What is the difference between normal aging and dementia?

Physicians often use a list like this to help differentiate between normal aging and dementia:

Normal aging:

  • The person remains independent in daily activities.
  • The person complains of memory loss but can provide considerable detail regarding incidents of forgetfulness.
  • The individual is more concerned about alleged forgetfulness than close family members are.
  • Recent memory for important events, affairs, and conversations is not impaired.
  • The person has occasional difficulty finding words.
  • The person does not get lost in familiar territory, but may have to pause momentarily to remember the way.
  • The individual operates common appliances even if she or he is unwilling to learn how to operate new devices.
  • There is no decline in interpersonal social skills.
  • Performance on mental status examinations is normal relative to the individual's education and culture.


  • The person is critically dependent on others for key daily living activities.
  • The person complains of memory problems only if specifically asked and cannot recall instances when memory loss was noticeable.
  • Close family members are much more concerned than the individual is about incidents of memory loss.
  • Recent memory for events and ability to converse are both noticeably impaired.
  • The person makes frequent word-finding pauses and substitutions.
  • The person gets lost in familiar territory while walking or driving and may take hours to return home.
  • The person cannot operate common appliances and is unable to learn to operate even simple new appliances.
  • The person loses interest in social activities or exhibits socially inappropriate behaviors.
  • Performance on mental status examinations is below normal in ways not accounted for by educational or cultural factors.


As we age, our bodies and all our organ systems begin to age as well. This is pretty obvious as many elderly people become frail and skin begins to wrinkle, which are the most obvious signs. The same thing can happen to our minds as well. As we age our brains can atrophy, which can lead to some symptoms of forgetfulness. The difference between dementia and normal aging is the ability to function and complete daily activities of living such as shopping, cooking, brushing teeth, and so forth. A person with dementia will have difficulty with theses tasks as well as memory issues. To distinguish between dementia and normal aging, we need to watch for symptoms such as repetitive questing, decreased organization, forgetting recent events, changes in hygiene and so forth. The best defense against dementia and forgetfulness is to keep an active mind and learn new things.
Dr. Gary Small, MD
Psychiatrist (Therapist)

Everyone has gradual decline of memory as they grow older. Doctors have established three major points to tell the difference between normal memory decline, cognitive impairment and dementia. 

  • Normal aging. You might not be able to find your keys or remember someone’s name. This is normal, age-related memory loss. Symptoms do not seem to disrupt your life. 
  • Mild cognitive impairment (MCI). If normal, age-related memory loss worsens, doctors call it mild cognitive impairment. People with MCI are still functionally independent. They can make up for memory losses. However, they are at greater risk for dementia.  A person with MCI has a one in 10 risk of developing dementia.
  • Dementia. Memory loss or cognitive impairment is so severe that the patient is no longer independent and relies on others for help. Alzheimer's disease is the most common type of dementia. 

A doctor’s exam (clinical assessment) is necessary to tell the difference between normal aging, MCI and dementia. This critically important part of an exam will help determine whether a person is functionally independent or needs help from others.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.