You spend 10 minutes searching for your keys before you leave the house.
....Or maybe you forget to grab them altogether.
From there your day is a merry-go-round of forgotten names and lost passwords. “Early-onset dementia,” you joke to a friend. But your laugh is brittle because you’re starting to suspect that this is exactly what’s happening.
While it's certainly possible—about 5.5 million people in the U.S., or 1 out of 10 people over 65, have Alzheimer’s, which is just one form of dementia—there's no need to panic. A recent report suggests that experiencing persistent and severe memory problems isn’t necessarily a sign of early dementia. You might just be stressed.
If you're skeptical, we get it. It's one thing to accept that stress is making you a tiny bit flaky, but severe, chronic memory problems have to be a sign of something serious—right? Not so, according to study author Marie Eckerström, a doctoral student at Institute of Neuroscience and Physiology and licensed psychologist at Memory Unit at Sahlgrenska University Hospital in Sweden.
For four years she and her team followed 1,077 adults age 40 to 79, many of whom said they were experiencing severe memory issues. These weren't just people who had trouble recalling a name at a cocktail party. “These were individuals who sought medical attention to investigate whether they were developing serious problems," Eckerström clarifies.
Although these people reported struggling cognitively in their everyday lives, 9 out of 10 of them fared just fine on memory tests, and they didn't have any of the chemical or physical changes in the brain that are associated with the early stages of dementia, either. So why did they feel like their cognitive health was declining?
In some cases, subjects had close family members with dementia, and familiarity with the condition might have caused them to worry excessively about their own brain health. But regardless of family history, 7 out of 10 participants in the study were suffering from severe stress, clinical burnout, or depression, says Eckerström. “These individuals have no objective signs of dementia,” Eckerström concluded. “The issue instead is usually stress, anxiety, or depression.”
The relationship between stress and memory has been well-documented, says Gretchen Gotthard, PhD, associate professor of psychology and neuroscience at Muhlenberg College. When you first encounter a stressful situation, your fight-or-flight response kicks into gear, and a burst of hormones like adrenaline actually enhances memory, at least in the short-term. (Back when humans were fighting off tigers, remembering where you last saw that tiger was pretty important for your survival.) But if stress persists, your body releases another hormone, cortisol, and chronic exposure to cortisol can impair your ability to think clearly.
“All individuals experience stress in their lives, and it can motivate us to achieve,” Gotthard says. But there's a difference between occasional stress and ongoing turmoil that actually disrupts your ability to function. “Chronic stress can lead to damage in key memory structures in the brain, like the hippocampus,” Gotthard says.
So how can you tell if your memory difficulties are stress-related or early signs of dementia? You may want to start with a checklist, like this one from The Alzheimer's Association. The catch is that symptoms on that list can mimic burnout as well. If you’re really concerned, you should seek out a neurologist for a Mini-Mental State Examination, which involves completing a questionnaire and takes under 30 minutes.
If your impairment is severe enough to interfere with your job or daily functioning, however, you probably need more in-depth neuropsychological testing, which may include an MRI and blood tests, says Richard J. Caselli, MD, associate director and clinical core director of the Alzheimer's Disease Center at Mayo Clinic in Arizona.
A thorough evaluation should also look for other possible causes of memory issues, like a thyroid disorder or stroke. “Usually [an expert] can tell if it’s Alzheimer’s based on a pattern of strengths and weaknesses on cognitive tests,” Caselli says.
"Passing" this kind of evaluation can certainly be a relief, but it doesn't exactly mean that you're healthy, either. If stress is to blame for your forgetfulness, you could still be in trouble down the line, says Gotthard. Although stress doesn't cause dementia, some research suggests that chronic, severe stress might make you more susceptible.
The key isn't to dodge all the stressors in your life, but rather to control how you respond to them, says Gotthard. Her prescription begins with eating and sleeping well and getting some exercise. (This easy breathing technique can lower anxiety by 44%.)
Simple meditation can also be a key tool in your treatment. It doesn’t have to be anything spiritual or involved, either. Research from Northwestern University, for example, suggests that changing your breathing pattern can both combat anxiety and boost your memory.
