Cognitive function

• Attention: following a conversation and taking in information. Distraction often makes new things harder to remember.
• Memory and learning: keeping an appointment in mind, understanding something new and recalling it later.
• Language and planning: finding words, making choices and putting steps in order. [1]

These are distinct skills, not one ‘intelligence score’. Ask what changed from your usual level and whether daily tasks suffer. Occasionally searching for a word differs from getting lost on a familiar route. [3] Read more about memory and brain fog.

Different cognitive abilities do not change together. Taking longer to learn or occasionally searching for a word can occur with aging. This differs from getting lost in a familiar place, repeatedly asking the same questions, or no longer managing familiar tasks. Such changes merit assessment; dementia is not a normal part of aging. [3]

Some older adults have mild cognitive impairment yet remain independent, and not everyone with it develops dementia. A fixed age at which everyone's cognition supposedly declines is misleading. Ask instead what changed, how quickly, and how everyday function has been affected. [3]

Poor sleep or low mood can reduce attention; hearing difficulties make a conversation harder to follow. Alcohol, medicines and physical illness may also contribute. Long-standing high blood pressure, diabetes and vascular disease deserve care to address broader health risks. Discuss persistent problems rather than trying a ‘brain booster’ or stopping medicines yourself. Stroke can cause different thinking problems depending on the injured area. [1][2]

Choose a feasible mix: enough sleep, movement within your ability, social connection and suitable care for hearing, vision and existing conditions. Write down steps or set reminders if planning is hard; have medicines reviewed if problems began after a change, but do not stop them yourself. [1]

In the ACTIVE study some trained skills in older adults declined less, particularly reasoning and speed of processing. This does not mean an arbitrary commercial app improves all thinking skills or prevents dementia. [1]

Arrange medical assessment when problems with memory, language, attention, or planning persist, worsen, or interfere with daily life. Sudden confusion, facial droop, weakness, or acute speech problems are emergencies. Sleep loss, depression, medicine effects, and physical illness can cause or worsen symptoms; self-labelling them as ‘brain fog’ or dementia can miss treatable causes. [2]