Why Is My Memory Getting Worse?

Memory changes can have many causes
The pattern and pace can provide important clues
A change from your usual function deserves attention

Why is my memory getting worse? You may forget names that once came easily, lose track of conversations, repeat questions, misplace things more often, struggle to remember what you just read, or find yourself relying increasingly on notes and reminders.

Occasional forgetfulness does not necessarily mean something is wrong. But when memory problems are becoming more frequent, interfering with daily life, or clearly different from your previous level of function, the change deserves a closer look.

The important question is not simply whether you forget things. It is how your memory has changed over time, what type of information you are having trouble remembering, and what else is happening when the problem becomes worse.

Is your memory actually getting worse?

Memory is difficult to judge from an isolated bad day. Poor sleep, stress, pain, fatigue, illness, medications, anxiety, depression, and distraction can temporarily make thinking and recall more difficult.

A more useful question is whether there has been a change from your own baseline.

For example, are you increasingly forgetting appointments despite writing them down? Are familiar names becoming harder to retrieve? Are you repeatedly losing your train of thought? Are you having more difficulty following instructions, managing finances, navigating familiar places, or completing tasks that once felt automatic?

These patterns may be more informative than simply saying, “My memory is bad.”

Does worsening memory always mean dementia?

No. Memory problems can occur for many reasons other than dementia. Sleep disorders, depression and anxiety, medication effects, metabolic problems, nutritional deficiencies, alcohol or other substances, infections, neurologic disorders, and other medical illnesses can affect memory and concentration.

The National Institute on Aging lists potentially contributing conditions including thyroid problems, medication side effects, depression and anxiety, sleep problems, vitamin B12 deficiency, head injury, and infections affecting the brain.

This is why worsening memory should not automatically be attributed to aging or dementia. I discuss this differential in more detail in Can Memory Problems Be Something Other Than Dementia?

Is it memory—or is it attention?

Sometimes information is not truly being forgotten because it was never fully encoded in the first place.

To remember a conversation, paragraph, appointment, or instruction, you first have to pay attention to it. The brain then has to process the information, hold it in working memory, and eventually store some of it for later retrieval.

If attention is disrupted by fatigue, pain, poor sleep, anxiety, sensory overload, illness, or another problem, a person may later feel as though the memory disappeared. In reality, the information may never have been stored efficiently.

This distinction can help explain why someone may have trouble remembering recent conversations or what they just read while still recalling events from years earlier.

Does your memory fluctuate or steadily decline?

The trajectory matters.

Some people describe a relatively steady decline. Others have good days and bad days. They may think clearly in the morning but struggle later in the day, or notice that their memory deteriorates after poor sleep, physical exertion, prolonged concentration, stress, or worsening illness.

Fluctuation does not identify a specific diagnosis, but it can be clinically useful. A fluctuating pattern may prompt a different evaluation than a progressive loss of cognitive abilities that continues regardless of sleep, fatigue, mood, or physical symptoms.

Keeping track of when memory is better or worse can sometimes reveal patterns that are difficult to recognize during a single office visit.

Can poor sleep make memory worse?

Yes. Sleep is closely involved in attention, learning, and memory. A person who is sleeping poorly may have trouble concentrating during the day and may not encode new information efficiently.

The result can feel like memory loss: forgetting conversations, rereading material, losing track of tasks, or having difficulty retrieving words.

Sleep problems may therefore be an important part of the evaluation when cognitive symptoms have recently worsened.

Can depression or anxiety affect memory?

Depression and anxiety can affect concentration, attention, processing speed, motivation, and memory. In some patients, these cognitive symptoms can be substantial.

At the same time, clinicians should be careful about assuming that worsening memory is explained entirely by mood. If cognitive difficulties continue to progress, interfere increasingly with function, or do not follow the course of the mood symptoms, additional evaluation may be appropriate.

Can medications contribute to memory problems?

Medications can sometimes contribute to forgetfulness, slowed thinking, sedation, or difficulty concentrating. The effect may become particularly noticeable after starting a new medication, increasing a dose, or taking several medications with overlapping effects.

A medication review is therefore an important part of evaluating new or worsening cognitive complaints. Prescription medications, over-the-counter products, supplements, alcohol, and other substances should all be considered.

What medical problems can affect memory?

Memory complaints can occur with a wide range of medical conditions. Depending on the history, clinicians may consider thyroid disease, vitamin B12 deficiency, sleep disorders, metabolic abnormalities, medication effects, depression, anxiety, neurologic disease, infection, and other systemic illnesses.

The evaluation should be guided by the patient’s age, medical history, medication list, neurologic findings, associated symptoms, and the pattern of cognitive change rather than by memory symptoms alone.

Can Lyme disease affect memory?

Lyme disease can be associated with cognitive complaints in some patients, including difficulty with memory, attention, word retrieval, processing speed, and mental stamina. However, memory problems are nonspecific and should not by themselves be used to diagnose Lyme disease.

The clinical context matters. Lyme disease may deserve consideration when cognitive changes occur alongside a compatible exposure history and other symptoms or findings that support the possibility of tick-borne illness.

Research on cognitive symptoms associated with Lyme disease is mixed. Some studies have documented abnormalities in memory, attention, verbal fluency, or processing speed, while other studies have found that subjective cognitive complaints do not always correspond to measurable impairment on neuropsychological testing.

A small neuroimaging study of patients with well-characterized post-treatment Lyme disease found that participants performed a working-memory task more slowly than controls while maintaining similar accuracy. Functional and structural brain-imaging differences were also reported, although the study included only 12 patients with post-treatment Lyme disease and does not establish what causes cognitive symptoms in an individual patient.

For a focused discussion, see Brain Fog and Cognitive Dysfunction in Lyme Disease.

Can Lyme disease be mistaken for dementia?

Rare cases of Lyme neuroborreliosis have produced cognitive syndromes that resemble dementia. This does not mean Lyme disease is a common explanation for progressive dementia or an established cause of Alzheimer’s disease.

In a 2014 study of 1,594 patients evaluated for dementia, Blanc and colleagues identified a small group with evidence of neuroborreliosis. Some stabilized or improved following antibiotic treatment, while others continued to decline and were ultimately diagnosed with conditions including Alzheimer’s disease, Lewy body disease, frontotemporal lobar degeneration, vascular dementia, or hippocampal sclerosis.

The study illustrates an important clinical principle: identifying Lyme exposure or positive testing does not eliminate the need to evaluate other causes of cognitive decline.

For more on this distinction, see Can Lyme Disease Be Mistaken for Dementia?

How do doctors evaluate worsening memory?

The evaluation usually begins with the history. When did the problem start? Has it progressed gradually or appeared suddenly? Does it fluctuate? Which types of memory are affected? What activities have become more difficult?

It can also be helpful to ask whether family members, coworkers, or friends have noticed a change.

A clinician may review medications, sleep, mood, alcohol or substance use, medical illnesses, neurologic symptoms, infections, nutritional issues, and other potential contributors. Depending on the situation, the evaluation may include cognitive testing, laboratory studies, neurologic examination, imaging, or referral for more detailed neuropsychological assessment.

When is worsening memory more concerning?

Memory changes deserve prompt medical attention when they are rapidly worsening, interfere with safety or independent function, are accompanied by confusion or significant behavioral change, or occur with new neurologic symptoms.

Sudden confusion or cognitive change—particularly when accompanied by weakness, difficulty speaking, severe headache, loss of consciousness, seizure, fever, or other acute neurologic symptoms—requires urgent medical assessment rather than routine outpatient evaluation.

For slower changes, the key question is often whether memory difficulty is beginning to interfere with everyday function.

Frequently Asked Questions

Why is my memory getting worse even though I am not old?

Memory problems can occur at many ages. Poor sleep, stress, depression, anxiety, medications, vitamin deficiencies, thyroid disease, neurologic disorders, infections, and other medical conditions can affect attention and memory. Age is only one part of the evaluation.

Can memory problems come and go?

Yes. Cognitive symptoms may fluctuate with sleep, fatigue, pain, stress, illness, medications, or other physiologic factors. The pattern of fluctuation can provide useful information but does not by itself identify the cause.

How can I tell whether I have memory loss or brain fog?

Brain fog is a broad term that may include poor concentration, slowed thinking, word-finding difficulty, mental fatigue, and working-memory problems. What feels like memory loss may sometimes reflect difficulty paying attention to or processing information rather than loss of stored memories.

Does worsening memory mean I have dementia?

No. Dementia is one possible cause of progressive cognitive decline, but many other conditions can affect memory. The pattern, progression, associated symptoms, medications, medical history, and effect on daily function all help guide the evaluation.

Can Lyme disease cause memory problems?

Lyme disease can be associated with cognitive symptoms including memory difficulty, poor concentration, word-finding problems, and slowed processing in some patients. These symptoms are nonspecific, however, and Lyme disease should not be diagnosed from memory complaints alone.

Clinical Takeaway

When a patient says, “My memory is getting worse,” I want to know what has changed from that person’s previous level of function. I also want to know whether the problem is steadily progressing or fluctuating with fatigue, sleep, pain, illness, stress, or other symptoms.

Memory complaints should not automatically be attributed to aging, dementia, depression, or Lyme disease. The pattern, timeline, associated symptoms, medical history, medications, and functional changes all matter.

Worsening memory is a symptom to investigate, not a diagnosis by itself.

Related Articles

These articles explore related patterns of cognitive difficulty and neurologic symptoms:

Why Do I Forget What I Just Read?
Brain Fog in Lyme Disease: Why It Happens and What Helps
Neurologic Lyme Disease Symptoms: Brain Fog, Dizziness, and More

References

1. National Institute on Aging. Memory, forgetfulness, and aging: What’s normal and what’s not? National Institutes of Health.
2. Blanc F, Philippi N, Cretin B, et al. Lyme neuroborreliosis and dementia. Journal of Alzheimer’s Disease. 2014;41(4):1087-1093.
3. Westervelt HJ, McCaffrey RJ. Neuropsychological functioning in chronic Lyme disease. Neuropsychology Review. 2002;12(3):153-177.
4. Benke T, Gasse T, Hittmair-Delazer M, Schmutzhard E. Lyme encephalopathy: Long-term neuropsychological deficits years after acute neuroborreliosis. Acta Neurologica Scandinavica. 1995;91(5):353-357.
5. Marvel CL, Alm KH, Bhattacharya D, et al. A multimodal neuroimaging study of brain abnormalities and clinical correlates in post treatment Lyme disease. PLoS ONE. 2022;17(10):e0271425.
6. Brackett K, Roche M, Firshein J, et al. Neuropsychiatric manifestations and cognitive decline in patients with long-standing Lyme disease: A scoping review. Cureus. 2024;16(4):e58120.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention