Dear Dr. Roach:

My wife, who is 66, has been leaving cupboard doors and some dresser drawers open for the past year or so. Is this a sign of anything to be concerned about? —

It sounds like this is a new behavior for her, and I would indeed be concerned about it.

Changes in behavior or memory can result from many different medical issues. In fact, the list of possibilities is so long that it’s almost impossible to name them all. However, evaluation starts with her

Answer: Anon.

regular doctor and includes a good general physical examination, a careful history and judicious laboratory evaluation. It is possible that her issues are due to: infection (a series of untreated bladder infections or indolent lung disease could possibly be behind it); metabolic (low sodium levels from a diuretic is a common cause); medications (many medicines can adversely affect memory and judgment); or some other issue. Unrecognized depression probably is the most common condition I see mistaken for dementia. However, the slow nature of its coming on does make me think about primary memory disorders, especially Alzheimer’s dementia. This is an important-enough condition that I want to spend a minute on it.

Alzheimer disease (the preferred name) is a disease of aging: It is rare before age 60, and the chance of developing it roughly doubles every five years after age 65. Memory problems, difficulty making decisions and trouble with spatial relations are common early findings. Personality changes and language trouble tend to occur later. The memory disorder in Alzheimer disease particularly affects recent memories — memories of more distant events are preserved until later in the course of the disease. I would caution you not to jump to the conclusion that your wife has Alzheimer disease. Your observations do make me concerned about it, but there are many possibilities. I can really just begin to talk about this complex condition, and I would recommend that you read more from many good sources. One that I use frequently is the Alzheimer’s Association at www.alz.org.