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Living with Dementia

What’s Causing Your Memory Loss?

  • - Dementia News
  • Jan 23, 2015
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Tags: | delirium | dementia | depression | hydrocephalus |

Everyone forgets things at some time. How often have you misplaced your car keys or forgotten the name of a person you just met?

Some degree of memory problems, as well as a modest decline in other thinking skills, is a fairly common part of aging. There’s a difference, however, between normal changes in memory and the type of memory loss associated with Alzheimer’s disease and related disorders. And some memory problems are the result of treatable conditions.

If you’re experiencing memory problems, talk to your doctor to get a timely diagnosis and appropriate care.

Memory loss and aging

Normal age-related memory loss doesn’t prevent you from living a full and productive life. For example, you may forget a person’s name, but recall it later in the day. You might misplace your glasses occasionally. Or maybe you find that you need to make lists more often than in the past in order to remember appointments or tasks.

These changes in memory are generally manageable and don’t disrupt your ability to work, live independently or maintain a social life.

Memory loss and dementia

The word “dementia” is an umbrella term used to describe a set of symptoms, including impairment in memory, reasoning, judgment, language and other thinking skills. Dementia begins gradually in most cases, worsens over time and significantly impairs a person’s abilities in work, social interactions and relationships.

Often, memory loss is one of the first or more-recognizable signs of dementia. Other early signs may include:

  Asking the same questions repeatedly
  Forgetting common words when speaking
  Mixing words up - saying “bed” instead of “table,” for example
  Taking longer to complete familiar tasks, such as following a recipe
  Misplacing items in inappropriate places, such as putting a wallet in a kitchen drawer
  Getting lost while walking or driving around a familiar neighborhood
  Undergoing sudden changes in mood or behavior for no apparent reason
  Becoming less able to follow directions

Diseases that cause progressive damage to the brain - and consequently result in dementia - include:

  Alzheimer’s disease, the most common cause of dementia
  Vascular dementia (multi-infarct dementia)
  Frontotemporal dementia
  Lewy body dementia

Each of these conditions has a somewhat different disease process (pathology). Memory impairment isn’t always the first sign of disease, and the type of memory problems may vary.


Could it be Alzheimer’s?

Alzheimer’s disease (AD) is the most common dementia in older people. Therefore, it should be one of the first diseases your doctor considers. Alzheimer’s disease usually begins with memory loss while FTD is usually a behavior or language disorder.

People with either disease will show cognitive difficulties and multitask poorly. And at the end stages, AD and FTD look very similar. Doctors use the early symptoms and the brain image, usually done on a MRI (magnetic resonance imaging) scanner, to reach the most appropriate diagnosis.

  The probability of AD is strongly affected by the age of the person showing the symptoms. The odds of having Alzheimer’s disease increase markedly the older you get while the odds for FTD may decrease with age.

  FTD often begins with distinct behavioral changes (socially inappropriate, apathetic, impulsive, etc.) while people with Alzheimer’s in the early stages tend to remain socially graceful despite their memory problems (they may even become skilled at covering up their difficulties). In advanced AD, people generally have trouble managing their finances, show poor judgment and irritability, and may become equally difficult to manage as FTD.

  Apathy in AD patients is milder, whereas apathy in FTD patients is more pervasive and more often reflects a lack of concern for others or lack of initiative.

  AD patients have an early and profound difficulty learning and retaining new information. As the disease progresses, memory for new and old information is lost. These memory problems may lead to language problems as well, but the root is a problem remembering. In contrast, most mildly impaired FTD patients generally know the day or time and their location, and they are able to keep track of recent events. They may not test well, but that may be due to lack of concern or effort in the testing situation.


Distinguishing between types of dementia

For physicians and families intent on pinning down a diagnosis, one major complicating factor is the existence of so many kinds of dementia. More than 50 conditions can mimic or cause dementia.

Alzheimer’s disease is by far the most common intractable condition. But other causes of irreversible dementia include blood vessel diseasevascular dementia), other degenerative disorders (frontotemporal lobar degeneration, Parkinson’s disease, Huntington’s disease), slow-growing brain tumors, or infections of the central nervous system (Creutzfeldt-Jakob disease, AIDS dementia, neurosyphilis).

In some types of dementia, treatment will improve mental functioning, and in a small percentage, the dementia is completely reversible if treatment begins before permanent brain damage occurs. That’s why it is important to report to a doctor any signs of dementia as early as possible.

Reversible dementias

Reversible dementias are often easier to diagnose than irreversible dementias because they are usually accompanied by other, obvious symptoms. In the following conditions or situations, however, dementia may be the primary, or even the only, symptom. Proper treatment may improve or even restore cognitive functioning.


Delirium causes changes in mental functioning that can closely resemble dementia, but there are two important differences:

  Speed of onset. The mental changes in delirium develop quickly, often in a matter of hours or days. In contrast, dementia evolves over months or years.
  Level of consciousness. In delirium, consciousness is either clouded or fluctuates between drowsiness and alertness. Dementia doesn’t affect the level of consciousness.

Delirium is considered a medical emergency, in part because it’s often the main expression of a sudden, life-threatening illness. Elderly people are also susceptible to delirium after surgery.

Alcohol withdrawal syndrome presents the classic picture of delirium. Similarly, delirium can occur from abrupt withdrawal from benzodiazepines, a group of anti-anxiety drugs that includes diazepam (Valium), chlordiazepoxide (Librium), and alprazolam (Xanax).

Toxic reactions to drugs

Medications are common culprits in mental decline. With aging, the liver becomes less efficient at metabolizing drugs, and the kidneys eliminate them from the body more slowly. As a result, drugs tend to accumulate in the body. Elderly people in poor health and those taking several different medications are especially vulnerable.

The list of drugs that can cause dementia-like symptoms is long. It includes:

  anti-Parkinson drugs
  anti-anxiety medications
  cardiovascular drugs

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