Memory Issues in Seniors: When to Seek Medical Help

Q: Memory Issues in Seniors: When to Seek Medical Help

Hello： In the early stages of dementia, it is important to first rule out other brain issues or interfering factors. <br>You can visit our hospital's Geriatric Dementia Clinic for evaluation and treatment.

Could you please clarify if the elderly person is experiencing memory loss, suspected dementia, and has a history of head lacerations?

Hello Dr.
Tsai, I would like to ask about some memory issues concerning my father.
He is over 65 years old and is retired.
My mother has been expressing concerns about his memory, saying that he often forgets the last food he ate and then goes looking for it after a while.
He also asks about things he can't find or questions whether new food on the table was bought or given by neighbors.
My mother has seen the neighbors give him food, but this kind of situation keeps happening.
From my perspective, I can't tell if this is just normal age-related forgetfulness or if there is a real memory impairment.
Recently, there was an incident where I finished dinner in front of my dad and was about to leave when he asked if I was going out to buy dinner.
After three seconds, he remembered that I had just eaten and even recalled what I ate.
My mother was beside him, and her expression seemed to say, "Here we go again." Now, my mother is increasingly convinced that there is something wrong with my dad and suspects there might be an issue with his brain, fearing it could be something like a brain tumor or the onset of dementia, similar to what a neighbor experienced.
My mother tends to overreact at times, and my dad is reluctant to go to the hospital, citing the severity of the pandemic.
I find it difficult to decide whether to insist on taking him to the hospital, while also worrying that my mother's excessive panic might be causing this overreaction.
If we do decide to take my dad to the hospital, which specialty should we consult first? Are there any criteria to determine if a hospital visit is necessary? Additionally, I have two more questions: My dad had a head injury from being struck by an object during his work, which required stitches at a major hospital.
He was observed to be normal during that period.
Could this past injury be related to his current issues? (I can't recall the exact time, but it should be over two years ago.) My dad also frequently experiences dental nerve pain and often takes painkillers on his own.
Could this also contribute to his forgetfulness? (He only recently agreed to see a dentist, who said it was an abscess.)

Niming C, 30~39 year old female. Ask Date: 2022/10/23

Dr. Cai Dongqi reply Family Medicine

Hello: In the early stages of dementia, it is important to first rule out other brain issues or interfering factors.
You can visit our hospital's Geriatric Dementia Clinic for evaluation and treatment.

Reply Date: 2022/10/23

More Info

When it comes to memory issues in seniors, particularly in your father's case, it is essential to approach the situation with both sensitivity and a clear understanding of the potential underlying causes. Memory problems can arise from a variety of factors, including normal aging, medical conditions, and psychological issues. Given your father's age and the specific symptoms you've described, it is prudent to consider seeking medical help.

Understanding Memory Issues
1. Normal Aging vs. Cognitive Decline: As people age, it is common to experience some degree of forgetfulness. This can include misplacing items or forgetting recent conversations. However, significant memory loss that interferes with daily life may indicate a more serious condition, such as mild cognitive impairment (MCI) or dementia, including Alzheimer's disease.

2. Symptoms to Watch For: The behaviors you've described, such as forgetting recent meals, asking repetitive questions, and confusion about familiar items, could be indicative of cognitive decline. While occasional forgetfulness is normal, the frequency and nature of these lapses are concerning. If your father is frequently unable to recall recent events or is confused about everyday items, it may warrant further evaluation.

3. Impact of Past Injuries: You mentioned that your father had a head injury from a falling object. Traumatic brain injuries (TBIs) can have long-term effects on cognitive function, including memory. Even if the injury occurred years ago, it could potentially contribute to current memory issues. A thorough neurological evaluation could help determine if there is a connection.

4. Dental Health and Memory: Chronic pain, such as that caused by dental issues, can also affect cognitive function. Pain can lead to difficulties in concentration and memory, as it may distract the brain from processing information effectively. If your father has been experiencing dental pain and has not sought treatment, this could be a contributing factor to his memory lapses.

When to Seek Medical Help
Given your concerns and the observations made by your mother, it would be advisable to seek medical help. Here are some steps you can take:
1. Consult a Primary Care Physician: Start with a visit to your father's primary care physician. They can perform an initial assessment of his cognitive function and overall health. This may include a physical examination, a review of his medical history, and cognitive screening tests.

2. Neurological Evaluation: If the primary care physician identifies potential cognitive issues, they may refer your father to a neurologist for a more comprehensive evaluation. Neurologists specialize in disorders of the nervous system and can conduct tests such as brain imaging (MRI or CT scans) to rule out structural issues like tumors or significant brain atrophy.

3. Psychological Assessment: In some cases, memory issues can be related to depression or anxiety, which are common in older adults. A psychologist or psychiatrist can evaluate for these conditions and recommend appropriate treatment.

4. Monitoring Symptoms: Keep a detailed log of your father's memory lapses and any other concerning behaviors. This information can be invaluable for healthcare providers in diagnosing and determining the best course of action.

Conclusion
In summary, while some forgetfulness can be a normal part of aging, the specific symptoms you've described in your father suggest that further evaluation is warranted. It is essential to address both physical and psychological health aspects, as they can significantly impact cognitive function. Encourage your father to see a healthcare provider, and consider accompanying him to ensure he receives the necessary support. Early intervention can make a significant difference in managing cognitive decline and improving quality of life.

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