Thought Leadership
Aug 26, 2025
Ask Alex: Normal Aging vs. MCI
Dr. Alex Bahar-Fuchs is NewDays' Director of Neuropsychology and a leading expert in cognitive interventions for older adults.
Q: I'm 68 and sometimes forget names or where I put my keys. My friends say this is just "normal aging," but I'm worried it could be something more serious. How can I tell the difference between normal aging and mild cognitive impairment?
Dr. Alex:
“It is absolutely normal to occasionally forget the names of people or where we have placed our belongings and this happens frequently to people regardless of age. However, when this happens to an older adult, it is more likely to raise questions, doubts, and fears because of the known association between age and dementia. It is also true however, that there is some decline in certain cognitive abilities or thinking skills that are simply part of normal aging. As a result, older people sometimes might feel that they are more forgetful than they used to be. Much of this has to do less with memory per se, and more with some of the basic processes that support memory function – how fast our mind works (processing speed), how effectively we can attend to things in the face of competing demands (divided attention), or how much information we can manipulate in our minds at a given time (working memory). Due to some decline in these processes in the course of normal aging, we might notice more difficulties- but in fact the difficulties are usually in “accessing” the information, rather than the information being truly lost.
The difference between normal ageing and mild cognitive impairment is both a matter of the severity/amount of cognitive challenges and the specific types of challenges. When people develop what experts call ‘Mild Cognitive Impairment’ or MCI, their performance on formal tests of cognitive abilities usually falls well below that of people of the same age and education but who have normal cognition. Usually, this happens in more than one type of thinking processes - for example, in addition to memory being impaired, it is possible that there are impairments in other areas such as language or executive function.
In normal aging, people continue being able to do most things they used to be able to do independently before, albeit sometimes a little more slowly. In contrast, people with MCI are more likely to experience greater challenges when engaging in mentally demanding everyday activities (e.g., online banking, organising a big holiday) – although they will often manage to mask this difficulty quite well by using a range of strategies to compensate for their difficulties.
MCI, particularly in early stages, may be difficult to distinguish from the changes seen as part of normal aging, and for this reason, a very large number of people with MCI are not diagnosed as such by a professional. In very early stages of MCI, a brief evaluation which is sometimes conducted by some doctors may not pick up the cognitive changes because they are still subtle. Researchers and clinicians are always trying to develop brief and sensitive tests that would help differentiate between normal age-related cognitive challenges and those that might indicate early stages of MCI or dementia. One area that generates a lot of interest is how sensory decline, for example, difficulty smelling in the absence of a known reason, may be a warning sign that someone is likely developing a neurodegenerative disease, and that the subtle cognitive challenges are therefore less likely to be “benign”. It is always recommended to seek the advice of an expert such as a clinical neuropsychologist if a more thorough evaluation is required.
Early detection of cognitive decline/MCI that is due to an underlying neurodegenerative disease such as Alzheimer’s disease means that people are able to get treatment early – there are drug and non-drug treatments that may play a role in delaying or slowing down the process of cognitive decline. In addition to the importance of a range of lifestyle approaches (e.g. increasing physical activity and improving sleep), a group of non-drug treatments, referred to as “cognitive treatments” have been repeatedly shown to improve thinking skills, mood and other outcomes in older people with and without MCI.“
Digging deeper
Normal Aging: What to Expect
As we age, our brains naturally undergo changes that can affect how quickly we process information and retrieve memories. Normal age-related cognitive changes typically include:
Occasional word-finding difficulties - taking a moment to recall a name or word
Slower processing speed - needing more time to complete complex tasks
Mild forgetfulness - occasionally misplacing items or forgetting appointments
Reduced multitasking ability - finding it harder to juggle multiple tasks at once
The key characteristic of normal aging is that these changes don't significantly impact your daily life or independence. You might take longer to remember someone's name, but you eventually do. You might need to write things down more often, but you can still manage your finances, drive safely, and maintain your relationships.
Mild Cognitive Impairment: When Changes Become Concerning
Mild cognitive impairment represents a middle ground between normal aging and dementia. With MCI, cognitive changes are noticeable and measurable, but they haven't yet severely impacted your ability to live independently. Key differences include:
Persistent memory problems that are worse than expected for your age
Difficulty with complex tasks like managing finances or following medication schedules
Problems that others notice - family and friends commenting on changes
Struggling with familiar activities that were previously routine
Getting lost in familiar places or having trouble following conversations
Research shows that MCI prevalence increases with age, affecting 6.7% of people aged 60-64, rising to 25.2% for those aged 80-84. Alarmingly, recent research indicates that 92% of MCI cases go undiagnosed, meaning millions of people aren't getting the help they need.
The Critical Difference: Impact on Daily Life
The most important distinction is how these changes affect your daily functioning. Normal aging might mean you occasionally forget where you parked at the grocery store, but you can retrace your steps and figure it out. With MCI, you might consistently have trouble remembering recent conversations, managing your bills, or following your usual routines.
Why Early Recognition Matters
Many people dismiss concerning symptoms as "just getting older," but this can be a costly mistake. Roughly one to two out of 10 people age 65 or older with MCI develop dementia over a one-year period, making early intervention crucial.
Here's what many people don't realize: there are proven interventions that can help. While we can't stop normal aging, we can meaningfully impact the trajectory of mild cognitive impairment through evidence-based cognitive therapies.
The Science of Hope
Recent breakthrough research has fundamentally changed what's possible for people with MCI. Studies like the I-CONECT trial at Harvard University have shown that regular conversational engagement can significantly improve cognitive function, with participants showing a 17% greater improvement in composite cognitive scores compared to control groups.
The key insight from decades of research is that our brains remain plastic throughout our lives. Just as physical therapy can help restore mobility after an injury, cognitive rehabilitation can help strengthen memory, attention, and problem-solving skills.
What You Should Do
If you're experiencing changes that concern you:
Don't dismiss your concerns - trust your instincts about changes in your thinking
Keep a cognitive diary - note specific examples of difficulties you're experiencing
Seek professional evaluation - a neuropsychologist can conduct proper testing
Ask about cognitive interventions - many doctors aren't yet aware of proven non-drug treatments
The most important message I can share is this: cognitive decline isn't something you have to simply accept. While normal aging is inevitable, there are evidence-based treatments that can help you maintain your cognitive abilities and independence longer than ever before.
Take Action Today
At NewDays, we've seen remarkable results helping people strengthen their cognitive abilities through our personalized treatment program. Our approach combines expert-led therapy with daily AI-powered exercises based on proven clinical research.
If you're concerned about changes in your memory or thinking, don't wait. The earlier we intervene, the more we can help you maintain the cognitive abilities that matter most to you.
Ready to learn more? Contact NewDays today to schedule a cognitive wellness review and discover how our science-backed treatment can help you take control of your cognitive health.
Have a question for Dr. Alex? Submit your cognitive health questions to hello@newdays.ai and it might be featured in our next Ask Alex post.
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