Mental Confusion – What’s Normal, What’s Not?

February 22, 2021

Although it’s normal to have memory lapses from time to time, we tend to notice them more as we get older. These changes do not automatically mean there is some sort of memory loss or memory disorder brewing in the brain. It simply may mean that stress, poor sleep, or hearing loss is interrupting normal memory function. It may be evidence of normal age-associated declines in skills such as memory processing speed or mathematical abilities. These normal changes are common but not universal, and while they may be bothersome, they do not significantly impair daily life. And the good news is they can be improved or even reversed with lots of mental stimulation or training. The news about aging is not all bad, either. It also brings greater emotional maturity, and wisdom characterized by broader and less black-and-white thinking.

In contrast to normal changes in cognition, it is not normal for a person to begin showing a pattern of frequent (i.e., several times a week) and worsening episodes of some of the following:


Forgetting appointments, the locations of objects, recent events or conversations, and other items

Language Problems:

Difficulty finding words, or episodes of using words incorrectly


Getting lost in previously familiar settings; Forgetting the correct day or date or general mental confusion

Impaired Activities:

Having difficulty doing tasks that were previously easy to do (for example, preparing a meal, driving a car)

Executive Problems:

Difficulty with organizing a daily schedule or thinking in abstract ways; Poor insight and judgment

Behavioral and Emotional Changes:

Behaving in ways that are unusual, overly nervous or reactive, apathetic, or inappropriate

It is important to distinguish between subjective changes and objective changes. Subjective changes are the ones that we notice in everyday life.  Objective changes are measurable. For example, someone may report dementia behaviors, but actual testing does not show any impairment.  Often individuals with a developing neurocognitive (memory/brain disorder) disorder are not aware of these changes and deny them or become upset when they are pointed out. It becomes more of a problem when someone is not willing to get help or he or she refuses to stop doing things that can pose a risk of harm to themselves or others. This lack of awareness is itself a sign that there is a problem and the person is not experiencing just normal, age-related decline.

Treatments and Activities for People with Dementia

If you suspect a memory disorder, don’t panic! Mild memory disorders must be evaluated and monitored, but do not always indicate that a person has Alzheimer’s disease. There may be causes of these changes that can be treated. There are many ways to improve, slow, or stabilize symptoms. At the end of the day, having a full screening and knowing the diagnosis at an early stage, beginning memory and/or dementia care and increasing support will always be the best outcome.

At Miami Jewish Health MIND Institute, we believe people with Alzheimer’s disease and other neurocognitive disorders can continue to live with purpose and joy. Our entire practice is devoted to empathic diagnosis, brain fitness, mind exercises, innovative research, and high-touch, one-on-one care and support for individuals and their families. Every family and every individual is unique. Their treatment should be too.

Take action. Schedule a full clinical assessment today, for you or for someone you love.

 width=This is an excerpt from “How We Age – A Doctor’s Journey Into The Heart of Growing Old.” Written by Marc E. Agronin, MD, a graduate of Harvard University and Yale Medical School. Dr. Agronin is Senior Vice President for Behavioral Health at Miami Jewish Health and Chief Medical Officer for MIND Institute. He is a leading expert in Alzheimer’s disease and geriatric mental health issues, and a nationally-sought author and speaker.


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