Memory Problems, Dementia, Alzheimer’s
Not all problems with brain capacity in old age are the result of Alzheimer’s disease. It should first be noted that increased forgetfulness is a very unspecific symptom. Often the person is simply dealing with the benign forgetfulness that comes with old age. Forgetfulness may, however, also be an initial symptom of Alzheimer’s or vascular dementia, or even a symptom of depression. Such disorders should be examined further.
The onset of dementia can manifest itself in the form of confusion, increasing forgetfulness, loss of one’s everyday capabilities and behavioral changes. In the early stages, the patient experiences short-term memory problems and disorientation. Sufferers often have a tendency to withdraw to hide the weakness. Dementia rarely occurs in young adults and is even less common in children.
What will the doctor want to know?
What symptoms in particular impair the person’s ability to function in their daily lives? Because forgetfulness can be caused by any number of different things, the person’s medical history is very important. Pre-existing conditions or diseases in the person’s own or their family’s medical history may provide clues. The person will also be asked what medications they are taking or substances that may be harmful to the brain, such as alcohol and drugs. It is also very important to talk with family members (third-party medical history) when diagnosing dementia. Whenever possible, they should accompany the patient during their first doctor’s visit.
Dementia results in a progressive deterioration of a person’s mental capacities. This impairs the person’s ability to function on their own until they eventually require nursing care. Typical symptoms include increasing forgetfulness (birthdays, medications, trouble concentrating, diminishing computational and problem-solving skills, slip-ups, problems with manual skills (household, personal hygiene, getting dressed), recognizing persons and objects, disorientation (time and place), speech disorders (especially speech comprehension). Whereas patients suffering from depression tend to express negativity about their situation, dementia patients often disguise their troubles.
- What causes Alzheimer’s disease is not known, but it leads to a deterioration of nerve cells in regions of the brain that are important for memory, perception and thought processes. Accumulations of proteins in the nerve cells (amyloid plaques) are typical of the disease.
- Depression can have similar symptoms. So the diagnosis is important, since the disorder is treated differently.
- Dementia is very often caused by a circulatory disorder in the brain. Dementia may develop after a major stroke or several minor ones or in people with vascular diseases, such as arteriosclerosis.
- Neurological diseases, such as Parkinson’s, are often accompanied by dementia in the late stages.
- In rare cases, there is a resorption disorder of the cerebrospinal fluid (hydrocephalus) or bleeding in the meninges (subdural hematoma).
- Dementia also occurs in as a result of infections that lead to an inflammation of the meninges or brain.
During initial diagnostics the symptoms (medical history) should be discussed and a neurological examination performed. Additional examinations may complement the diagnosis to varying degrees: neuropsychological testing, laboratory tests, cranial MRI, brainwave measurement (EEG) and lumbar puncture (testing the cerebrospinal fluid).
The following examples show how important comprehensive diagnostics are when making treatment decisions: Depression responds very well to medication. A resorption disorder of the cerebrospinal fluid (hydrocephalus) or a blood clot can be treated by performing a neurosurgical procedure. Inflammatory brain disease (encephalitis) or a vitamin B12 deficiency can also be identified and treated.
The treatment of chronic diseases like Alzheimer’s differs greatly from patient to patient. Symptoms are treated in each case with the goal of alleviating current symptoms and having a positive effect on the course of the disease. Non-drug treatments are also very important and help patients to maintain a good quality of life for as long as possible.