Women in midlife who notice occasional word‑finding trouble, misplaced items or a slower pace of thought often wonder whether these signs point to Alzheimer’s disease or another form of dementia. Dr. Rhonda Voskuhl, a professor of neurology at UCLA and co‑founder of Cleopatra RX in Los Angeles, says the first step is to compare current cognition with how it functioned ten years earlier.
The 10‑year assessment
Speaking at the Livelong Women’s Health Summit in New York City, Dr. Voskuhl explained that a quick benchmark can help women gauge whether their experience is likely tied to hormonal shifts. “The first question is, are you worse than you were 10 years ago?” she asked, referencing the Voskuhl Brain Fog Menopause Assessment used in UCLA’s Comprehensive Menopausal Program. She added that a decade provides a “pretty good spot” for recalling past performance, such as multitasking ability, word‑finding speed and overall processing.
By reflecting on whether they were already struggling with these tasks a decade ago, women can create a personal baseline. This self‑comparison, she said, helps both patients and physicians track symptom trajectories over time.
Why standard tests may miss early changes
Standard neuropsychological exams often fail to capture subtle, everyday shifts in cognition—a phenomenon known as subjective cognitive decline. The Centers for Disease Control and Prevention reports that roughly one in nine adults experience such decline, yet fewer than half discuss it with a healthcare professional.
Dr. Voskuhl illustrated the limitation of routine testing with an NFL analogy. She noted that a professional football player who feels weaker may still score normally on a neurological exam, but his personal perception remains valid. “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,’” she said. “What the player is feeling still matters, even if a standard test shows no obvious decline.” The same principle applies to women experiencing menopausal brain fog.
Distinguishing brain fog from early dementia
Experts agree that the key difference lies in how memory loss affects daily function. According to the Mayo Clinic, menopausal brain fog typically produces temporary, inconsistent lapses—misplacing items, slower processing, or occasional word‑finding difficulty—while overall reasoning skills and independence remain intact. Symptoms often fluctuate and may worsen with stress or poor sleep.
In contrast, early dementia presents as persistent, progressive memory loss that interferes with basic tasks such as managing finances, navigating familiar routes, or exercising sound judgment.
Given the overlap in subjective experience, Dr. Voskuhl advises a full medical evaluation when concerns arise. Recommended assessments include brain MRI scans and vascular or thyroid screenings to rule out conditions like blood‑vessel disease or thyroid imbalance.
She also cautioned women to seek physicians who listen. “When they have doctors who don’t listen to them, they need to find another doctor,” she said, underscoring the importance of patient‑centered care.
By using the ten‑year self‑assessment, women can better differentiate hormone‑related fog from more serious neurodegenerative processes and engage healthcare providers with clearer context for their symptoms.
Mitchell Landsberg is a Senior Technology Correspondent at News Raise. He covers consumer electronics, artificial intelligence, software developments, and digital privacy trends.
