Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
Ioften hear half-jokey comments about “senior moments” from people who’ve got to the top of the stairs and forgotten what they came up for. What they really want to know is whether this is the start of a slippery slope.
There are lots of causes of memory loss other than dementia. The most obvious is having other things on your mind. Depression with low mood, tearfulness, disturbed sleep or appetite or lack of enjoyment of life can affect concentration and memory.
Medicines, like strong painkillers, steroid tablets, Parkinson’s medication and combinations of tablets can make you prone to forgetfulness. So too can physical illness, including urine or chest infections and underactive thyroid.
There are actually over 60 conditions which can cause dementia, but Alzheimer’s disease accounts for more than half. The second most common type is “vascular dementia”, caused by blockages in multiple small blood vessels in the brain. You can cut your risk with a healthy lifestyle, but it’s especially important in order to avoid vascular dementia.
The first thing your doctor will want to know is what you’re forgetting most often. For instance, in dementia, people tend to forget recent events most often, but can hang on to longstanding memories. You may find yourself forgetting names and addresses, or repeatedly searching for the word for common everyday objects. Others may notice that you’re asking the same questions time and again.
DEMENTIA DOES GET MORE COMMON WITH AGE, BUT EVEN IF YOU LIVE TO 95, YOU HAVE A 3 IN 5 CHANCE OF NOT BEING AFFECTED.
People with dementia may have difficulty learning new tasks, and can become easily confused and disorientated. This is a particular issue if they’re in unfamiliar surroundings. They may forget to eat or wash, and even how to dress themselves. At every stage of dementia, a regular routine and reminders of the time of day, can reduce distressing confusion. Dementia can also lead to personality changes and low mood.
If your doctor suspects dementia, they’ll do blood tests to look for possible other causes of memory loss (such as infection or underactive thyroid). They should refer you for a full hospital assessment, where they will decide if specialised scans and other tests are indicated. People with dementia are looked after by a multidisciplinary team including doctors, specialist nurses, counsellors, physiotherapists, occupational therapists (to help with home adaptations) and sometimes a dietician.
Several medications have been developed recently to help Alzheimer’s specifically. Most aim to raise the brain levels of a chemical called acetylcholine, which is often low in Alzheimer’s. They’re not a cure and don’t work for everyone, but they can be prescribed for people with early or moderate symptoms and can be continued for as long as they provide benefit. They’re usually started by a specialist but the GP will often be able to issue prescriptions after that.
Much of the treatment of dementia doesn’t come in the form of tablets. Carers make a world of difference, with the help of specialist teams who can set up a care plan to help someone with dementia live as independently as possible. Of course, carers need to look after themselves, too, with support from their GP’s team. Next week: Get a good night’s sleep
MANY PEOPLE WITH DEMENTIA LIVE FULFILLING LIVES FOR YEARS, AND FAMILY HELP TO PROVIDE REGULAR REMINDERS AND ROUTINE HELP ENORMOUSLY.