UCLA neurologist's '10-year rule' offers midlife women a way to tell brain fog from dementia

Walking into a room and forgetting why you're there. Losing a word you've known for years. Dropping a train of thought mid-sentence. For millions of women in midlife, these moments arrive with an unsettling question: is this menopause, or is this the beginning of something worse?

Dr. Rhonda Voskuhl, a professor of neurology at UCLA and co-founder of Cleopatra RX in Los Angeles, has a practical first step for sorting that out — one she calls the 10-year assessment. Speaking at the Livelong Women's Health Summit in New York City, Voskuhl described the benchmark, which is part of the Voskuhl Brain Fog Menopause Assessment used at UCLA's Comprehensive Menopausal Program.

The first question is, are you worse than you were 10 years ago? 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.— Dr. Rhonda Voskuhl, professor of neurology, UCLA

The logic is straightforward: menopausal brain fog, driven by declining estrogen during perimenopause and menopause, tends to produce temporary and inconsistent lapses — misplacing objects, slower processing speed — while overall reasoning and independence stay intact, according to Mayo Clinic. Dementia, by contrast, causes persistent, progressive memory loss that begins to interfere with basic daily tasks: managing finances, following familiar driving routes, exercising sound judgment.

The 10-year comparison gives both patients and physicians a personal baseline rather than a generic population average — which matters because standard neurological tests frequently miss what clinicians call subjective cognitive decline, the experience of noticing real changes in your own performance even when formal testing registers as normal.

Voskuhl illustrated the gap with an analogy: an NFL player who tells his doctor he feels weaker than he used to be may still test as strong by standard measures. The felt decline is real even when the instrument doesn't catch it. Women in perimenopause, she argues, are in the same position — their own sense of their cognitive baseline is meaningful clinical data.

I think they should listen to themselves. They know. Just ask yourself.— Dr. Rhonda Voskuhl, professor of neurology, UCLA

The CDC reports that roughly one in nine adults report subjective cognitive decline, yet fewer than half ever raise these memory concerns with a healthcare professional — a gap Voskuhl's self-assessment is designed to help close by giving women a concrete way to frame the conversation before they walk into a doctor's office.

The self-assessment is a starting point, not a diagnosis. Experts advise that anyone with persistent cognitive concerns seek a full medical evaluation — including brain MRIs or vascular screenings — to rule out underlying causes such as blood vessel disease or thyroid imbalances. Menopausal brain fog symptoms also tend to fluctuate and can worsen with stress or poor sleep, which can itself help distinguish them from the steadier progression of early dementia.

When they have doctors who don't listen to them, they need to find another doctor.— Dr. Rhonda Voskuhl, professor of neurology, UCLA

For women whose concerns are being dismissed, Voskuhl's message is direct: the subjective experience of cognitive change is worth taking seriously, and finding a physician who agrees is part of the process.

Why it matters — Millions of midlife women experience memory lapses that standard tests miss and doctors may dismiss; a simple personal benchmark could help them seek timely, appropriate care rather than either panicking or going unheard.

Reported by foxnews.com, newspub.live, au.headtopics.com, ground.news