Feeling foggy and forgetful? Midlife brain fog vs younger onset dementia

Jenny took great pride in her powerful recall of names, places and the small details that escape so many of us. She could multitask with the mastery of a professional juggler.

But almost out of nowhere, her powers deserted her. It felt as if a fog had descended on her brain. She struggled to remember dates and details that had always come so easily to her. She was 49 years old and a year into menopause when she felt the impact of midlife brain fog. Her confidence took a huge hit.

“Initially, I noticed that when I was typing, my brain would be thinking one thing but when I would read back what I had typed, there were key connector words missing,” she recalls.

“I started using my iPhone for reminders. I was worried about missing things.”

She also worried that she was developing dementia.

Jenny’s story is not unique. Many women experience brain fog during perimenopause, the time leading up to and just after menopause when hormones fluctuate. It can be a frightening experience because like Jenny, many women worry they’re slipping into dementia.

But it’s worth knowing that midlife brain fog has different symptoms to younger onset dementia (also called early onset dementia), and importantly, younger onset dementia is uncommon.

What is midlife brain fog?

Brain fog is not a medical term, but most people agree that it’s perfect for describing some of the symptoms women experience around menopause.

The symptoms, common at midlife, might include:

• difficulty concentrating or focusing
• confusion
• poor memory
• forgetfulness
• not having the right words
• losing your ‘train of thought’
• slow thought processes.

Fortunately, experts believe these symptoms are temporary.

One such expert is Associate Professor Caroline Gurvich, a clinical neuropsychologist and deputy director of HER Centre Australia. Associate Professor Gurvich looks at how hormones impact women’s mental health and brain function.

Our brains love the hormone oestrogen – it helps to protect brain cells. But around menopause, levels of oestrogen first fluctuate and then drop.

While it’s not yet known exactly what causes midlife brain fog, Associate Professor Gurvich’s research suggests that these hormonal changes may bring on symptoms of fogginess and forgetfulness.

Reassuringly, she says this hormonal shift “doesn’t mean your ability to engage in intellectual tasks is gone” or that your cognitive skills are reduced forever.

Taking time to adjust is generally what’s needed. “We think that as our hormone fluctuations ease and other menopausal symptoms like night sweats, mood changes and sleep disturbance become less intense, brain fog is also likely to resolve,” she explains.

What else is going on at midlife?

It’s worth remembering that shifting hormones are not the only challenge facing midlife women. The mental load on women during this life stage can be high – from managing teenage children to caring for elderly parents and balancing busy careers with running a household.

Added stress and menopausal night sweats also have big impacts on sleep at midlife. And as Associate Professor Gurvich says, lack of sleep can make a foggy brain feel even worse. That has been Jenny’s experience and she is now seeing a sleep specialist for help.

Even with all this in mind, how do you know that you’re not developing dementia?

Younger onset dementia explained

Younger onset dementia is any kind of dementia that happens before age 65.

Dr Marita Long, Head of the Jean Hailes Women’s Brain Care Clinic, says there are noticeable differences between midlife brain fog and dementia.

“With brain fog, symptoms are usually temporary and get better over time, and they don’t stop you from living independently. With dementia, the symptoms are progressive and ultimately impact the person’s ability to maintain independence. Sometimes, you might notice changes in the person’s personality and the way they communicate and make decisions. Navigating social situations can also become more difficult.”

Common symptoms of dementia include:

• memory loss
• difficulty planning or problem-solving
• trouble completing everyday tasks
• confusion with time or place
• problems understanding images and spatial relationships
• problems with speaking or writing
• misplacing things and having trouble retracing steps
• decreased or poor judgement
• withdrawing from work or social situations
• changes in your mood and personality.

Dr Long says younger onset dementia is uncommon. But, she adds: “If you are concerned about your brain health at any age, it’s important to talk to your doctor.”

What you can do

Associate Professor Gurvich says that women should be reassured that occasional forgetfulness and word finding difficulties are common around menopause.

Most women who have concerns about their brain health during this time still perform within expected ranges on neuropsychological tests (tests often used in screening for dementia).

“But if these symptoms are leading to distress or substantially impacting daily functioning, women should speak to a healthcare professional,” she adds.

Both Associate Professor Gurvich and Dr Long agree there are steps we can take to support our brain health. They include:

• keeping physically active
• practising mindfulness meditation, which can help to reduce anxiety and stress
• challenging our brains by learning a new language or musical instrument, or by joining a book club
• avoiding smoking and excessive amounts of alcohol
• eating a Mediterranean diet, which contains lots of brightly coloured fruits and vegetables that are vital for brain health
• maintaining social connections
• using tools, such as a diary, lists and calendars, to support your memory and reduce anxiety linked to brain fog.

Learn about Memory and cognition as you age or explore more on the Dementia Australia website.

Stock photos used. Posed by models.