2008/03/21 00:00:00
By Nanette Lavoie-Vaughan - March 21, 2008
Learn how to tell the difference between a forgetful parent and one suffering from dementia.
All of us have “senior moments” at one time or another. Perhaps you forgot where you placed your car keys, or you returned from the grocery store only to realize you forgot to purchase milk. These small “brain glitches” are normal at any age and become more frequent with age. But how can you tell if your parent is crossing the line from normal forgetfulness to true dementia?
The key to recognizing early warning signs of dementia is to be aware of the pattern, consistency, and type of forgetfulness your parent displays. If these “senior moments” are increasing in frequency and affecting your parent’s ability to carry out day-to-day functions, you have cause to be concerned.
Ask a health care provider to evaluate your parent if you spot any of the following telltale signs:
- Repeating the same conversation each time you talk
- Forgetting to take medications or taking extra pills because of forgetfulness
- Paying bills late or missing payments
- Getting lost while driving familiar routes
- Difficulty balancing thee checkbook
- Unexplained purchases (including large quantities or unusual items)
- Unexplained weight loss (perhaps because of forgetting to eat)
- Change in appearance (wearing the same outfit everyday, an unkempt appearance)
An evaluation will rule out any physical cause for behavioral and mental changes. Physical causes can include infection, low vitamin B or iron levels, depression, strokes, and seizures. A doctor also can give a presumptive diagnosis of dementia based on a physical exam, laboratory tests, a CT scan or MRI of the brain, and a mini mental exam (a set of questions and simple tests for cognitive function).
A definitive diagnosis is more difficult, because brain structures affected by dementia are not always indicated on a scan. In addition, there are many forms of dementia:
- Alzheimer’s disease. This is the most widely recognized form of dementia and is characterized by the formation of plaques and tangling of nerve fibers in the brain. The decline that occurs as the condition progresses follows a distinct pattern, referred to as stages. Each stage marks a specific decline in memory and brain function.
- Vascular or multi-infarct. This form is caused by “mini-strokes,” which disrupt the blood flow to specific parts of the brain, rendering them useless. This condition might present itself more subtly than Alzheimer’s and doesn’t always follow prescribed stages.
- Lewy-body. Signs of dementia and Parkinson’s disease characterize this disease. In addition to the cognitive and memory problems, Lewy-body patients often have trouble maintaining balance and experience a shuffling gait, tremors, and stiffness of the arms and legs.
- Mixed dementia. This is a combination of Alzheimer’s and vascular dementia.
- Alcohol- or drug-induced dementia. This form of brain damage often is seen in younger people, generally as a direct result of alcoholism or drug use.
Unfortunately, there is no cure for dementia. Treatment focuses on slowing the progressive nature of this disease. Your health care provider can tell you if one of the currently available drugs (such as Aricept, Exelon, Namenda, and Razadyne) is right for your loved one. Medications to treat dementia-associated depression, anxiety, and behavioral issues (agitation, paranoia, and delusions) also might be prescribed if appropriate.
Dementia is not a diagnosis to wish on anyone, but erroneously attributing its warning signs to normal aging or senility can rob your parent of years of improved function and quality of life. Early diagnosis and treatment are essential.
Additional resources:
Alzheimer’s Education and Referral Center — www.alzheimers.org
Alzheimer’s Association — www.alz.org
Nanette Lavoie-Vaughan is an adult nurse practitioner and professional consultant. She is a featured speaker at national professional conferences and writes about geriatrics for multiple publications. If you’d like to send Nanette a comment, question, or suggestion for a future column, please e-mail rolereversal@moaa.org.