What to do When Reading Gets Harder

Treating underlying conditions and using helpful strategies may be all it takes to get you back on track.

Reading for pleasure is one of life's great gifts. It's an escape to another world or a path to increased knowledge. Plus, reading about a subject that's new to you challenges the brain, which may help create new brain cell connections. But many aspects of health can affect our ability to read in older age.


Chronic disease and age-related changes can have a big effect on your ability to read. Consider these factors:
Poor vision. Maybe you have double vision or you can't see up close, or maybe it's hard to read in a room that isn't well lighted.
Pain. "Osteoarthritis at the base of the thumb, wrist, or fingers is common with age and can affect your ability to hold a book," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
Pain or numbness in the extremities. This symptom, called neuropathy, can make it uncomfortable to hold reading material for extended periods.
Tremors. Shaky hands from Parkinson's disease or other conditions may keep you from holding a book still enough to read the words.


Changes in thinking skills can also affect your reading ability. Reading requires attention, short-term memory, and recall, which decline a little as we age. "It's normal when you're older that your reading might be slower or that you have to occasionally read a sentence more than once to get its meaning. Your ability to read and retain information may take more effort," notes Dr. Joel Salinas, a neurologist at Harvard-affiliated ­Massachusetts General Hospital.
Sometimes fuzzy thinking gets in the way of reading. This might happen because of a medication that makes it harder to concentrate; a lack of sleep; nutrient deficiency; or lifelong reading or learning disabilities, which can get worse as you age.
Likewise, if you always had difficulty concentrating when you were younger (perhaps because of undiagnosed attention deficit hyperactivity disorder), your attention span may shrink further in older age.
"People often think that they wind up reading the same sentence over and over because of memory issues. But if your attention isn't focused on the sentence you're reading, you're not likely to register enough of the sentence to understand what your eyes just passed over," Dr. Salinas points out.

Grandfather and grandson reading at lake. (Getty)


Mild cognitive impairment (MCI) may also be behind reading skills decline. MCI can make it harder to understand or retain what you're reading.
MCI is a noticeable change in thinking and memory skills, but not enough that it becomes a huge barrier to your ability to take care of yourself and finish your daily tasks. You may miss some appointments, lose things often, have more difficulty recalling names or words you'd like to use, or have a harder time finding familiar places and keeping track of important dates.


Talk to your doctor when you notice thinking skills issues that occur frequently. Start with your primary care doctor, who can perform a mini evaluation or send you to a neuropsychologist for a thorough evaluation. "Neuropsychologists can test for how fast you read, how much you understand, and what you recall from what you read," Dr. Salinas says.
When physical changes are the problem, treating the underlying condition can help you read better. For instance, maybe you just need a new pair of reading glasses.


Sometimes all it takes to improve reading are a few strategies.
If you have pain or tremors, Dr. Shmerling recommends propping up a book on a pillow or book holder. If you find it's hard to flip pages, try an electronic reading device (like an iPad or Kindle). With an electronic device, the page stays steady, and it's just a tap to turn the page. For vision challenges, electronic reading devices and large-print books can help greatly.
When attention is the challenge, Dr. Salinas suggests reading in a quiet space, reading out loud, mouthing the words as you read, listening to the audiobook recording while you read, or using a sheet of paper to reveal one line of text at a time so you don't skip ahead.
The important thing is to try.
"There are solutions that work for most obstacles to reading," says Dr. Shmerling, "and for most people, it's a great way to keep up with what's happening in the world and to keep the mind working."