Have you ever misplaced your keys, forgotten a phone number or drawn a blank when trying to recall someone’s name? For most people, this type of forgetfulness is a normal part of aging and not generally a cause for concern. But when memory loss becomes disabling or interferes with daily living, it may be a warning sign of dementia.
“Patients and their families often ask when the right time for a memory assessment is,” says Dr. Steven Tam, a geriatrician who entered the specialty after personal experience taking care of his own grandmother who suffered from vascular dementia. “One of the keys is if there are cognitive changes beginning to affect the patient’s everyday life.”
“Geriatricians are skilled at understanding the whole picture, taking into account the complex situation of multiple diseases, medications and symptoms, as well as appreciating the needs of the family and caregivers of patients with dementia,” says Tam. A general term for memory loss and a decline in mental ability, dementia is a condition that can include the following changes: memory loss, behavior or mood changes.
At UC Irvine’s SeniorHealth Center, geriatricians, physician assistants, pharmacists, social workers, psychologists and nurses all work together to provide a comprehensive approach for patients with dementia. Patients with memory loss are given an initial physical exam and memory screening. If results indicate a problem, the patient undergoes an in-depth cognitive evaluation by a geropsychologist. The comprehensive assessment tests attention, concentration, memory, and verbal and problem-solving skills. Geriatricians work closely with neurologists at UC Irvine. A clinical evaluation may include blood or spinal cord fluid tests and brain imaging scans.
“It’s important to obtain an accurate diagnosis as soon as possible. The symptoms may be caused by a neurodegenerative condition such as Alzheimer’s, or other condition including undetected small strokes, or even potentially reversible conditions,” says Tam. Depression, medication interactions, sleep problems, thyroid disorders, anxiety or vitamin deficiencies are all treatable conditions that may contribute to memory loss.
“Once a diagnosis is established, we can initiate the most effective treatment and provide support to our patient’s family, helping them understand what to expect,” says Tam.
Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. Vascular dementia is caused by poor blood flow to the brain, and can result from any number of conditions that narrow the blood vessels, such as stroke, diabetes and hypertension. Other forms include dementia with Lewy bodies (an abnormal protein deposit in the brain stem and cerebral cortex), Parkinson’s disease dementia, frontotemporal dementia (affecting language and behavior) and Huntington’s disease. Each type requires its own treatment approach.“It’s not just ‘get the answer and send them on.’ The real work is using the knowledge to make their lives better. Our focus is to make our patients’ lives better today as a result of our work,” says Bonnie Olsen, PhD, geropsychologist at the SeniorHealth Center.
Dementia is not an inevitable part of aging, but its prevalence does increase with age. Because the first of the baby boomers reached age 65 last year, a rapidly increasing number of Americans will face a greater risk for Alzheimer’s disease and other dementias. According to the Alzheimer’s Association, as baby boomers age, one in eight will get Alzheimer’s disease after turning 65; at 85 that risk increases to nearly one in two. And if they don’t have it, chances are they will likely be caring for someone who does.
To make an appointment with a UCI Health geriatrician, call 714-456-7007.
