Evaluating Memory Loss
Changes in memory and brain health can have several causes. The most important part of making a diagnosis is to obtain accurate information from close family members and friends who know the patient well. We need to establish that a decline in a level of functioning has occurred that cannot be explained by depression or systemic illnesses such as renal or heart failure, and that the process is progressively worsening. The baseline of each individual is unique and determines the level with which we establish if there has been a deterioration.
A urinary tract infection can cause major confusion in an elderly person and should not be labeled as dementia. Pneumonia, head trauma and medication side effects often cause memory problems too, but patients get better over time and as such they do not meet the diagnostic criteria for dementia.
Memory problems are ubiquitous and by themselves are not worrisome for the onset of dementia. We all forget our keys, may have difficulty finding our car in the parking garage, or walk into the basement and not remember why we went there. Memory problems are concerning, and a sign of dementia, when a patient forgets major events, names or things that are significant. Not showing up at a daughter's wedding, forgetting names of grandchildren or not remembering how to drive are concerning enough to warrant a dementia evaluation.
Tests
To help determine the cause of your or your loved one’s memory loss, your provider may recommend:
- blood tests for thyroid and B12 levels
- brain imaging with CT scan or MRI
- paper-pencil tests to measure memory, learning, language, orientation and other brain functions such as drawing or abstract thinking
Treatments
Medications helpful for making a person with mild dementia talk more, have more interest in interacting with family members, and show less agitation or paranoid thoughts include Aricept, Razadyne and Exelon. Aricept is the most commonly used drug in this class. It helps patients live in their own homes for a longer period of time and delay transfer to a nursing home for two years or more. Numerous studies have shown that the earlier treatment starts the more the patient benefits.
Patients who have increasing difficulty with taking care of their basic needs such as getting dressed, eating or using the bathroom can benefit from taking a drug called Namenda. Clinical trials indicate that patients with moderate to severe dementia benefit the most if they take a combination of Aricept and Namenda together.
Caring for the Caregiver
It is critical that caregivers of patients with dementia take care of themselves, too. Family members often feel guilty about not spending enough time with their loved one and may give up their own free time to provide care. Over time, this can lead to high stress, increased blood pressure, depression and burnout. But reliable support can help you sustain long-term care.
Helpful resources for caregivers include:
- The Alzheimer’s Association, which offers free education, support groups and a 24/7 helpline. More information is available at www.alz.org or by calling 1-800-272-3900.
- "The 36-Hour Day", a trusted and practical guide for families caring for someone with dementia.
- Medicare caregiver supports, which are also available at no cost;
Learn More Here.