Have you ever worried that you or a loved one may be losing cognitive abilities with age? If so, you are not alone — many adults over 65 have the type of cognitive decline or loss we regard as a “normal” consequence of age.
Normal Signs of Aging
According to the website, HelpGuide.org, the following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:
- Becoming easily distracted or having trouble remembering what was just read, or the details of a conversation.
- Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by his father’s name.
- Not quite being able to retrieve information that is “on tip of your tongue.”
- Occasionally forgetting an appointment or walking into a room and forgetting why you went there.
- Occasionally forgetting where things were placed that are used regularly, like eyeglasses or keys.
For many people, slight lapses in memory from time to time are a natural and normal part of the aging process; however you or a loved one are struggling with ability to perform everyday activities, or any behavior, memory or thinking skills, then there may be a bigger issue at hand.
Symptoms of Cognitive Decline and Dementia
Cognitive decline and dementia are two common conditions that are not considered normal aspects of aging. According to the World Health Organization, nearly 50 million people worldwide have some form of dementia with nearly ten million cases added every year.
Cognitive decline and dementia differ from age-related memory loss in that they are degenerative diseases that will gradually worsen over time. For many people, symptoms of cognitive decline start out subtly and may only be noticeable to the person experiencing them.
Early-stage symptoms of dementia typically include:
- Becoming lost in familiar places
- Losing track of the time
When the disease progresses, the middle stage symptoms of dementia become “clearer and more restricting,” including:
- Becoming forgetful of recent events and people’s names
- Becoming lost at home
- Experiencing behavioral changes, including wandering and repeated questioning
- Having increasing difficulty with communication
- Needing help with personal care
Symptoms eventually lead to “near total dependence and inactivity” during the late stage of dementia, including:
- Becoming unaware of the time and place
- Experiencing behavior changes that may include aggression
- Having an increasing need for assisted self-care
- Having difficulty recognizing relatives and friends
- Having difficulty walking
Ways to Choose the Right Healthcare Professional
Choosing the right healthcare professional is critical if you’re concerned that you or a loved one may be experiencing dementia or another cognitive disease.
Make an appointment with one of the appropriate healthcare providers below to address your concerns:
- Family Doctor or Primary Care Physician
According to an article published by U.S. News, making an appointment with your primary care physician (PCP) is the best first step to receiving comprehensive care. Primary care physicians should be able to get a complete medical history, family history, social history, current medication list and a review of any loss of abilities to perform day-to-day activities.
During an initial visit, your physician will most likely perform a full physical exam as well administer a cognitive assessment to gain a better understanding of your symptoms and rule out other possible conditions. Your physician may also order lab tests, including blood work, a CT scan or an MRI, as well as make a referral to a dementia-specific specialist for further testing.
- Geriatrician or Geriatric Psychiatrist
According to the University of North Carolina School of Medicine, your best choice for a dementia-specific specialist is a geriatrician with a special interest in dementia, or a geriatric psychiatrist.
A geriatrician is a “primary care internist or family practitioner who specializes in complex conditions of older people and can provide care for all of an older adult’s medical needs whereas a geriatric psychiatrist specializes in the emotional and mental needs of older individuals. They conduct thorough memory, mood, sleep, and thinking evaluations. They are particularly good at assessing memory problems associated with life stress, anxiety, depression, excess drinking, or family conflicts.
If you are unable to obtain a referral to either one of these specialists (or your insurance will not cover the cost of these visits), your primary care doctor may refer you to a neurologist.
A neurologist has specialized training in diagnosing, treating, and managing disorders of the brain and nervous system. Some neurologists are specifically trained in diagnosing cognitive decline and dementia and so it is important for you and your family to ask your primary physician and conduct research for the appropriate neurologist to ensure you are being referred to the most appropriate specialist. During your initial consultation, the neurologist will perform more comprehensive tests to determine your mental fitness.
- Psychiatrist, Psychologist, and Social Worker
Many people struggle following a diagnosis of cognitive decline or dementia. A psychologist or social worker can provide counseling and support and also help to address behavioral issues. They can also offer support to the family unit in order to best support the newly diagnosed individual. As mentioned above, the University of North Carolina School of Medicine suggests visiting a geriatric psychiatrist because they focus solely on the emotional and mental needs of older individuals.
If you suspect that you or a loved one is experiencing cognitive decline or dementia then starting with your primary care physician is the best first step. You shouldn’t however feel restricted by their opinion. If you are not happy with the results of primary care physician’s assessment, or, if that doctor does not seem to feel an evaluation for diagnoses and treatment of the cognitive problem is that important, then it’s time to get a second opinion.