Memory problems: Is it Alzheimer's Dementia?.
This is a very common query, that every person and their family, are bogged with when an individual experiences the memory problem. The answer is complicated but in general “NO”. There are many causes and reasons why any one experience a memory problem. At times memory problem can be attributed to other psychological problems, which causes impairment in attentiveness and concentration such as Depression, Anxiety, substance abuse (like alcohol) etc.
A mere presence of the memory problem is not a dementia: One need to have other associated signs and symptoms such as problems with language and fluency of speech, inability do tasks which one was able to do before, loss of ability to drive or move around in familiar places without getting lost/confused, trouble with day to day executive functions such as planning, organizing self for the day, paying bills etc.
Recent texts describes the Dementia as Major Neurocognitive Disorders. There are many types of Dementias. The most common types are caused by: Alzheimers Disease, Lewy Body disease, Vascular ( stroke), Fronto Temporal and others caused by Parkinson Disease, Huntington Disease, NPH, Nutritional deficiencies, Infections and Head trauma etc. It's important to remember that in advanced age, mostly the etiological factors are Mixed. A good history from the patient and their family is crucial in addition to the blood tests, imaging studies of the brain ( MRI, PET). A chronological description of the onset of various symptoms is critical to differentiate between different types of the Memory problems. The most common etiological factor for developing the Alzheimers Disease is the advanced age. Genetics do play a role but it's limited to approx. 10% of the dementias due to Alzheimer’s Disease. There are few treatments to address the memory problem: If its due to depression or anxiety- treat the underlying psychological condition. Others such as Vitamins and supplements (in B12 deficiency), Antibiotics (if infections-i.e syphilis), surgery- VP shunt (in NPH), appropriate control of blood pressure (strokes). Other treatments such as changes in the environment to reduce the behavioral problems in Dementia patients-simple things such as adequate lighting to reduce the sundowning during the evening hours. The medication: Donepezil, Rivastigmine, Galantamine, Memantine etc will only slow down the process of further damage-though does not prevent the future damage. Will cont. with more on individual types of Dementia’s in the future blogs.