Expert: Mary Gordon - 11/12/2008

Question
Hi, My mother is 59 and I just visited with her and I am
seeing evidence of memory loss between her and my father.  
They live on a hobby farm and have no dementia since
they're sharp enough to run it.  But I have noticed that
they didn't believe most of the things I talked about with
them, and when I was right they corrected me with the wrong
information.  They have done this before, but now they do
it so much it is emotionally hard to talk to them.  It
shows my mother is forgetting more and more facts, and my
father now doubts all kinds of conversations because he is
so used to having to doubt what she says.  Of course he
might have memory problems now too.  Does this sound like
just natural aging, or could this be some signs of coming
dementia?

Answer
Hi Jason, what you are describing is not part of natural aging.

People just don't get senile from being older (and by the way, 59 is hardly ancient). It's always caused by something damaging their brains. Memory problems can be caused by all kinds of things - after all, your brain is a very sensitive organ. If you are seeing worrisome signs that your mother is having some cognitive difficulties, she needs first and foremost to see her doctor, and tell him or her what is going on and have a complete check up.

Confusion and memory problems can stem from small strokes (so small the person may not show other signs of stroke), drug interactions or side effects, thyroid problems, pernicious anemia, poorly controlled diabetes, dietary insufficiencies, depression - and a stack of other things.  So, the first step is to make sure your mother isn't suffering from some problem that might affect her memory - especially if the "something" might be treatable.  A good assessment includes a full physical with assorted blood tests, some psychiatric evaluation to rule out depression, a review of history and medications, a neurological work up, frequently a CAT or other brain scan to rule out strokes, tumors etc.

If the doctor can't find an immediate physical cause, he or she will often refer the person to a neurologist. A good assessment will check out the extent of your mother's deficits.  Often a neurologist will look for other areas of impairment, such as perception, reasoning, judgement, coordination, reaction time and personality.

Things families notice first when cognitive problems are brewing often include memory lapses, trouble with numbers or time, getting disoriented in familiar places (i.e. getting "turned around" on the way to the store), trouble thinking of words, asking the same question repeatedly,  getting upset easily or frustrated, changes in routine (i.e. they sometimes stop participating in things they previously loved), difficulty solving simple problems (i.e. not being able to figure out what to do when something goes wrong). It can be subtle, but if the alarm bells are going off in your head, I'd listen to them.  

Clearly, something is amiss, and if your dad can see it too - between the two of you, you need to get her properly examined by doctors to make sure you find out the cause. You would never forgive yourself if later on you find out she has something that could have been treated and reversed if it had been caught early enough.

If on the other hand, she has some sort of irreversible dementia starting up, such as early onset Alzheimer's (which is relatively rare) you also need to know that so that the family can plan for the future and get things set up legally and financially to make sure everyone is protected.

Hope this helps.

Mary G.