Seeing through the fog: Memory loss vs. dementia

Whether it’s forgetting where you put your keys or no longer remembering the stories of your youth, memory loss is something we all experience.

The brain is like a pool, explains Douglas Wornell, MD, medical director of psychiatric services at MultiCare Auburn Medical Center. There’s the tiles, walls and pump system — and the water that fills it.

Dementia is like the tiles and pump system, Dr. Wornell says. As pools age, their tiles may crack and the pipes may erode. It’s an irreversible change — like the brain experiencing anatomical changes over time that result in memory loss.

Delirium is like the water, which must have an ideal chemical balance or it can become toxic, which is often temporary, he says. For the brain, an adverse event, injury or change in environment can cause delirium that lasts hours, days or weeks.

Both dementia and delirium can be startling and even scary to experience. Memory loss and delirium are normal parts of life, though.

Brain fog is actually a form of delirium

The idea of brain fog gained popularity during the COVID-19 pandemic, but Dr. Wornell explains what people were actually experiencing was a soft form of delirium. Brain fog is a nonmedical term generally used to explain a funny feeling in the brain, and can be associated with any number of adverse causes.

“It all boils down to the chemistry in the brain … If you’re really upset about something for a few days, you’re more likely to be in a ‘brain fog’ and have forgetfulness because you’re focused on that event.”

Delirium can impact mood, memory, your ability to make choices and virtually any function of the brain, he adds. It’s not serious enough to require emergency care — more likely it’s something you notice after the fact.

Things such as a new medication, illness, acute alcohol intoxication, a minor injury, a traumatic or significant event (even falling in love), or a change in environment can result in a state of delirium. Even younger adults who experience a big change — such as moving or starting a new job — may say they feel like they’re in a “brain funk,” Dr. Wornell says.

“We just don’t recognize it as [delirium],” he says. “It all boils down to the chemistry in the brain … If you’re really upset about something for a few days, you’re more likely to be in a ‘brain fog’ and have forgetfulness because you’re focused on that event.”

Memory loss is normal

Understanding how easily our brain chemistry can shift may provide an explanation for moments of forgetfulness. While many worry that memory loss means they’re developing dementia, Dr. Wornell explains that not all age-related memory loss is cause for concern.

“There’s a natural memory loss with aging resulting from actual anatomical changes with your brain,” he says.

Thankfully, knowing that memory may become a challenge as you age gives you the power to prepare.

The most dangerous driver on the road — after impaired drivers — are those over the age of 65 making a left turn, Dr. Wornell says. Be cautious and take slower left turns or consider a new route that may be easier to navigate.

Additionally, day-of-the-week medication boxes or other reminder tools can be helpful to stay on track.

If you’re over the age of 60, have ruled out any immediate cause for your memory loss, and it’s becoming a more consistent issue, consult your doctor or other health care provider.

Dementia has many causes

One of the first noticeable symptoms of dementia is often memory loss.

Dementia isn’t one specific disease or condition. For example, the leading cause of dementia in the United States is Alzheimer’s, while in Japan it’s stroke, Dr. Wornell says.

How dementia comes about can be a variety of causes, including a genetic predisposition, high blood pressure, diabetes or Parkinson’s disease, Dr. Wornell says. In more severe cases, nearly everyone in a family will be diagnosed with dementia.

Beyond memory loss, dementia can have permanent impacts on overall well-being, especially as the disease progresses and the brain undergoes more changes. Other symptoms include difficulty communicating, reduced ability to organize or handle complex tasks, coordination and vision challenges, and psychological changes such as mood swings, anxiety and depression.

While general memory loss is normal and doesn’t always lead to dementia, Dr. Wornell says that being cognizant of your brain chemistry and ensuring you have a healthy lifestyle can help improve longevity.

Caring for your brain

Taking care of your brain is like maintaining your pool water, Dr. Wornell explains.

“It’s about what you can do to keep the pool water the temperature and color you want,” he says.

Even a small change in medication can alter the pool chemistry, Dr. Wornell adds. If you start taking Xanax to sleep at night, for example, you may feel brain fog in the morning.

But you can’t always avoid medications, especially if you’re living with other conditions, whether physically or mentally.

Chronic mental illnesses, such as depression or schizophrenia, have been linked to progressive memory challenges, Dr. Wornell says. Injuries are also a primary risk factor, including traumatic brain injuries or post-concussive syndrome from high-contact activities like military service or sports.

“If you have those injuries, especially when you’re young, the scarring will still be there when you’re 60 and put you more at risk,” he explains.

Lifestyle is another big one, Dr. Wornell adds. Using cigarettes, drugs or alcohol are all related to the development of progressive brain disease. A lack of exercise or a sedentary lifestyle, as well as diet (especially consuming a large amount of processed foods) can also impact your brain’s health.

So, keep your pool water clean and balanced by exercising regularly, avoiding harmful substances and reducing your risk for injury.