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Losing a train of thought, struggling to recall once-familiar words, or forgetting the reason for walking into a room can leave older adults wondering if they are experiencing early signs of Alzheimer’s disease or dementia.
However, these brain blips can often be tied to hormone shifts later in life, medical experts note — and women who experience a loss of estrogen during perimenopause and menopause are particularly affected.
According to Dr. Rhonda Voskuhl, a professor of neurology at UCLA and co-founder of Cleopatra RX in Los Angeles, women experiencing memory struggles in midlife should compare their cognitive function to their own past performance before assuming something is seriously wrong.
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“I think they should listen to themselves,” Voskuhl told Fox News Digital at the Livelong Women’s Health Summit in New York City on Friday. “They know. Just ask yourself.”
The 10-year assessment
To help women gauge whether their memory lapses are tied to hormonal shifts, Voskuhl recommends using a quick benchmark – comparing their current mental state to where it was a decade ago.
“The first question is, are you worse than you were 10 years ago?” she said, referencing the Voskuhl Brain Fog Menopause Assessment used at UCLA’s Comprehensive Menopausal Program.
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“Ten years is a pretty good spot. And they think, ‘What was I doing 10 years ago? What was I like? Was I having problems finding the words? Was I at the point where I couldn’t multitask anymore? Was I slow in my processing?’ And they’ll remember.”
This comparison can help reveal whether a woman’s cognitive changes may be linked to menopause, while giving patients and physicians a baseline for tracking symptoms over time.
The NFL analogy
Standard memory tests don’t always catch subtle shifts in everyday cognitive function. In the medical community, this is known as subjective cognitive decline, when patients notice changes even though neurological testing remains normal.
The Centers for Disease Control and Prevention reports that roughly one in nine adults report subjective cognitive decline, yet less than half discuss these memory concerns with a healthcare professional.
To illustrate why routine tests can miss early menopausal brain fog, Voskuhl compared it to a high-performing athlete.
“They know if they’re not like they used to be.”
“If somebody is an NFL football player and he says, ‘I’m weaker than I used to be,’ and I go and do my neurological test, I say, ‘Oh no, you’re still strong,'” Voskuhl said.
What the player is feeling still matters, even if a standard test shows no obvious decline, she noted.
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Women, too, can often recognize when their cognitive abilities have changed from their own baseline and should trust those observations, according to Voskuhl.
Understanding the difference between hormonal brain fog and neurodegenerative disease comes down to how memory loss impacts daily function, experts agree.
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Menopausal brain fog typically involves temporary, inconsistent lapses like misplacing items or experiencing slower processing speed, but overall reasoning skills and independence remain intact, according to Mayo Clinic. Symptoms often fluctuate and can be exacerbated by stress or poor sleep.
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By contrast, early dementia causes persistent, progressive memory loss that interferes with basic daily tasks like managing finances, following familiar routes while driving or exercising sound judgment.
Amid cognitive concerns, experts advise seeking a full medical evaluation, including brain MRIs or vascular screenings, to rule out underlying issues like blood vessel disease or thyroid imbalances.
For women who feel their concerns are being dismissed, Voskuhl offered this advice: “When they have doctors who don’t listen to them, they need to find another doctor.”
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