I work with a lot of men and women in their 60s, 70s, 80s, and occasionally people in their 90s in my practice. Working with older people is one of the parts of my counseling practice that I enjoy the most.  This is one of the most frequent issues older people bring as their reason for coming to therapy.  Usually, they are also struggling with feelings of frustration, worry and sadness about this and many other issues that frequently go along with aging.  Like you, they want to know what these changes mean and whether they can get back to former, higher levels of cognitive functioning.

Several decades ago any changes in brain function and cognitive sharpness were just marked up to “getting old” and if it seemed worse than was normal for other people their age the problem was put into the blanket category of getting senile or general dementia.  In the past 20-30 years there has been remarkable progress in the science of understanding the human brain. We have come to understand a lot about the difference between normal brain aging and brain diseases, such as vascular dementia, Alzheimer’s, and stroke and other things that affect brain functions.

With respect to your question, there are several actions you can take to find out what might be causing your decreased efficiency, memory and organizational functioning. There are several levels of evaluation and screening available and different approaches that may help improve the problem.

Some decrease in cognitive functioning is common in both women and men. Women may experience this due in part to hormonal changes that occur during and after menopause. In this instance, you should have your hormones tested and talk with your doctor about the risks and potential benefits of hormone therapy that might improve your mental functioning. Another common reason for losing cognitive sharpness is lack of use of your brain!  Taking classes to stimulate your intellect, getting into a book club, and the newer “brain training” books, classes, and online programs can be fun and very effective ways to combat and even reverse some age-related declines.

The next level of evaluation involves seeing your doctor and getting a general preliminary screening for potential brain problems, such as initial signs of dementia.  If there are strong concerns, your doctor can refer you to a neurologist or neuropsychologist for further testing and evaluation. This is very helpful in ruling out serious problems that might be contributing to your symptoms.  Although diagnosis of dementia is still somewhat inexact, in most cases testing can be very helpful in figuring out whether there is actually a medical reason for what you are experiencing.

Regarding interventions, as I mentioned above brain training programs are a wonderful first line intervention that can really make a difference, regardless of the reason for your difficulty. You might try Lumosity (www.lumosity.com ), which has both free and inexpensive paid online versions. There are a number of other excellent programs, some cheaper and some quite expensive.  It pays to get recommendations from others who have used them and do a little research to see which one seems best suited for you.

Obviously, if there is a significant medical issue, such as Alzheimer’s, mini-strokes or a brain tumor, potential medication side effects or other biochemical issues, many of these can be effectively treated medically.  In addition, counseling with someone familiar with cognitive decline and aging can also be very helpful in dealing with the emotional, psychological and life adjustment issues related to these problems.  It is definitely worth some investigation and the news may well be better than you think; and if there are serious problems, it pays to find out early.