Small changes in the speed of mental processes and recall of unimportant information can occur with normal aging. Memory for new information begins to slip in middle age. You may need to repeat new things a few times, or link them to something you already know well. Keeping lists of things you need to remember may be required, when it was not before.

Memory slips further in late life (especially after 75). The process of remembering new things takes more time. This alone is not a sign of Alzheimer’s disease. However, loss of important abilities requiring mental skill, such as keeping track of money and shopping for food are never lost due to aging. When important abilities are lost due to problems with memory, dementia is likely.

Some 2 to 4 million persons have dementia associated with aging. Of these individuals, as many as two-thirds have Alzheimer's disease. Several new treatments of Alzheimer’s are proven to relieve some of the symptoms and slow the deterioration from the disease. The following lists some things that may improve the life of a person with Alzheimer’s:

• drug treatment of Alzheimer’s

• prevention of stroke

• caregiver education and support

• counseling for patient and family

• day treatment

• respite care

A person with Alzheimer’s may have years of comfortable, good life remaining. As most persons with Alzheimer’s are older, life may end before the slow progress of the brain disorder seriously interferes with the quality of life. Working to slow the disease and improve its symptoms is the important goal in Alzheimer’s.

In addition to these, family caregivers can learn to cope with the problem by learning about the disease. Much information and help is now available through your local Alzheimer’s Association, and others. Planning ahead can also relieve the burden of the family if the disease progresses.

The earlier the diagnosis, the more likely the symptoms will respond to treatment. The early signs of dementia include problems with the following:

• Learning and remembering new information. Repeating things. Forgetting conversations or appointments.

• Handling complex tasks. Trouble performing tasks that require many steps such as balancing a checkbook or cooking a meal

• Reasoning ability. Trouble solving everyday problems at work or home, such as knowing what to do if the bathroom is flooded.

• Spatial ability and orientation. Trouble finding familiar places while driving.

• Language. Trouble finding the words in conversation.

• Behavior. Trouble paying attention. More irritable or less trusting than usual.

 

Talk to your doctor as soon as possible if you think you or a family member may have signs of dementia. Primary care doctors (internal medicine and family practice) are a good place to start. The first step in getting help for a memory problem is a thorough medical evaluation. The medical evaluation will first eliminate any possible treatable medical cause of the memory problem. Many treatable conditions that effect memory are found during investigations of memory loss. These include depression, prescription drugs, and a variety of medical conditions.

The memory evaluation will focus on three questions:

• Is an important memory disorder present?

The evaluation will test the function of the mind in a number of areas. This will establish the importance of the memory changes. Sometimes in early memory loss more extensive testing is needed to determine the importance of the memory complaints. This more extensive testing is performed by professionals called neuropsychologists.

• Can the memory problem be improved?

The medical evaluation and testing will find any problems or medicines that affect memory. The doctor will suggest ways to correct these problems or determine their effect on memory.

• What is the cause of the memory problem?

Over 100 different diseases can cause serious memory loss. However, a few conditions account for over 90% of the causes of dementia. The doctor will gather enough information to identify the most likely cause of the memory problem. The doctor can also determine what other evaluations or professionals are likely to be of help. Neurologists and psychiatrists also work with persons with memory disorders.

The memory evaluation will include

• A thorough history and examination;

• A group of laboratory tests to find hidden causes of memory loss;

• Sometimes a brain imaging study (CT or MRI).

 

Sometimes the cause of the memory problem is not clear after the primary care doctor does his or her work. Three types of specialists can help with memory problems, their evaluation, and their management.

• Neurologist

Neurologists are medical doctors who specialize in diseases of the brain and nervous system. The have broad experience in these diseases, and understand the unusual causes of memory loss. They are the experts in the "differential diagnosis" of memory loss--what list of possible causes applies to an affected person and which cause is most likely.

• Psychiatrist

Psychiatrists are medical doctors who specialize in the mind and mental disorders. Psychiatrists, particularly those with special training or interest in older persons, are experts in the management of the mental complications of memory problems. Depression, behavior problems, and severe confusion often interfere with best functioning of the affected person and caregiver. Depression is also a common cause of memory complaints.

• Neuropsychologist

Neuropsychologists are experts in the measurement of mental function. They can test the brain in many areas, and offer the best answers to questions of the nature and seriousness of mental changes in early cases. The neuropsychologist can provide information to other doctors on the pattern of mental changes that is useful in determining the cause, particularly in difficult and unusual cases.

Alzheimer’s type dementia is a chronic disease that may allow years of active, functional living. Learning to live well with Alzheimer’s disease is both possible and useful to all.