Q: I am 72-years old and can’t remember things. I also can’t pay my bills. I want to have a brain scan but wonder what you would suggest. Thank you.
A: The most common reasons to order a brain scan include looking for an aneurysm, tumor, bleeding, causes for headaches, skull fractures and diseases or disorders affecting the skull or blood vessels within the brain. Therefore, this would not likely be the way to begin in most instances, but given your age and cognitive decline, it may be an appropriate part of a workup.
Despite our ages, we all forget things at times. I prefer to tell people I have overloaded circuits when I forget meetings or birthdays. I’m not sure this is accurate but we all forget now and then. We lose our car keys or forget where we put a note, meet someone and draw a blank as to his or her name, forget to take our vitamins or prescription drugs in the morning, and so on. Some degree of memory loss and a minor decline in other thinking skills are simply a common part of aging. It happens. A decline in cognition includes asking the same question repeatedly, getting lost when walking or driving in a familiar neighborhood, forgetting words when speaking with someone, and experiencing mood or behavioral changes for no apparent reason.
The place to begin is with your primary care physician. Make an appointment and be sure to bring a family member or friend along who knows you well. This person may be able to fill in some of the details you are concerned about and will be able to go over what your physician has to say once you leave the office. You doctor will take a history of your concerns, examine you, order blood testing and perhaps other testing. He or she will ask numerous questions in an attempt to provide answers, such as whether you have recently begun a new medication that could have an adverse effect on you. So, I am not suggesting you breathe a sigh of relief but am recommending you work with your doctor to get to the bottom of things.
Addressing memory loss and the possibility of dementia can be troubling; however, if there is a problem, you will have time to consider if you should make some major lifestyle changes. For example, if you own your own home or rent an apartment by yourself you may choose to move in with a relative who can oversee your activities and help with some functions that you feel you require assistance on. If you drive, you may need to make a decision whether you can continue doing so safely or if you should check into public transportation. If you have problems taking medication, you can have someone fill your pill containers on a weekly basis that will remove the burden from your shoulders. If you have difficulties preparing meals, you may wish to check into Meals on Wheels or an equivalent that will deliver to your door. Bill paying can be a task for the best of us. Find someone you trust who can write your checks for you and file those paid invoices away. You will still be in control by signing the checks but will be relieved of the burden of remembering to pay on time. Review your paperwork to be assured you have a Power of Attorney, Health Care Proxy and Living Will in place. If you don’t, take steps to accomplish this promptly. Put all important papers such as life insurance policies and your social security card in a spot where they can be found easily if necessary. Make a list of important telephone numbers to be placed along side your phone or in the drawer of the stand your phone rests on. And, whether your memory is failing or not, much of this should be done by all of us.
There are a number of medical problems that could account for your perceived issues. You could have a vitamin B-12 deficiency, an under-active thyroid gland, depression, anxiety, stress, or be on a medication that is affecting you adversely. So, simple blood tests can put a portion of these possibilities to rest; a review of your medications with your physician can address that aspect; and so forth. Let your physician work with you based on the information you provide. You’ll be glad you did.
Readers who would like related information can order Dr. Gott’s Health Report “Alzheimer’s Disease” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
