Am I losing my mind?

“Doc, I think I’m losing my mind. I lose my keys all the time. That darn remote control seems to grow legs and hide from me. Am I going to have Old-Timer’s Disease?” asks a 60-year old with genuine concern.
I intentionally refer to “Alzheimer’s Disease” by name to clarify the situation.
“Tell me more about your memory issues,” I ask as an open-ended line of questioning.
“Three days ago, I was at my brother’s house for two hours looking for my lost cell phone and found it on top of the bathroom countertop, right where I left it. Ten days ago, while at my sister’s 67th birthday party at the park by the river, I forgot the candles for her cake. On the first of this month, I could not find my tennis shoes for a jog; the weather was beautiful that day. I found them the next day in my garage at home, right where I left them.”
Typically, the most profound deficit involves the loss of memory of events occurring at a particular time and/or place. Clearly, this patient recalled the particulars of the events with sharp acumen.
Things like procedural and motor memory do not get affected in Alzheimer’s disease until later stages. These are motor skills like playing the piano, knitting and raking leaves.
As a general rule, most patients with true dementia come in to the office because of family concerns regarding brain executive functions being affected early in this disease process. These are things like balancing a checkbook, paying bills and driving. These individuals usually get noticed because of errors in these types of life situations. They may receive calls from the bank, concerns from the Department of Transportation and letters from bill collectors.
In addition, these individuals typically lose the ability to see their impairment, which is another common feature of dementia. This compounds the noticeability of the problem by everyone except the person with the dementia.
Here are a few things going in this woman’s favor:
• She is very concerned about her possible memory impairments.
• She is able to recall locations and dates of specific circumstances surrounding the problem.
• There is an absence of concern from her friends andfamily. This is not likely dementia.
Current evidence recommends physicians use specific testing techniques to help tease out dementia from multiple other problems that mimic some features of dementia. If dementia is likely, there are treatments in the form of medications, physical and cognitive therapies that are available to help treat this unfortunate process.
Charity Baker, DO
FAAFP