzheimer's disease, and the results were striking: knowledge was low, fear was high. Since then, I've given talks for the Alzheimer's Association, written about dementia and aging, and counseled families navigating the early stages. So, let's talk about what's normal and what's not.

WHAT IS DEMENTIA, ANYWAY?

Dementia is the umbrella term for a decline in cognitive ability serious enough to interfere with daily life. It's more than just forgetting things. It also affects focus, language, problem-solving, completing tasks, and being oriented in time and place. Personality changes and emotional outbursts often come with it too.

Here’s a quick anatomy of the umbrella, because “dementia” isn’t one disease, it’s a category. (I know this part is drier, hang with me.)

• Alzheimer's disease: (the most common) a progressive neurological disease where the build-up of plaques and tangles damage how brain cells connect and form memories.

• Vascular dementia: blood flow issues to the brain affecting focus, problem-solving, and processing speed more than memory, often after strokes.

• Lewy body dementia: abnormal protein deposits in the brain, leading to problems with behavior, mood, and thinking.

• Frontotemporal disorders (FTD): degeneration of the brain's frontal and temporal lobes, and more common in people under age 65.

• Parkinson's disease: dementia often develops in the later stages.

SEVEN WARNING SIGNS OF DEMENTIA -- WITH REAL EXAMPLES OF PEOPLE I’VE KNOWN

1. Memory loss that disrupts daily life

Can't remember the name of the actor in that movie you watched yesterday? Totally normal. (His name will come to you at 2 a.m., I promise.) Forgetting the name of your partner or children? That’s different and a red flag.

Repetition is also a particularly telling sign. If family members are saying "you just told us that" or "you asked that same question ten minutes ago" and you have no memory of it, that’s a clue. Forgetting a grandchild's recent wedding you attended or needing sticky notes around the house explaining how to use the coffee maker aren't typical senior moments. They're worth paying attention to.

My mother was visiting and I was setting the table for dinner. She asked if I was going set a place for my father. Huh? This was in May and my father passed away in February. When my mother completely forgot my father had died just three months earlier, I knew something was wrong.

2. Challenges in planning or problem-solving

This one sneaks up on people because it often shows up in tasks we take for granted like following a recipe, paying bills, balancing a checkbook.

My mother's friend Betty was legendary for her chocolate cake. She baked it for every gathering for decades. Then the cake started tasting off. Her husband Ray replaced every single ingredient, new flour, new sugar, new eggs, and it still wasn't right. Eventually Ray discovered Betty was adding a half cup of baking powder instead of a half teaspoon. She was diagnosed with dementia shortly after. That cake was an early telltale sign.

3. Difficulty completing familiar tasks

You've driven home from the grocery store a thousand times. If one day you leave the parking lot and an hour later you still can't find your street, that's something to pay attention to.

When Bill's wife found him standing in the kitchen holding the kitty litter box and crying because he couldn’t remember what to do with it, she knew something was wrong. This was their first unmistakable clue. He was later diagnosed with dementia. Other red flags: forgetting the rules for Bridge despite playing for 40 years, or picking up the TV remote, pressing buttons, then holding it to your ear like a phone.

4. New problems with words

We all fish for a word sometimes. It's right there, on the tip of your tongue, and then it surfaces three hours later in the shower. Normal.

The distinction is when it's happening constantly, or when you start substituting words that don't quite fit like calling your watch a "hand clock," your hearing aids "earrings," or your shoes "foot slippers." Adorable in a Disney movie. Less adorable in real life. Worth getting checked out.

5. Misplacing things AND losing the ability to retrace steps

Even though I haven’t moved an inch from my desk, I regularly misplace my pen, my phone or a paper I was just reading. Still there, somehow invisible to me. Annoying, but normal.

The dementia version looks different: putting your book in the freezer, your reading glasses in the oven, then accusing someone of stealing them. Before my family realized my mother had dementia, her purse had been "stolen" at least eight times. As a small, older woman we assumed she was an easy target. Later we figured out she'd been walking away and leaving her purse behind. This too is a good example of how we don’t always realize the red flag in front of us.

My friend’s mother, Shirley once drove to the mall and came home in a cab. She had no memory of which mall, which cab company, or where she'd parked. It took her family and the police over six months to locate the car.

6. Decreased or poor judgment

This one often shows up in two places: personal hygiene and finances.

On the hygiene side, we're not talking about a lazy Sunday in sweats. We mean genuinely not bathing, wearing the same clothes for days in a row, routinely skipping basic grooming, especially when it’s a noticeable and sustained departure from someone's previous habits.

On the financial side: giving large sums of money to phone scammers, TV evangelists, or near-strangers. Riley hadn’t paid her property taxes for years and a man who came to the door got her to sign a lien on her house for a loan to pay the taxes. Her daughter discovered the house was for sale and the taxes were not paid. Luckily an attorney was able to disentangle the fraud., but the damage was nearly catastrophic. Stories like Riley’s aren't just gullible moments. They're often signs that the brain's ability to assess risk and make sound judgments has been compromised.

7. Changes in mood and personality

A new, sudden onset of depression in later life (not the occasional blues), but a real shift, can be a sign of dementia. So can withdrawing from friends and social activities, often because one is embarrassed or confused and can't keep up with conversations the way they used to.

And then there are the more startling personality shifts.

My sweet Aunt Zella tried to stab her best friend with a pair of scissors.

Roberta attacked her daughter-in-law with a knife.

May was attempting to strangle her beloved dog before her partner walked into the room.

And prim, proper Janice, who once blushed during deodorant commercials, suddenly couldn't stop talking about sex.

All of it deeply out of character. All of it signs that something profound had changed.

BEFORE YOU SPIRAL: A FEW IMPORTANT REASSURANCES

If you noticed some of these signs in yourself or someone you love, please don't panic.

The most important thing to know is these symptoms are not automatically dementia. Memory and cognitive changes can also be caused by medication side effects, hormone imbalances, vitamin deficiencies, alcohol use, blood clots, brain infections, stress, or depression. Most of those are treatable and reversible. This is why getting an evaluation matters. The goal is not to confirm your fears, but to rule things out and find out what's actually going on.

And if it is dementia, early diagnosis genuinely helps. There are newly approved medications that can slow progression, and they work best when started early. Putting your head in the sand won’t make dementia go away. It just delays your options.

THE TAKEAWAY (AND THE MOST IMPORTANT THING TO REMEMBER)

The fear of dementia is uniquely powerful. Most illnesses threaten the body; this one threatens the You that you've spent a lifetime building. That's why every forgotten word starts to feel loaded with meaning and every senior moment becomes a potential sign.

Which is why this small distinction is the most reassuring thing I can give you:

Misplacing your keys? Normal aging. 

Forgetting what your keys are for? Time to call the doctor.

So, if you occasionally forget why you walked into a room, welcome to the club. Just try to write it down next time…

Preferably not as "$ store."

(Image Source: Canva)