Memory problems in 75 year old
October 8, 2021 1:49 PM Subscribe
My 75 year old mother is having memory problems. She doesn't want to investigate it, but should we take her to the doctor -- is there anything that anyone can do? Or should my dad go, without her, to find out what to watch for?
My mom is starting to have noticeable memory problems. She is afraid to go to the doctor because she doesn't want to hear that she has dementia. (She has pretty severe anxiety, as well.) Additionally, she is the type of person who will take prescribed medicine (unless she doesn't like the side effects), but she will not make lifestyle changes such as exercising or giving up alcohol. Is there any hopeful reason she should go see a doctor, for example a treatment that could improve her situation or slow down her decline?
On the other hand, is it possible for my dad to go see a memory doctor without her, so he can be better prepared for what's coming, know what signs to watch for, etc.?
Additionally, what do I need to know about the future of a parent with problems like this?
My mom is starting to have noticeable memory problems. She is afraid to go to the doctor because she doesn't want to hear that she has dementia. (She has pretty severe anxiety, as well.) Additionally, she is the type of person who will take prescribed medicine (unless she doesn't like the side effects), but she will not make lifestyle changes such as exercising or giving up alcohol. Is there any hopeful reason she should go see a doctor, for example a treatment that could improve her situation or slow down her decline?
On the other hand, is it possible for my dad to go see a memory doctor without her, so he can be better prepared for what's coming, know what signs to watch for, etc.?
Additionally, what do I need to know about the future of a parent with problems like this?
IANAD.
Some memory problems are treatable, eg vitamin b12 deficiency, side effects of polypharmacy. Some aren’t treatable. The prognosis for people with memory problems depends on the underlying cause.
If you’re in the US, there’s likely to be a chapter of the Alzheimer’s Association somewhere near you, and they have resources for caregivers. Your dad may want to give them a call. Here is a link about what you can do if you notice memory loss.
posted by eirias at 2:26 PM on October 8, 2021 [9 favorites]
Some memory problems are treatable, eg vitamin b12 deficiency, side effects of polypharmacy. Some aren’t treatable. The prognosis for people with memory problems depends on the underlying cause.
If you’re in the US, there’s likely to be a chapter of the Alzheimer’s Association somewhere near you, and they have resources for caregivers. Your dad may want to give them a call. Here is a link about what you can do if you notice memory loss.
posted by eirias at 2:26 PM on October 8, 2021 [9 favorites]
The only caveat to this is that sometimes memory problems are not caused by dementia. In seniors for example, urinary tract infections can do it.
https://www.seniorplanningservices.com/2017/03/20/not-memory-loss-sign-dementia/
posted by storybored at 2:28 PM on October 8, 2021 [6 favorites]
https://www.seniorplanningservices.com/2017/03/20/not-memory-loss-sign-dementia/
posted by storybored at 2:28 PM on October 8, 2021 [6 favorites]
My parent is roughly the same age and has many of the same characteristics. The "good" news is that 80% of dementia patients have Alzheimers, and there is no treatment for Alzheimers. The drug that was recently approved, to much fanfare and controversy, clearly does not work, to the point where both trials of it were stopped early due to, and I quote, "futility". Interacting with people has been shown to help. You will find plenty of folks, even doctors, who ascribe dementia-fighting properties to various diets, but as far as I know nothing has been proven to help, certainly not once the symptoms have started in earnest.
Which is not to say that there aren't things that can be done to prepare. It is very important to get power of attorney taken care of, both because you want to get the person's wishes captured while they are still able to state them, and also for the more practical reason that someone must be of relatively sound mind to grant power of attorney. Give the Alzheimer's Association a call, they have a 24-hour hotline that can make some helpful suggestions and referrals. You might want to look for a geriatrician, a primary care physician who specializes in treating senior citizens. If you don't already have an elder law attorney, geriatrician, etc., identified it can take some time to find all these people.
posted by wnissen at 2:36 PM on October 8, 2021
Which is not to say that there aren't things that can be done to prepare. It is very important to get power of attorney taken care of, both because you want to get the person's wishes captured while they are still able to state them, and also for the more practical reason that someone must be of relatively sound mind to grant power of attorney. Give the Alzheimer's Association a call, they have a 24-hour hotline that can make some helpful suggestions and referrals. You might want to look for a geriatrician, a primary care physician who specializes in treating senior citizens. If you don't already have an elder law attorney, geriatrician, etc., identified it can take some time to find all these people.
posted by wnissen at 2:36 PM on October 8, 2021
Finding out the reason behind her memory loss is important; there are many potential causes. She should be seen if at all possible--an early and accurate diagnosis can make a huge difference in planning for the future, even if the cause itself is progressive and not curable.
Your dad can call the Alzheimer's Association at 800-272-3900 if he's in the US; if he's in another country you can find the appropriate organization here.
posted by assenav at 2:42 PM on October 8, 2021
Your dad can call the Alzheimer's Association at 800-272-3900 if he's in the US; if he's in another country you can find the appropriate organization here.
posted by assenav at 2:42 PM on October 8, 2021
There are many benefits to a diagnosis. The earlier the better, but she should definitely go as soon as she can. Maybe appealing to her empathetic side would help, something like, “mom, I know you’re very scared, but finding out what’s going on can help us and dad could find out how to get support for you.” (Also you mention anxiety - I think that can be a symptom of some dementias, so possibly a good geriatrician or memory care provider could also help with her anxiety).
As mentioned above, there are also other reasons for memory loss and it’s possible she could get treated for that. The only drugs for Alzheimer’s are for early-stage disease, which makes a diagnosis even more critical. There is a new drug and while it’s approval is very controversial, perhaps the knowledge that there is potentially a new drug would help encourage your mom to talk to her doctor. (Brand name is aduhelm, the studies are called the Ahead study).
posted by areaperson at 2:42 PM on October 8, 2021 [2 favorites]
As mentioned above, there are also other reasons for memory loss and it’s possible she could get treated for that. The only drugs for Alzheimer’s are for early-stage disease, which makes a diagnosis even more critical. There is a new drug and while it’s approval is very controversial, perhaps the knowledge that there is potentially a new drug would help encourage your mom to talk to her doctor. (Brand name is aduhelm, the studies are called the Ahead study).
posted by areaperson at 2:42 PM on October 8, 2021 [2 favorites]
One reason for her to see her regular doctor would be to rule out polypharmacy issues: she may be taking medicines prescribed by different doctors, or taking supplements that she hasn't mentioned to her docs, and these medicines can be interacting badly. There are various other things that should be ruled out, or looked for. A friend in her seventies has mild dementia and she had all sorts of tests to rule out other stuff.
If she does get a diagnosis of dementia you and your father and other family members will figure out the way forward with help from doctors and support groups.
posted by mareli at 2:51 PM on October 8, 2021 [4 favorites]
If she does get a diagnosis of dementia you and your father and other family members will figure out the way forward with help from doctors and support groups.
posted by mareli at 2:51 PM on October 8, 2021 [4 favorites]
I am no clinician, just a pathology resident, but I’d want a relative of mine to get on memantine and donepezil just in case they really do help slow the progress of dementia. That way you can all, mom included, feel as though you’ve done what you can. As others have said, they will also test her thyroid and B12 levels.
posted by 8603 at 2:55 PM on October 8, 2021
posted by 8603 at 2:55 PM on October 8, 2021
There are a lot of possible causes of memory loss! Here's one list -- it's long.
If you can, get in with a geriatrician/geriatric specialist. That specialty is going to be aware of and able to handle the complexity of multiple prescriptions, motivations, realistic expectations, social factors -- it's going to be your best approach, I think. I have seen that a number of internal medicine/PCP's have this as a specialty.
posted by amtho at 2:59 PM on October 8, 2021 [1 favorite]
If you can, get in with a geriatrician/geriatric specialist. That specialty is going to be aware of and able to handle the complexity of multiple prescriptions, motivations, realistic expectations, social factors -- it's going to be your best approach, I think. I have seen that a number of internal medicine/PCP's have this as a specialty.
posted by amtho at 2:59 PM on October 8, 2021 [1 favorite]
Tell her that there are so very many things that can cause memory problems - stress, anxiety, UTI's, medications, sleep apnea, allergies, insomnia, benign brain tumors, concussion, migraines, non-dementia aging-related memory changes that never get worse than mislaying keys and having trouble retrieving names etc. that you want her to go to the doctor so as to figure out which one of those it is because it's probably not dementia and it would be silly to make her suffer when a sleep study or antibiotics or some extra support and affection will probably put her back to rights. Yes, it could be dementia, but most of the time when you smell smoke the house is not burning down. That horrible surge of fear when you think something is terribly wrong needs to be investigated but there is such a good chance that it's not the Big One.
Basically she is living with all the misery of having gotten a dementia diagnosis without having had one.
posted by Jane the Brown at 3:01 PM on October 8, 2021 [9 favorites]
Basically she is living with all the misery of having gotten a dementia diagnosis without having had one.
posted by Jane the Brown at 3:01 PM on October 8, 2021 [9 favorites]
It's worth it just to rule out any particular degenerative disorder whose progress is able to be slowed if not arrested. My Dad would be better off if his Parkinson's had been identified earlier. His Mom had Alzheimer's and he didn't want to engage with it either.
posted by snuffleupagus at 3:41 PM on October 8, 2021 [1 favorite]
posted by snuffleupagus at 3:41 PM on October 8, 2021 [1 favorite]
I’d want a relative of mine to get on memantine and donepezil just in case they really do help slow the progress of dementia.
I'm a neurologist. Memantine and donepezil do not slow the progression of any disease. They've been around for 10+ years; if they were disease-modifying we'd know by now. But they can treat the symptoms of dementia, particularly dementia due to Alzheimer's disease. I've seen some folks really perk up and become much more cognitively aware and interactive on these medications. I've seen others who have had no response.
Prevagen is snake oil. So is Neuravive. So, for that matter, is aducanamab. A MIND diet (Mediterranean + DASH i.e. low sodium diet) and aerobic exercise are the only things that have been shown to slow the course of neurodegenerative disease, but you say your mom won't make lifestyle changes.
However. There are many, many reversible causes of memory issues -- UTI, B12 deficiency, thyroid dysfunction, and others. At the very least, if I were in your shoes, I'd want my mom to get tested for and potentially treated for these reversible causes. Ideally she should see a neurologist; PCP clinic schedules are on the order of 5 minutes per patient at least in my area, which is just obscene and a topic for a whole nother Ask. If you are in the US and need help finding a neurologist, feel free to MeMail me. My professional network is mostly East Coast but I know people in academic centers across the country.
Your dad going on his own won't be able to accomplish anything, unfortunately. I have patients of mine, who happen to be caregivers for loved ones with dementia, and the most I can do, unless the loved one is also my patient, is listen sympathetically.
posted by basalganglia at 4:17 PM on October 8, 2021 [24 favorites]
I'm a neurologist. Memantine and donepezil do not slow the progression of any disease. They've been around for 10+ years; if they were disease-modifying we'd know by now. But they can treat the symptoms of dementia, particularly dementia due to Alzheimer's disease. I've seen some folks really perk up and become much more cognitively aware and interactive on these medications. I've seen others who have had no response.
Prevagen is snake oil. So is Neuravive. So, for that matter, is aducanamab. A MIND diet (Mediterranean + DASH i.e. low sodium diet) and aerobic exercise are the only things that have been shown to slow the course of neurodegenerative disease, but you say your mom won't make lifestyle changes.
However. There are many, many reversible causes of memory issues -- UTI, B12 deficiency, thyroid dysfunction, and others. At the very least, if I were in your shoes, I'd want my mom to get tested for and potentially treated for these reversible causes. Ideally she should see a neurologist; PCP clinic schedules are on the order of 5 minutes per patient at least in my area, which is just obscene and a topic for a whole nother Ask. If you are in the US and need help finding a neurologist, feel free to MeMail me. My professional network is mostly East Coast but I know people in academic centers across the country.
Your dad going on his own won't be able to accomplish anything, unfortunately. I have patients of mine, who happen to be caregivers for loved ones with dementia, and the most I can do, unless the loved one is also my patient, is listen sympathetically.
posted by basalganglia at 4:17 PM on October 8, 2021 [24 favorites]
Finding out the cause of the memory loss is important. My mother had the same fears and hers was caused by her kidneys not working as well as they should have and poisons building up in her blood stream. They fixed that problem with drugs and a change of diet, later she had memory problems caused by small strokes she had that were otherwise unnoticeable, again that could be treated. A friend of hers of a similar age had memory and behaviour problems caused by dehydration, elderly people do not feel thirst as sharply as they used to and can become dehydrated. My FIL thought he had dementia, turned out he was on way too many meds that were contra indicated that it was leading to confusion and memory loss. Not saying these are any of the causes of your mothers situation but there are so many things other things it may be that it is definitely worth going to see a doctor before jumping to conclusions. Also then any decisions and arrangements made going forward are informed decisions.
posted by wwax at 5:01 PM on October 8, 2021
posted by wwax at 5:01 PM on October 8, 2021
If anecdata is helpful, my mother (also anxious) has had memory problems that are becoming increasingly obvious. We did persuade her to see a doctor; of course she (and all of us!) worried that it could be dementia, but reading up on other possible causes helped her make the appointment. And indeed it seems to be due to an issue with her parathyroid which is treatable.
In terms of how to prepare, we’ve been using it as a spur to ensure they have all their ducks in a row regarding estate planning, power of attorney etc, and that info regarding household finances and upkeep is available to both parents.
posted by sizeable beetle at 6:43 PM on October 8, 2021
In terms of how to prepare, we’ve been using it as a spur to ensure they have all their ducks in a row regarding estate planning, power of attorney etc, and that info regarding household finances and upkeep is available to both parents.
posted by sizeable beetle at 6:43 PM on October 8, 2021
For your father _and_ you, find your local instance of the Alzheimer's Association. They offer many resources, and in our city at least had regular group discussions for family members and caregivers. Not only were the discussion leaders usually knowledgeable and helpful, but realizing what others were going through, and talking with those whose loved ones were at various stages of dementia, helps too.
posted by TimHare at 7:43 PM on October 8, 2021
posted by TimHare at 7:43 PM on October 8, 2021
Following up on beccaj's post:
Please put your elderly relative's assets in a trust that they aren't the grantor for - basically transfer ownership of all of their assets to someone else.
Once they're relying on Medicare, if their insurance or their cash runs out Medicare will absolutely come after everything they own.
posted by bendy at 11:20 PM on October 9, 2021
Please put your elderly relative's assets in a trust that they aren't the grantor for - basically transfer ownership of all of their assets to someone else.
Once they're relying on Medicare, if their insurance or their cash runs out Medicare will absolutely come after everything they own.
posted by bendy at 11:20 PM on October 9, 2021
As I understand it, you are looking for two kinds of answers: what should your mom do, and how can you convince her to do it?
I'm not a medical professional so I'm not going to try to supplement basalganglia's excellent advice on what she should do! But in terms of how to convince her, I would highly recommend Seven Steps To Managing Your Memory by Andrew Budson and Maureen O'Connor. Budson is a neurologist and O'Connor is a neuropsychologist so they're very knowledgeable, but they write simply and clearly. The book is aimed in particular at elderly people who are beginning to have memory concerns. It may convince her to at least partially adapt a MIND diet. Also, while the book is not unrealistically upbeat, it talks about some of the more hopeful possibilities that can come out of visiting a neurologist, so it may make her less frightened to visit.
I also see Budson and O'Connor have a new book out aimed at the families of people with dementia. I haven't read it, but based on their previous book, I suspect it will be useful and clearly written. It may help answer your question about what you should prepare for in the future. There's a brief excerpt here.
posted by yankeefog at 2:13 AM on October 10, 2021
I'm not a medical professional so I'm not going to try to supplement basalganglia's excellent advice on what she should do! But in terms of how to convince her, I would highly recommend Seven Steps To Managing Your Memory by Andrew Budson and Maureen O'Connor. Budson is a neurologist and O'Connor is a neuropsychologist so they're very knowledgeable, but they write simply and clearly. The book is aimed in particular at elderly people who are beginning to have memory concerns. It may convince her to at least partially adapt a MIND diet. Also, while the book is not unrealistically upbeat, it talks about some of the more hopeful possibilities that can come out of visiting a neurologist, so it may make her less frightened to visit.
I also see Budson and O'Connor have a new book out aimed at the families of people with dementia. I haven't read it, but based on their previous book, I suspect it will be useful and clearly written. It may help answer your question about what you should prepare for in the future. There's a brief excerpt here.
posted by yankeefog at 2:13 AM on October 10, 2021
In my previous answer, I mentioned Budson and O'Connor's new book (Six Steps To Managing Alzheimer's Disease and Dementia: A Guide for Families). I don't know if this information is still useful to the OP, but I've now read the book, so just as a follow up:
Like their previous book, this new book is extremely informative and clear. However, it is potentially less reassuring than the previous book, because it deals with the later and more severe stages of dementia. I definitely wouldn't give it to your mom if she is already scared about a diagnosis. But it would be an excellent resource for you to understand what you may face in the future.
posted by yankeefog at 2:47 AM on December 9, 2021
Like their previous book, this new book is extremely informative and clear. However, it is potentially less reassuring than the previous book, because it deals with the later and more severe stages of dementia. I definitely wouldn't give it to your mom if she is already scared about a diagnosis. But it would be an excellent resource for you to understand what you may face in the future.
posted by yankeefog at 2:47 AM on December 9, 2021
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My mom lost her home when my dad got dementia as we could not afford the care and she needed to have no assets in order for the state to take over. She had to sell her small trailer and use the proceeds for the care. (They had "good" insurance but well, it's all such a nightmare).
If she is unwilling to handle the medical aspect of this this minute, perhaps looking into getting assets out of her name for "the future". It would have helped us so much with their care.
Please see a GOOD elder lawyer if this is not something that has been taken care of.
Wishing you the best.
posted by beccaj at 2:24 PM on October 8, 2021 [3 favorites]