— DEAR MAYO CLINIC: As his caregiver, how can I tell if my father’s memory loss is just a natural part of aging, or if it’s the early stages of Alzheimer’s disease? At what point should I take him to be seen by a physician?
ANSWER: In many people, memory becomes less efficient with age. Beyond aging, other factors like taking certain medications or underlying health problems can affect memory, too. Memory lapses become a concern when they start to affect important areas or details of a person’s life that they would typically remember. If you are worried about your father’s memory loss, make an appointment for him to see his doctor.
As people age, the number of cells, or neurons, in the brain decreases. That can make it harder to learn new things or remember familiar words. Older adults may have difficulty coming up with names of acquaintances, for example, or they may have trouble finding their reading glasses or car keys. Some people become concerned that those memory lapses could signal the beginning of Alzheimer’s disease or dementia. That is rarely the case.
The type of forgetfulness that is worrisome involves forgetting information that a person formerly would always have remembered. For example, a favorite social event gets missed, like a tee time for a weekly golf game. Or perhaps an appointment that an individual would usually make a priority goes unnoticed, like a dental checkup. If this happens once in a while, it probably is not a problem. If a person starts to have trouble making these connections regularly, then it is time to see a doctor.
The forgetfulness could be a symptom of mild cognitive impairment. In addition to lapses in memory, this condition also may include problems with language, thinking and judgment. For example, someone with mild cognitive impairment might occasionally have trouble finding their way around familiar places. They may lose their train of thought often or have trouble following a conversation.
In general, although mild cognitive impairment may be frustrating and inconvenient, it usually does not disrupt a person’s day-to-day activities or abilities. Most people with this disorder, for example, still can drive safely, pay their bills and take care of themselves.
Mild cognitive impairment can be a precursor to Alzheimer’s disease or another form of dementia. But that’s not always the case. In some people, symptoms stay the same and don’t get any worse. In a few individuals, symptoms may get better with time.
It should be noted, too, that even if your father often forgets important items, that doesn’t necessarily mean he has mild cognitive impairment. It could be a symptom of another medical condition, such as anxiety, depression, vitamin B-12 deficiency, or thyroid problems, among others. Memory loss also can be a side effect of many medications. So it’s worthwhile to discuss these problems with your father’s doctor to find out if the source of memory loss could be something treatable.
If your father starts having problems in his day-to-day life due to memory lapses or difficulty with other mental tasks, that definitely needs to be addressed with a physician. Examples include becoming overwhelmed or confused when faced with decisions, having a difficult time driving, getting irritated or upset when mental concentration is required to complete a task, or having trouble following step-by-step instructions.
If his doctor suspects Alzheimer’s, imaging exams and laboratory tests can help show what’s happening within the brain. Tests that assess memory and other thinking skills, judge functional abilities and identify behavior changes also can be useful in diagnosing Alzheimer’s disease. The doctor may want to ask you questions about your father’s cognitive skills, functional abilities and behaviors and how they’ve changed over time. This type of thorough evaluation often can help identify Alzheimer’s disease in its early stages. — Ronald Petersen, M.D., Ph.D., Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minn.
Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. Email a question to firstname.lastname@example.org. For more information, visit www.mayoclinic.org.