Forgetfulness: It's Not Always What You Think
People who are worried about memory problems should see their doctor. If the
doctor believes that the problem is serious, then a thorough physical,
neurological, and psychiatric evaluation may be recommended. A complete medical
examination for memory loss may include gathering information about the
person's medical history, including use of prescription and over the counter
medicines, diet, past medical problems, and general health. Because a correct
diagnosis depends on recalling these details accurately, the doctor also may
ask a family member for information about the person.
Tests of blood and urine may be done to help the doctor find any problems.
There are also tests of mental abilities (tests of memory, problem solving,
counting, and language). A brain CT scan may assist the doctor in ruling out a
curable disorder. A scan also may show signs of normal age related changes in
the brain. It may be necessary to have another scan at a later date to see if
there have been further changes in the brain.
Alzheimer's disease and multi infarct dementia can exist together, making it
hard for the doctor to diagnose either one specifically. Scientists once
thought that multi infarct dementia and other types of vascular dementia caused
most cases of irreversible mental impairment. They now believe that most older
people with irreversible dementia have Alzheimer's disease.
Even if the doctor diagnoses an irreversible form of dementia, much still
can be done to treat the patient and help the family cope. A person with
dementia should be under a doctor's care, and may see a neurologist,
psychiatrist, family doctor, internist, or geriatrician. The doctor can treat
the patient's physical and behavioral problems and answer the many questions
that the person or family may have.
For some people in the early and middle stages of Alzheimer's disease, the
drugs tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon), and
galantamine (Razadyne, formerly known as Reminyl) are prescribed to possibly
delay the worsening of some of the disease's symptoms. Another drug, memantine
(Namenda), has been approved for treatment of moderate to severe AD. Doctors
believe it is very important for people with multi infarct dementia to try to
prevent further strokes by controlling high blood pressure, monitoring and
treating high blood cholesterol and diabetes, and not smoking.
Many people with dementia need no medication for behavioral problems. But
for some people, doctors may prescribe medications to reduce agitation,
anxiety, depression, or sleeping problems. These troublesome behaviors are
common in people with dementia. Careful use of doctor prescribed drugs may make
some people with dementia more comfortable and make caring for them easier.
A healthy diet is important. Although no special diets or nutritional
supplements have been found to prevent or reverse Alzheimer's disease or multi
infarct dementia, a balanced diet helps maintain overall good health. In cases
of multi infarct dementia, improving the diet may play a role in preventing
Family members and friends can assist people with dementia in continuing
their daily routines, physical activities, and social contacts. People with
dementia should be kept up-to-date about the details of their lives, such as
the time of day, where they live, and what is happening at home or in the
world. Memory aids may help in the day to day living of patients in the earlier
stages of dementia. Some families find that a big calendar, a list of daily
plans, notes about simple safety measures, and written directions describing
how to use common household items are very useful aids.