Many older people worry about becoming more forgetful. They think forgetfulness is
the first sign of Alzheimer's disease. In the past, memory loss and confusion were
considered a normal part of aging. However, scientists now know that most people
remain both alert and able as they age, although it may take them longer to remember
things.
A lot of people experience memory lapses. Some memory problems are serious, and
others are not. People who have serious changes in their memory, personality, and
behavior may suffer from a form of brain disease called dementia. Dementia seriously
affects a person's ability to carry out daily activities. Alzheimer's disease is one of many
types of dementia.
The term dementia describes a group of symptoms that are caused by changes in
brain function. Dementia symptoms may include asking the same questions
repeatedly; becoming lost in familiar places; being unable to follow directions; getting
disoriented about time, people, and places; and neglecting personal safety, hygiene,
and nutrition. People with dementia lose their abilities at different rates. Dementia is
caused by many conditions. Some conditions that cause dementia can be reversed,
and others cannot. Further, many different medical conditions may cause symptoms
that seem like Alzheimer's disease, but are not. Some of these medical conditions may
be treatable. Reversible conditions can be caused by a high fever, dehydration, vitamin
deficiency and poor nutrition, bad reactions to medicines, problems with the thyroid
gland, or a minor head injury. Medical conditions like these can be serious and should
be treated by a doctor as soon as possible.
Sometimes older people have emotional problems that can be mistaken for dementia.
Feeling sad, lonely, worried, or bored may be more common for older people facing
retirement or coping with the death of a spouse, relative, or friend. Adapting to these
changes leaves some people feeling confused or forgetful. Emotional problems can be
eased by supportive friends and family, or by professional help from a doctor or
counselor.
The two most common forms of dementia in older people are Alzheimer's disease and
multi-infarct dementia (sometimes called vascular dementia). These types of dementia
are irreversible, which means they cannot be cured. In Alzheimer's disease, nerve cell
changes in certain parts of the brain result in the death of a large number of cells.
Symptoms of Alzheimer's disease begin slowly and become steadily worse. As the
disease progresses, symptoms range from mild forgetfulness to serious impairments in
thinking, judgment, and the ability to perform daily activities. Eventually, patients may
need total care.
In multi-infarct dementia, a series of strokes or changes in the brain's blood supply may
result in the death of brain tissue. The location in the brain where the strokes occur and
the severity of the strokes determine the seriousness of the problem and the symptoms
that arise. Symptoms usually begin abruptly and progress in a step-wise fashion with
repeated strokes. At this time, there is no way to reverse the damage that has already
been caused by a stroke. However, treatment to prevent further strokes is very
important.
Diagnosis
People who are worried about memory problems should see their doctor. If the doctor
believes that the problem is serious, then a thorough physical, neurological, and
psychiatric evaluation may be recommended. A complete medical examination for
memory loss may include gathering information about the person's medical history,
including the use of prescription and over the counter medicines, diet, past medical
problems, and general health. Because a correct diagnosis depends on recalling these
details accurately, the doctor also may ask a family member for information about the
person.
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.