The Doctor Is In

QUESTION: My 75-year-old father is becoming more forgetful. How can I tell if it’s just “senior moments” or if it’s dementia or Alzheimer’s disease?

Dr. Raskin: When your 75-year-old father forgets where he put his car keys, this can be a good example of normal age-associated memory impairment. When he forgets what they are called or what to do with them, then that can be a sign of dementia or Alzheimer’s disease.

Almost 40 percent of people over the age of 65 experience some form of memory loss, which can be deemed as part of the aging process. When this occurs, it usually means you have a harder time recalling new pieces of information, such as the name of the new restaurant where you ate last week. Often, the name will come back to you later when you least expect it.

By definition, dementia is memory loss that is severe enough to impair someone’s ability to function in day-to-day life, which is clearly different from someone’s prior level of functioning. Dementia is not a specific disease, but rather a group of symptoms affecting thinking and social abilities. It is a general term that involves more than memory loss, but may also include loss of language skills, changes in behavior and personality and loss of ability to do many high-level functions, such as paying bills or managing finances.

Alzheimer’s disease is the most common type of dementia in people age 65 and older, and its hallmark is the progressive gradual decline in short-term memory. This may be progressive over seven to 10 years. There are many other causes of dementia, including those caused by small strokes or from years of alcohol abuse. There are even some forms of dementia that may be reversible, such as nutritional deficiencies or medication side effects for example.

You are not very specific about the kinds of things your dad is forgetting, but there are a few red flags that would signify more of a dementia process than just normal aging.

First, is he is still independent in his daily activities? Those with dementia often rely heavily on others for their key daily living activities.

Second, those with normal aging usually complain that their memory is sliding, but they will often remember many details about the things they can’t remember. Those with dementia may not recall what they are even trying to remember. In addition, if your dad occasionally struggles to find a word that he is saying, this could be normal. If he frequently pauses to find words or substitutes wrong words, this may be a more ominous sign.

Further, is your dad still functioning normally in a social setting with good interpersonal skills? Those suffering from dementia will often lose interest in social activities or start to have inappropriate social behaviors. I have many stories of patients with dementia who have lost all their abilities to filter what they are saying, and the things they do say cannot be repeated in a newspaper read by kids.

Other symptoms to watch out for include getting lost in familiar places, asking the same question over and over, repeated falls or loss of balance, personality changes and changes in hygiene.

With the first signs of any possible memory impairment, I strongly urge you to bring your family member or loved one to their primary care physician to be evaluated. Be aware that Alzheimer’s disease cannot be diagnosed with a simple blood test. In general, a thorough evaluation of memory and mental status needs to be performed to document the severity of the situation. However, blood work – along with brain imaging – may help rule out some other causes of dementia.

If Alzheimer’s disease is diagnosed, the current medications available are not cures but may help slow down the decline of memory and other related symptoms. The sooner the medications are started, the better the chance they can improve things. In addition, the earlier the diagnosis is made, the more time the family has to plan the support that the patient will need in the future.

If, however, the doctor says your dad is okay, you can help him cope with normal age-related memory difficulties. Keeping routines, increasing blood flow to the brain with exercise and keeping mentally alert with crossword puzzles or taking a class to learn a new language can all be helpful.

For more information, visit alzheimers.org.

Palisadian Damon Raskin, M.D., is a board-certified internist who offers preventative medicine, concierge services and addiction medicine to patients in and around the Palisades. Contact: (310) 459-4333. To submit your medical questions, like or follow us on Facebook.com/PalisadianPost or Twitter.com/PalisadianPost and send a message.