Is It Dementia or Just Age-Related Memory Decline?

Dementia or memory decline?

Dear Dr.
Liang,
My father is 60 years old and generally maintains a regular routine with his meals and exercise.
He plays mahjong with friends 2-3 times a week.
However, he has a smoking habit that has lasted for 30 years (and is currently trying to quit), with no significant medical history aside from occasional hypertension.

In recent months, both my mother and I have noticed that my father struggles to accurately name certain everyday items (about 2-3 times a week).
For example:
1.
Substituting words: When discussing something, he suddenly cannot recall a specific term and keeps saying "that thing" instead.
It is evident that he is trying hard to think and is aware that he cannot express himself, rather than just reflexively saying "that thing."
2.
Inability to name fixed terms: There have been instances where he wanted to tell my mother about a kiwi but could not find the word.
Once, he also tried to tell me about a kiwi but ended up saying "kiwi" in English (which is correct, but he was unable to say "kiwi" in Mandarin).
However, it could also be that he rarely uses the term "kiwi" in conversation.
3.
Confusion of terms: He mentioned to his grandson that he would take him to the night market next week but naturally said he would take him to the supermarket instead.
It seems he was picturing the night market but ended up saying supermarket.
I sometimes experience similar issues myself (at 27 years old) or with peers.
I cannot determine if my father's behavior indicates a possibility of dementia or if it is simply a result of aging and memory decline.
I read online that early stages of frontotemporal dementia may present with symptoms of language difficulties, which has made me somewhat concerned.

However, aside from the aforementioned issues, my father has not forgotten important matters in daily life or promises he has made to others, and he does not confuse dates or times.
His daily living skills appear normal, and there are no other unusual behaviors.
Since my grandmother had dementia, my father has personally witnessed the progression of the disease from early stages to the point where the patient can no longer care for themselves.
He tends to be a more negative person, so I hope to gather more information or observe more pronounced symptoms before encouraging him to seek medical attention.
Therefore, I would appreciate any advice you could provide.
Thank you!

Xiao Zhang, 20~29 year old female. Ask Date: 2017/10/23

Dr. Liang Yinpan reply Geriatrics

Dear Ms.
Chang,
Your father, who is 60 years old, is experiencing symptoms of speech fluency issues, which may be caused by a neurodegenerative disease.
Please take him to a neurology outpatient clinic for a thorough examination by a specialist to identify the underlying cause and provide appropriate treatment to alleviate the symptoms.
Wishing you and your family good health.
Best regards,
Dr.
Liang Yin-Pan
Changhua Hospital
October 24, 2017

Reply Date: 2017/10/23

More Info

Determining whether memory decline in an older adult is due to natural aging or a more serious condition like dementia can be challenging. In your father's case, there are several factors to consider based on the symptoms you've described.

1. Nature of Memory Issues: The specific memory problems you've noted, such as difficulty recalling certain words or mixing up names, can be common in both aging and early stages of dementia. It's important to differentiate between occasional forgetfulness, which is often normal, and more persistent memory issues that interfere with daily life. For instance, if your father is still able to manage his daily activities, remember important dates, and maintain social interactions, this may suggest that his memory issues are more age-related.

2. Frequency and Impact: You mentioned that these memory lapses occur about two to three times a week. If these instances are infrequent and do not significantly impact his ability to function, it may be less concerning. However, if these lapses become more frequent or start to affect his daily life—such as forgetting to take medications, getting lost in familiar places, or having trouble following conversations—this could indicate a need for further evaluation.

3. Cognitive Testing: While online resources can provide some insight, a formal cognitive assessment by a healthcare professional is crucial. Tests like the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA) can help gauge cognitive function more accurately. These assessments can identify subtle cognitive changes that may not be apparent in everyday interactions.

4. Family History: Given your father's experience with his mother’s dementia, it is understandable that he may be more anxious about his own cognitive health. Family history can play a significant role in the risk of developing dementia, particularly Alzheimer's disease. This concern may also lead to increased self-monitoring and anxiety about memory lapses.

5. Lifestyle Factors: Your father's lifestyle, including regular social interactions (like playing mahjong) and physical activity, is beneficial for cognitive health. Additionally, addressing his smoking habit is important, as smoking can negatively impact cognitive function over time. Encouraging him to maintain a healthy diet, engage in regular exercise, and stay socially active can help mitigate some risks associated with cognitive decline.

6. When to Seek Help: If you notice an increase in the frequency of memory lapses, or if he begins to exhibit other symptoms such as changes in mood, personality, or daily functioning, it would be prudent to consult a neurologist or geriatrician. They can provide a comprehensive evaluation and discuss potential next steps, including further testing or interventions.

In summary, while your father's memory issues may be a normal part of aging, it is essential to monitor the situation closely. If his symptoms worsen or if you have ongoing concerns, seeking professional medical advice is the best course of action. Early intervention can be crucial in managing cognitive health, whether it involves lifestyle changes, cognitive therapies, or other medical treatments.

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