Is It Brain Fog or Early Dementia?

We all forget things once in a while – where we left our keys?  Why we entered a room?  These are common as we age.  But, when should we worry?  When does forgetfulness become an early sign of dementia?  Studies have shown that during the menopausal transition, approximately 60% of women may experience more forgetfulness, difficulty concentrating and cloudy thinking.  Let’s explore this more deeply. 

Recently, a patient of mine, Linda, came to see me for this same reason.  She is a 53 year-old, mother of two, who is still having menstrual cycles, although irregular every 2-3 months.  For the past 4-5 months, Linda has noticed that her memory is getting worse, forgetting where she put her purse/wallet, the names of streets/relatives and trouble finding the right words to say. She says her brain feels “foggy”.  

Her sleep has been especially disrupted since mid-March when the CO-VID pandemic emerged.  She frequently wakes up at 2:00 or 3:00 at night with anxious thoughts and can’t fall back asleep.  Occasionally, she has some night sweats but these don’t happen every month.  Her overall function at work as an office manager has not changed significantly and she feels like she’s still doing a “pretty good” job even though she is adapting to the many Zoom calls and managing duties online. 

She now would like a complete evaluation regarding her “brain fog” and worries that this might be an early sign of dementia.

Let’s review some things we have learned over the past months while following our Amazing Over 40 blog posts.  Menopause is defined as twelve consecutive months with no menstrual cycle.  This puts Linda in the “perimenopausal” category. Check out my Menopause 101 blog here!

She is experiencing occasional night sweats, which are hot flashes/flushes that occur at night time.  Linda denies any other common symptoms of perimenopause/menopause such as vaginal dryness, mood swings, or heart palpitations, although she does note a decrease in sex drive.  This she accounts for due to the fact that both her 25 year-old daughter and 28 year-old son are back living at home due to CO-VID, which makes times for intimacy extremely rare.

To best evaluate Linda’s brain fog, it is important to realize that “brain fog” may be due to many factors, and is very common during the perimenopause/menopausal transition.  I assure Linda that these symptoms can be completely normal but that other factors, besides early Alzheimer’s disease, might lead to these same cognitive changes.  

These Include:

• Vitamin B Deficiency, especially Vitamin B1, B6, B9 and B12.
• Thyroid Disorder – such as hypothyroidism
• Mineral Deficiencies: Calcium, Magnesium and Zinc
• Inflammatory Conditions such as Chronic Fatigue Syndrome, Lupus, Fibromyalgia or Rheumatoid Arthritis
• Medications – blood pressure medications, anti-anxiety/depression medications, chemotherapy, etc.

In order to rule out most of these conditions, I’ve ordered a full blood work-up for complete laboratory evaluation.  Linda says she will have these done within the next 7-10 days.  In the meantime, I again assure Linda that these symptoms are experienced by many women during this time and can be managed.  But, we do need to make sure that nothing more serious may be occurring.

I also offer Linda with some tips to help during this time.

• Exercise – even walking around the block can help with brain function, clear out stress and breathe in fresh air.
• Meditation – this has been shown to help calm the mind and change the anatomy of the brain. Learn more here!
• Eat healthier foods – like fresh fruits and vegetables.  Clear out the kitchen of chips, cookies, crackers or other foods loaded with preservatives, which can literally “fog” up your brain.

Stay tuned to see Linda’s labs and our plan to help her with “brain fog” and achieving clearer thinking!

• In health and happiness,
• Dr. Diana

https://www.webmd.com/menopause/news/20161012/more-evidence-menopause-brain-fog-is-real?print=true

https://pubmed.ncbi.nlm.nih.gov/27683911/