Dementia––When should you be concerned about your short-term memory?
Courtesy Kerry Mahan, MD, Denton County LIVING WELL Magazine
Have you misplaced something lately and wondered if you should be concerned about your short-term memory? Every 68 seconds someone is diagnosed with the most common form of dementia: Alzheimer’s dementia. One of four family members is, or will be, acting as caretaker for an Alzheimer’s patient.
Who should be concerned about the state of their short-term memory?
The answer is a matter of age. Individuals older than 65 years have dementia at a rate of 5 to 8% while individuals older than 80 years have dementia at a rate of 50%. Dementia is the loss of mental functions that include: short-term memory, reasoning, language, visual perception, and thinking––so severe it impairs an individual’s daily activities of life. Patients with dementia exhibit a change in mood, behavior, and personality. Dementia warning signs include repeating stories, repeating asked questions, getting lost, misplacing items, grasping for the right words, personality changes, confusion, lack of hygiene, and strange behaviors.
Alzheimer’s dementia is the most common dementia causing 80% of diagnosed dementia cases. The cause of Alzheimer’s dementia is the breakdown of the neuron that produces the chemical acetylcholine, a neurotransmitter. Definitive diagnosis of Alzheimer’s dementia can be made only at autopsy; however, early detection via screening exams followed by thorough medical evaluation is important.
The purpose of a thorough medical evaluation for dementia is twofold:
- First, is to appropriately diagnosis Alzheimer’s dementia and initiate treatment with cholinesterase inhibitor medications to preserve the patient’s memory, thinking, language, and judgment.
- Second, is to accurately diagnosis each of the other 50 types of dementia and to initiate treatment, especially in the 20% of those dementias that are reversible.
The SAGE Self Administered Geocognitive Examination is a self screen exam that is available online for individuals wanting early detection. This screening tool detects 80% of examiners with mild thinking and memory impairment while 95% of normal examiners will have normal exams. Anyone having a positive screening exam or anyone expressing the warning signs of dementia should undergo a thorough medical evaluation. Typically, the medical evaluation includes a neurological exam, a battery of laboratory tests and sometimes, a CT scan or MRI of the brain. The purpose of these exams is to diagnosis and treat reversible dementia such as subdural hematoma, vitamin B12 and folate deficiency, syphilis, hypothyroidism, hyperparathyroidism, AIDS, normal pressure hydrocephalus, and hypoglycemia. Depression is another treatable disease process. Depression does not cause dementia but it does appear in the elderly with the presentation of similar symptoms to dementia and is referred to as pseudo dementia. The remaining causes of dementia, albeit less treatable, still require a medical diagnosis and disease management. Examples are: Parkinson’s disease, Huntington disease, stroke, head injury, lung disease, liver disease, kidney disease, and tumor.
All dementia is not the same; therefore, early diagnosis affords early treatment and sometimes a cure.
In Alzheimer’s dementia, treatment consists of cholinesterase inhibitor medication that maintains mental functions of memory, thinking, and language. For other dementias, treatment is also geared toward treating the underlying disease. For example, in dementia caused by vitamin B12 deficiency, the treatment is to restore vitamin B12 levels. Dementia patients can experience mood and behavioral changes as a result of altered visual perception, thinking, judgment, and language. Treating patients with medications targeting depression, anxiety, and impulsive behavior, can improve their quality of life.
If you or a loved one experience the warning signs of dementia or have a positive screening exam, seek medical care from a provider specializing in adult medicine.
Internists concentrate solely on the comprehensive care of adults. Board certified internal medicine specialists, like Dr. Kerry Mahan, investigate complex, multisystem disease processes and are skilled in patient management. Because internists are often consulted to solve perplexing medical problems, they are called “the doctor’s doctor.” And according to the American Board of Internal Medicine, an Internal Medicine Board Certification “enhances the quality of the healthcare by identifying those internist…who demonstrate the knowledge, skills, and attitude essential for excellent patient care.”
Dr. Kerry Mahan is available to address concerns related to dementia or other comprehensive adult medical issues.
