We lose the car keys again, can’t remember the title of the great movie we saw last year, and forget a friend’s birthday. Panic sets in, and the specter of Alzheimer’s disease rears its ugly head.
Everyone over the age of 50 is struck by these incidents and begins worrying. Sometimes we dismiss them with a joke, sometimes we feel a rush of fear.
But lots of other medical problems and conditions, many of them reversible and easily treatable, can mimic the signs of dementia. If we know about this, with the help of our doctors, we shouldn’t panic.
First, check with your doctor about all the meds you may be taking, their side effects and their interactions with each other.
The American Geriatrics Society’s “Choosing Wisely” program says:
Older patients disproportionately use more prescription and non-prescription drugs than other populations, increasing the risk for side effects and inappropriate prescribing. Polypharmacy may lead to diminished adherence, adverse drug reactions and increased risk of cognitive impairment, falls and functional decline. Medication review identifies high-risk medications, drug interactions and those continued beyond their indication. Additionally, medication review elucidates unnecessary medications and underuse of medications, and may reduce medication burden. Annual review of medications is an indicator for quality prescribing in vulnerable elderly.
A thorough physical exam may find other causes for your problems with memory, according to the Alzheimer’s Assn.
Information from a physical exam and laboratory tests can help identify health issues that can cause symptoms of dementia. Conditions other than Alzheimer’s that may cause confused thinking, trouble focusing or memory problems include anemia, depression, infection, diabetes, kidney disease, liver disease, certain vitamin deficiencies, thyroid abnormalities, and problems with the heart, blood vessels and lungs.
More than 50 conditions can mimic or cause dementia, according to helpguide.org, with material from Harvard Health publications. This makes it harder to find out what is really going on. “For physicians and families intent on pinning down a diagnosis, one major complicating factor is the existence of so many kinds of dementia”
Here are some of the mental declines that are reversible with treatment, says helpguide.org:
People sometimes manifest dementia-like symptoms—forgetfulness, disorientation, inattentiveness, and slowed responses—when they are depressed. This so-called pseudodementia can masquerade as the depression that often accompanies Alzheimer’s disease, but there are subtle differencees. In pseudodementia, the depressed mood begins before there is any mental decline. Typically, the person complains about memory loss or lack of concentration, looks sad or worried, and speaks in a flat, expressionless tone.
Water on the brain
Hydrocephalus (“water on the brain”) is an excess of cerebrospinal fluid around the brain. This condition can result from head trauma, brain hemorrhage, or meningitis (inflammation of the membrane covering the brain), but most cases occur spontaneously without an obvious preceding illness. In addition to developing dementia, people with this condition lose bladder control and walk in a slow, hesitant manner, as if their feet are stuck to the floor. A surgically implanted tube (shunt) that drains fluid from a cavity in the brain (the lateral ventricle) to the jugular vein or to the abdomen brings rapid improvement, provided treatment is started soon after the symptoms appear
Consuming excessive amounts of alcohol for a decade or more can also cause impaired thinking that resembles Alzheimer’s disease. In dementia due to alcoholism, memory, orientation, and attention deteriorate, although verbal skills are not always severely affected. In this type of dementia, abstinence may partly restore mental functioning.
Helpguide.org has a longer list of ailments that may mimic Alzheimer’s disease.
A new blood test, used in a trial with 573 people, showed good results as a diagnostic predictor of Alzheimer’s disease.
“Maria Carrillo, vice president of medical and scientific relations at the Alzheimer’s Association, said such a blood test could prove easier to administer than current tests used to detect early onset of the disease,” discussing the findings in an article by Health Day in US News &World Report.
“Blood-based biomarkers would be a great and useful option — more accessible, less invasive, easier to gather and less expensive to process,” Carrillo said. “Several are under development for preclinical Alzheimer’s disease. More research investment in this area is urgently needed.”
“The results, while intriguing, are preliminary,” Carrillo said. “They require replication and validation by other scientists in larger and more diverse populations to give them credibility, before further development for clinical use is warranted.”
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