Forgetfulness: It's Not Always What You Think (cont.)

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.

Treatment

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 (Reminyl) are prescribed to possibly delay the worsening of some of the disease's symptoms. 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 more strokes.

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.

Advice for Today

Scientists are working to develop new drugs that someday may slow, reverse, or prevent the damage caused by Alzheimer's disease and multi-infarct dementia. In the meantime, people who have no dementia symptoms can try to keep their memory sharp.

Some suggestions include:

  • Developing interests or hobbies and staying involved in activities that stimulate both the mind and body.
  • Giving careful attention to physical fitness and exercise also may go a long way toward keeping a healthy state of mind.
  • Limiting the use of alcoholic beverages is important, because heavy drinking over time can cause permanent brain damage.

Many people find it useful to plan tasks; make "things-to-do" lists; and use notes, calendars, and other memory aids. They also may remember things better by mentally connecting them to other meaningful things, such as a familiar name, song, or lines from a poem.

Stress, anxiety, or depression can make a person more forgetful. Forgetfulness caused by these emotions usually is temporary and goes away when the feelings fade. However, if these feelings last for a long period of time, getting help from a professional is important. Treatment may include counseling or medication, or a combination of both.

Some physical and mental changes occur with age in healthy people. However, much pain and suffering can be avoided if older people, their families, and their doctors recognize dementia as a disease, not part of normal aging.

For additional information, please visit the Dementia Center.

Source: National Institute on Aging, National Institute of Health (www.nia.nih.gov)


Last Editorial Review: 7/7/2004