Client Education

Memory Issues

Is It Time to See a Doctor?

By: Denise Hamilton, Special to AccentCare

If you are experiencing memory loss, a key question becomes when to seek a doctor's advice.

Physicians suggest that people ask themselves whether the memory problems occur frequently and with enough severity to interfere with their social, business or personal life. If the answer is yes, it is time to make that appointment.

The first step for most people is a visit to a primary care doctor to carefully describe your symptoms.

• How often do you forget things?
• Is it just names, or do you get lost on the freeway?
• Can you remember why you entered a room?
• Are you able to read the paper and remember what you read?
• Can you cook a dinner for four and get it on the table with minimal trouble?
• Has the memory loss been gradual and almost imperceptible, or sudden and massive?

You will want to be as specific with your doctor as you can.

Most doctors will first run a battery of tests to determine whether the memory loss can be attributed to a physical cause, such as poor nutrition, an electrolyte imbalance, a Vitamin B deficiency, the interaction of prescription or over-the-counter drugs or other medical problems, such as a stroke or heart disease.

Some primary-care physicians with expertise in the field can then order CAT and MRI scans. If not, you may want to ask for a referral to a neurologist who can evaluate you. Other specialists with experience in this field may include gerontologists, internists, psychiatrists and clinical psychologists who study memory, brain injury and aging.

There are also a growing number of clinics in big cities and universities throughout the nation that specialize in memory loss, including the Memory Disorders and Alzheimer? Clinic at the University of California, Los Angeles.

These clinics also start their procedures with a complete physical and a detailed patient history to rule out other causes of memory loss.

"A simple review of [a patient?] medication list can often produce a culprit," says Michael Mega, director of the UCLA clinic.

If a patient's health and medication check don? turn up any problems, Mega then sends patients to a neuropsychologist, who conducts a four-hour visual and verbal memory test. If results show that the patient? memory performance is worse than 66 percent of people in their 20s, then the person may meet the definition of having Mild Cognitive Impairment.

Studies have shown that people with MCI are at higher risk for developing Alzheimer's disease. Clinics also conduct MRI and CAT scans, which provide doctors with colorful pictures of the brain? activities and can reveal abnormalities, such as tumors or dead tissue due to strokes. Doctors are especially concerned with the parietal lobe of the brain and the hippocampus, the part of the brain thought to control memory. "If they have hippocanthal atrophy, roughly 80 percent will develop Alzheimer? in four years," Mega says.

Likewise, through positron emission topography (PET), doctors can observe brain activity while patients are at rest or while their brains are subjected to stimuli. Variations in activity in specific regions of the brain or low activity levels have been associated with early Alzheimer? disease. Scans can also show certain abnormalities and shrinkage of the brain that occurs with Alzheimer's.

It is very possible that all these tests will turn up nothing but a case of "benign forgetfulness," the age-related memory loss that we all experience. But if tests reveal Mild Cognitive Impairment or Alzheimer's disease, then doctors have a battery of treatments and drugs they can try, many of which seek to mimic the brain's own production of hormones and chemicals.