What Else Can Affect Thinking?

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Changes in memory or thinking do not automatically mean dementia. How clearly we think can be affected by our physical health, mood, sleep, medication, hearing, vision and surroundings. Sometimes one thing is contributing. Sometimes several things are happening at the same time.

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Physical Illness

Being unwell can affect concentration, memory and alertness, particularly in older people. Someone may seem more forgetful, slower to respond or less able to manage their usual activities while they are unwell or recovering.

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A sudden change in thinking is different from a gradual change and needs prompt medical assessment.

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Medication

Some medicines can affect alertness, concentration or memory.

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Changes may sometimes appear after:

• starting a new medicine

• changing a dose

• stopping a medicine

• taking several medicines together

If you think medication may be contributing, speak with the person's GP or pharmacist.

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Prescribed medication should not be stopped or changed without appropriate professional advice.

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Poor Sleep and Fatigue

It is harder to concentrate, remember information and solve problems when we are tired.

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Someone who is not sleeping well may:

• take longer to think

• become more easily distracted

• forget information

• struggle more with complicated activities

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If difficulties are noticeably worse when the person is tired, fatigue may be adding to the problem.

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Pain

When someone is in pain, it can be harder to concentrate on other things. Someone living with pain may find it harder to concentrate, remember information or plan what they need to do. Pain can also affect sleep and mood, which may make everyday thinking more difficult.

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Mood, Stress and Anxiety

How we feel can have a real effect on how we think.

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Stress, anxiety or low mood may make it harder to:

• concentrate

• remember information

• make decisions

• get started with activities

• cope when something unexpected happens

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This does not mean the difficulties are imagined. Emotional wellbeing can genuinely affect how someone functions day to day.

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Hearing

Hearing loss can sometimes look like a memory or thinking problem.

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Someone may appear to:

• forget what was said

• misunderstand questions

• lose track of conversations

• respond in a way that does not quite fit

• become quieter when several people are talking

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If information was not heard clearly in the first place, it is much harder to understand or remember it.

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Vision/Eyesight

Vision affects much more than reading. Imagine having foggy glasses, or glasses with black spots on them. 

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Changes in eyesight can make it harder to:

• find objects

• read medication labels

• recognise details

• judge steps or distances

• get around unfamiliar places

• cope in visually busy environments

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This can sometimes look like confusion or a thinking problem. Vision difficulties can also make an existing cognitive difficulty harder to manage.

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Alcohol

Alcohol can affect memory, concentration, judgement, balance and reaction time. It can also interact with medication and other health conditions. If alcohol could be affecting everyday functioning, it is useful to mention this when discussing the person's overall health with a healthcare professional.

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A Change in Environment or Routine

Sometimes the difficulty is not only within the person.

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Someone may manage very well in their own familiar home but struggle:

• during a hospital stay

• while staying somewhere unfamiliar

• after moving home

• when their normal routine changes

• in noisy or busy places

• when they are rushed

• when too much information is being given at once

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Familiar routines and surroundings can make everyday activities easier because there is less unfamiliar information to deal with. This is why someone may seem much more capable in one situation than another.

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Sometimes Several Things Are Happening Together

It is not always as simple as one cause.

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For example, someone may have some memory difficulty but also be:

• sleeping poorly

• struggling to hear

• taking several medications

• living with pain

• feeling anxious or low

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Each of these can make everyday thinking harder.

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Looking at the whole person, rather than memory alone, can help build a clearer picture.

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Why Writing Things Down Helps

Because there can be many reasons for changes in memory or thinking, it helps to write down a few clear examples of what you are noticing. This is not about watching every mistake. It is simply about giving a healthcare professional a clearer picture of what is happening in everyday life.

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It can be helpful to note:

• what has changed

• when you first noticed it

• how often it is happening

• how it is affecting everyday activities

• anything that seems to make it better or worse

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This information can help a healthcare professional consider whether things such as medication, illness, sleep, mood, pain, hearing, vision or another health issue might be contributing.

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You do not need to work out the cause yourself.

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Your role is simply to describe what you are seeing. A healthcare professional can then consider the wider picture and advise whether further assessment may be helpful.

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The Main Message

Memory and thinking can be affected by many things. Some may be temporary. Some may be treatable or manageable. Sometimes several factors are contributing at the same time.

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That is why changes in thinking are best considered alongside the person's:

• overall health

• medication

• sleep

• mood

• pain

• hearing

• vision

• everyday environment

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Writing down a few clear examples can help a healthcare

professional understand what is happening and decide what

support or further assessment may be helpful.