Questions to Discuss with Your Doctor

Your doctor will probably begin by asking you about recent memory problems to define the parameters of your symptoms. Here are some typical questions:

• How long have you been having trouble with your memory?

• Did the trouble come on gradually or suddenly?

• Has the problem been getting better or getting worse, or has it remained about the same?

• What sorts of things have become more difficult to remember?

• Is the problem interfering with your usual activities, such as reading, cooking, or performing on the job?

• Have other people—friends, family members, or colleagues—independently commented on your memory problem?

• Are you taking any medications?

• Do you have any current health problems?

• What medical problems have you had in the past?

• Do you have a family history of illnesses that can affect brain function and memory, such as high blood pressure, high cholesterol, heart disease, Alzheimer's disease, or other neurological disorders?

• Have you been feeling depressed or stressed?

Answers to these questions can indicate whether your symptoms are typical of a memory disorder, such as Alzheimer's disease or mild cognitive impairment, an age-related condition that is less severe than Alzheimer's disease but may be a precursor to it. Symptoms that distinguish age-related memory loss from mild cognitive impairment and Alzheimer's disease are listed in Table 6.1.

Memory problems related to Alzheimer's disease usually commence insidiously and progress relentlessly; an abrupt decline in memory usually suggests other causes, such as a more acute neurological problem or perhaps a medication you've recently started.

table 6.1 Symptoms of Age-Related Memory Loss, Mild Cognitive Impairment, and Alzheimer's Disease_

Symptoms

Normal Age-Related Memory Loss

Mild Cognitive Impairment (Amnesic Type)

Dementia

Difficulty remembering names, appointments, and other everyday information

Occasional

More frequent

Most of the time

Problems with memory and concentration that can be measured by standardized tests

None; test performance is in line with age peers

Mild to moderate impairment compared to age peers

Moderate to severe impairment compared to age peers

Problems with cognitive functions other than memory (e.g., making and executing plans, solving problems, making judgments)

Rare; problems are subtle when present and do not have an impact on everyday function

Rare to mild deficits with occasional slight impact on daily activity

Moderate to severe impairment with clear impact on everyday function and activities

Difficulty with activities of daily living (e.g., dressing, brushing teeth)

None

None

Moderate to severe problems in aspects of self-care

Increased difficulty with household tasks and hobbies

None

Occasional difficulty with complex activities

Moderate to severe impairment

Your doctor will need to know whether you're taking any medications that might affect your memory. If so, and if you started taking it shortly before you noticed a change in your memory, then the diagnostic process might focus on that drug. Depending on the medication, your doctor might ask you to stop taking it for a while or prescribe an alternative drug to see whether your memory improves.

But even if a medication is a possible culprit, your doctor should also give you a thorough examination to determine if there are other medical or psychological factors that might be contributing to your memory problem.

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