Spotting the Difference: Typical Aging or Alzheimer’s?

By Austin McKee, LMSW

Aging naturally brings changes to our thinking, but how can we tell when those changes signal something more serious? While a slight slowdown in processing speed is a normal part of aging, dementia is not. The challenge lies in distinguishing between typical age-related changes and the early signs of dementia. Because some dementia symptoms can resemble natural aging, many cases aren’t diagnosed until the disease has progressed.[1] However, there are subtle differences that, when recognized early, can lead to timely intervention, better care, and strategies that may help slow disease progression.

In this article, we’ll explore seven key areas where cognitive shifts often appear, highlighting the crucial differences between normal aging and dementia-related diseases, particularly Alzheimer’s Disease. These areas include:

  • Memory
  • Language
  • Problem-Solving and Planning
  • Orientation
  • Judgment and Reasoning
  • Mood and Behavior
  • Activities in Daily Living

Recognizing these distinctions can be life-changing, paving the way for timely intervention, proper support, and better care.

Memory

Memory is how the brain takes in, stores, and recalls information. There are three main types of memory- sensory, short-term, and long-term.[2]

Sensory memory is the first stage in memory processing. This stage quickly captures detailed information from a person’s environment. However, only a small portion is passed to short-term memory for further processing.[3]

Short-term memory, also known as active memory, is where we store everyday details—like what we had for breakfast or where we left our car keys.[4] In Alzheimer’s disease, short-term memory is often one of the first areas to decline.[5] As it fades, even simple routines can become unfamiliar and frustrating, disrupting daily life. 

Long-term memory acts as a vault for our past experiences, knowledge, and skills—protecting information for years, even decades, until we need it.[6] In Alzehimer’s, these memories often remain intact during the early and middle stages, while recent memories fade first.[7] This is why individuals with Alzheimer’s may vividly recall moments from their youth, sometimes even seeing themselves as their younger selves, reconnecting with a time when life felt more familiar and secure. 

Memory in Typical Aging vs. Early Alzheimer's Disease

Forgetfulness

  • Typical Aging: Occasionally misplacing items but usually finding them after retracing your steps. 
  • Early Alzheimer’s: Misplacing items in unusual places, like putting keys in the fridge, and struggling to recall recent events, even with reminders.

Information Recall

  • Typical Aging: Names or details may take longer to recall but surface with patience or a prompt.
  • Early Alzheimer’s: Repeatedly asking the same questions, forgetting recent conversations, and needing frequent reminders for once-familiar information.

Memory Lapses

  • Typical Aging: Brief forgetfulness, like forgetting why you entered a room, but remembering after a moment.
  • Early Alzheimer’s: Frequent memory lapses, such as forgetting the day or why you are in a familiar place. 

Retaining Skills

  • Typical Aging: Well-practiced skills remain intact despite occasional minor mistakes.
  • Early Alzheimer’s: Struggling with once-familiar tasks, such as cooking or paying a bill, and needing more support and instruction. 

Following Conversations

  • Typical Aging: Occasionally losing track of a conversation but easily picking it back up. 
  • Early Alzheimer’s: Difficulty following conversations, repeating sentences, or struggling to find words more frequently. 

Language

Language is our tool for expressing thoughts, ideas, and emotions. In Alzheimer’s, the areas of the brain responsible for language processing—primarily the temporal and parietal lobes—are gradually affected. As the disease progresses, this can make it increasingly difficult for individuals to find the right words, follow conversations, or understand what’s being said.[8]

Language in Typical Aging vs. Early Alzheimer's Disease

Word-Finding/Vocabulary 

  • Typical Aging: Occasionally having trouble recalling a word, especially less common ones, but overall vocabulary remains stable.
  • Early Alzheimer’s: Frequently struggling to find common words and pausing longer than usual mid-sentence. Often relying on vague terms like “cooking thing” instead of “stove”. 

Following Conversations

  • Typical Aging: Briefly losing track during a conversation, but can re-engage with context.
  • Early Alzheimer’s: Increasing difficulty keeping up and needing repetition, especially with fast-paced or group discussions.

Storytelling

  • Typical Aging: Occasionally forgets minor details but maintains a clear and logical flow.
  • Early Alzheimer’s: Stories become disorganized, with repeated details, missing key points, or blending real memories with things seen or heard elsewhere. 

Problem Solving and Planning

Problem-solving and planning involve assessing situations, considering multiple options, and taking appropriate action by following logical steps.[9] These skills are essential for daily life, whether for simple tasks like doing laundry or more complex ones like managing bills. Everyday activities such as following a recipe, grocery shopping, or getting dressed may seem routine, but they rely on the brain’s ability to organize, prioritize, and make sound decisions.

Problem-Solving and Planning in Typical Aging vs. Early Alzheimer's Disease

Managing Complex Tasks

  • Typical Aging: Complicated activities may require more time, but can still be completed successfully.
  • Early Alzheimer’s: Noticeable mistakes occur with multi-step tasks, such as following a recipe, leading to frustration and feeling overwhelmed.

Financial Management

  • Typical Aging: Occasionally forgetting to pay a bill on time but catching the mistake quickly and correcting it. 
  • Early Alzheimer’s: Struggling with managing finances, such as missing bill payments or making unusual purchases, often resulting in financial disorganization.

Following Instructions

  • Typical Aging: Able to follow multi-step directions, though it may take a bit more time or effort to maintain focus.
  • Early Alzheimer’s: Struggling to complete familiar tasks, like doing laundry, leading to repeated mistakes or unfinished steps.

Maintaining Daily Routines

  • Typical Aging: Keeps up with regular daily habits, with occasional lapses that are easily corrected.
  • Early Alzheimer’s: Forgetting routine activities, like taking medication, and needing frequent reminders or assistance to stay on track.

Adapting to Routine Changes

  • Typical Aging: May take some time to adjust but can adapt with reassurance and reminders.
  • Early Alzheimer’s: Struggles with changes in routine, often feeling confused or distressed by new situations.

Orientation

Orientation refers to an individual's awareness of key aspects of their environment, including place (where they are), time (the current time), person (their own identity), and event (what is happening around them). As Alzheimer's disease progresses, these areas of orientation are often impacted, leading to confusion and disorientation.[10]

Orientation in Typical Aging vs. Early Alzheimer's Disease

Place

  • Typical Aging: Briefly forgetting why you entered a room or needing a moment to adjust to an unfamiliar setting but quickly reorienting.
  • Early Alzheimer’s: Getting lost in familiar places, like a well-known grocery store, and needing help to find your way around.

Time

  • Typical Aging: Occasionally forgetting the date, but recalls it with a reminder.
  • Early Alzheimer’s: Frequently losing track of time, confusing days or seasons, and struggling to gauge how much time has passed. 

Person (Self-Identity)

  • Typical Aging: Maintains a clear understanding of identity, including name, key life details, and relationships.
  • Early Alzheimer’s: Typically retains core identity but may struggle with details like age, role in the family or forgetting important personal history.  

Event

  • Typical Aging: May occasionally need reminders about plans or recent conversations but stays aware of current events and what’s happening around them.
  • Early Alzheimer’s: Often becomes confused about what’s currently happening, may mix up past and present events, or forget recent occurrences altogether.

Judgment and Reasoning

Judgment and reasoning refer to a person’s ability to assess situations, solve problems, and make informed decisions.[11] Judgment involves evaluating risks and making appropriate choices, while reasoning allows us to think logically and weigh different options.[12] [13] Whether it’s taking a detour to avoid traffic or weighing the pros and cons of selling a car, strong judgment and reasoning skills help us think critically and navigate daily challenges. In individuals with Alzheimer’s disease, judgment and reasoning become impaired, and can lead to risky behavior.   

Judgment and Reasoning in Typical Aging vs. Early Alzheimer's Disease

Decision-Making

  • Typical Aging: Takes longer to make decisions but remains logical and thoughtful.
  • Early Alzheimer’s: Struggles with choices, making unusual or impulsive decisions.

Problem-Solving

  • Typical Aging: Occasionally needs extra time or input but can resolve issues independently.
  • Early Alzheimer’s: Increasing difficulty handling new or slightly unfamiliar situations, like getting confused when following a new recipe.

Assessing Risks

  • Typical Aging: Recognizes hazards and avoids risky situations.
  • Early Alzheimer’s: Makes unsafe choices, like leaving the stove on or dressing inappropriately for the weather.

Managing Finances

  • Typical Aging: Prefers simpler money management methods but continues handling bills and budgeting effectively.
  • Early Alzheimer’s: Struggles with paying bills, misplacing money, or making uncharacteristic purchases.

Understanding Consequences

  • Typical Aging: Learns from mistakes and adjusts behavior accordingly.
  • Early Alzheimer’s: Repeats mistakes, such as leaving doors unlocked or mismanaging finances.

Mood and Behavior

Mood refers to a person’s internal emotional state, while behavior reflects how that mood is expressed through external actions. In Alzheimer’s disease, mood and behavior often become more pronounced due to changes in the brain that affect emotional regulation and cognitive function.[14] For example, in the early stages of Alzheimer’s disease, a person may experience frustration or confusion (mood) due to memory loss or increased difficulty with everyday tasks. These feelings can lead to behaviors such as irritability, agitation, or withdrawing from social interactions.

Mood and Behavior in Typical Aging vs. Early Alzheimer's Disease

Mood

  • Typical Aging: Occasional mood shifts due to stress or life events. 
  • Early Alzheimer’s: More intense, persistent mood changes driven by confusion or frustration.

Response to Stress

  • Typical Aging: May feel frustrated or anxious but copes effectively.
  • Early Alzheimer’s: Becomes easily frustrated or withdrawn, particularly in new or unfamiliar situations.

Irritability & Agitation

  • Typical Aging: Short-lived irritability tied to specific stressors. 
  • Early Alzheimer’s: Frequent agitation triggered by memory lapses or difficulty completing daily tasks.

Response to Routine Disruptions

  • Typical Aging: May experience mild frustration with changes in routine but adapts quickly.
  • Early Alzheimer’s: Disruptions in routine can cause significant confusion, frustration, and distress.

Social Withdrawal

  • Typical Aging: Maintains social connections.
  • Early Alzheimer’s: Avoids social interactions due to embarrassment or difficulty following conversations.

Activities in Daily Living

Activities of daily living (ADLs) are essential self-care tasks performed daily, including eating, dressing, bathing, grooming, and toileting. While mild difficulty with ADLs can be a normal part of aging due to physical changes, forgetting to perform them or experiencing confusion, agitation, or distress around these tasks is not.[15]When a person struggles to complete ADLs properly, it can lead to unsafe living conditions, increased health risks, and a loss of independence.

ADLs in Typical Aging vs. Early Alzheimer's Disease

Eating

  • Typical Aging: Maintains interest in food and uses utensils properly. 
  • Early Alzheimer’s: Forgets how to use or hold utensils, loses interest in food, or eats the same thing repeatedly.

Dressing

  • Typical Aging: Continues to dress independently and appropriately.
  • Early Alzheimer’s: Starts to struggle with buttons and zippers, wears clothes incorrectly and chooses seasonally inappropriate attire.

Bathing/Grooming

  • Typical Aging: Practices regular hygiene with minor adjustments for safety.
  • Early Alzheimer’s:  Forgets hygiene routines or resists bathing due to confusion or fear.

Toileting

  • Typical Aging: May urinate more frequently but maintains control and independence in using the restroom.
  • Early Alzheimer’s: Forgets restroom locations, has occasional accidents, or struggles with clothing.

Recognizing the Subtle Differences

While natural aging and early Alzheimer’s share some similarities, the key difference lies in the frequency, persistence, and impact of these changes. In typical aging, memory lapses, language difficulties, and changes in daily tasks are often mild and fleeting, with individuals able to recover or adjust easily. In contrast, early Alzheimer’s disease leads to more frequent disruptions, such as repeated forgetfulness, challenges in finding the right words, and difficulty maintaining routines or completing tasks. 

Recognizing the subtle differences between typical aging and early Alzheimer’s disease can be life-changing. While early detection is less common, it is possible, and the sooner a diagnosis is made, the greater the chance to slow disease progression and manage symptoms.

 

If this article has made you pause and wonder whether you or a loved one may be experiencing early signs of dementia, know that you’re not alone—help and resources are available. Visit Alzheimer’s Texas or contact our 24/7 Helpline at (512) 241-0420. Our caring team is available to answer questions, provide resources, and support you in understanding the changes you or your loved one may be experiencing. Taking the first step can feel overwhelming, but it’s the beginning of a path toward clarity, care, and empowerment.

Austin McKee, MSSW, is the Helpline Specialist and Content Creator at Alzheimer’s Texas. With a Master of Science in Social Work, Austin has extensive experience in geriatric care, including social support and engagement, end-of-life care, and caregiver support. She is passionate about bridging the gap between generations, fostering mutual understanding, and helping people recognize the inherent value and purpose in individuals of all ages, regardless of physical or cognitive changes.

Sources:

[1] University of California San Francisco, Healthy Aging., last reviewed 2025, https://memory.ucsf.edu/symptoms/healthy-aging (accessed February 28 2025).  

[2] VeryWellMind, What is Memory?, last reviewed June 19, 2024,  https://www.verywellmind.com/what-is-memory-2795006 (accessed February 24, 2025). 

[3] Cleveland Clinic, Sensory Memory., last reviewed 12/3/2024, https://my.clevelandclinic.org/health/articles/sensory-memory (accessed March 11, 2025). 

[4] VeryWell Mind, How Short-Term Memory Works., last reviewed May 9, 2023, https://www.verywellmind.com/what-is-short-term-memory-2795348, (accessed on March 8, 2025). 

[5] Mayo Clinic, Alzheimer’s Disease., last reviewed November 8, 2024, https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447 (accessed February 24, 2025). 

[6] VeryWellMind, What is Memory?, last reviewed June 19, 2024,  https://www.verywellmind.com/what-is-memory-2795006 (accessed February 24, 2025). 

[7] Alzheimer’s Society, Memory loss and dementia., last reviewed February 23, 2021, https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/memory-loss (accessed February 26, 2025). 

[8] National Institute on Aging, Communicating with Someone who has Alzheimer’s Disease., Last reviewed July 11 2024, https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/communicating-someone-who-has-alzheimers (accessed on February 15, 2025). 

[9] ASQ, Problem Solving., last reviewed November 2024, https://asq.org/quality-resources/problem-solving, (accessed March 9, 2025). 

[10] VeryWellHealth, ‘What Alert and Oriented’ means in Dementia., last reviewed December 21, 2024, https://www.verywellhealth.com/what-is-orientation-and-how-is-it-affected-by-dementia-98571 (accessed February 23, 2025).  

[11] Forbes, The Power of Critical Thinking: Enhancing Decision-Making and Problem Solving., last reviewed July 28 2023, https://www.forbes.com/councils/forbescoachescouncil/2023/07/28/enhancing-decision-making-and-problem-solving/ (accessed February 26, 2025). 

[12] Merriam-Webster, Judgement., last reviewed February 25, 2025, https://www.merriam-webster.com/dictionary/judgment (accessed February 28, 2025).

[13] Merriam-Webster, Reasoning., last reviewed February 26, 2025, https://www.merriam-webster.com/dictionary/reasoning (accessed February 26, 2025).

[14] National Institute on Aging, Alzheimer’s Caregiving: Managing Personality and Behavior Changes., last reviewed July 11, 2024, https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/alzheimers-caregiving-managing-personality-and  (accessed March 7, 2025). 

[15] National Library of Medicine, Activities of Daily Living., last reviewed June 26, 2023., https://www.ncbi.nlm.nih.gov/books/NBK470404/, (accessed March 5, 2025).