mild memory problem, or they can cause memory changes in a person who has not previously experienced memory loss.
On the one hand, conditions such as infection, fever, dehydration, and thyroid problems can cause temporary changes in memory that improve when the condition is treated. Urinary tract infections are notorious for causing memory problems and confusion in older people.
On the other hand, some types of diseases or injuries that cause damage to the brain may not be reversible. Alzheimer’s disease is the most common cause of irreversible memory loss. (For more information on Alzheimer’s disease and other causes of dementia, see the appendix.)
Strokes and traumatic injury to the head often cause memory problems that show improvement in the months after the trauma but frequently leave some irreversible changes.
If you are concerned about your memory and want to rule out a physical cause, the first step is to see your doctor, who is familiar with your medical history. Some physicians receive little training in assessing the mental status of older people. In that case it may be worthwhile to consult a physician with specific training in geriatrics or neurology, who has the diagnosticskills to distinguish among a wide assortment of possible causes of memory loss. A medical assessment often includes
• A social and medical history taken from both the patient and a relative or friend
• A thorough physical exam
• A neuropsychological exam, which is a series of tests that provides information about the thought processes
• Blood tests, which are used to detect thyroid, kidney, and liver malfunctions; certain nutritional deficiencies, such as pernicious anemia or vitamin B 12 deficiency; infections; and metabolic and chemical imbalances
• Urinalysis, which is used to detect infections in the urinary tract
Other tests that may be indicated include
• A CT scan of the brain (computerized axial tomogram), which is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal images (often called slices) of the brain
• An MRI of the brain (magnetic resonance imaging), which is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body, including the brain
• A PET scan of the brain (positron emission tomogram), which is a nuclear medicine scan that shows how the brain and its tissues are working (Other imaging tests, such as MRI and CT scans, only reveal the structure of the brain.)
• An EEG (electroencephalogram), which is a measurement of electrical activity (brain waves) in the brain
• A lumbar puncture (spinal tap), which is an analysis of spinal fluid that can detect malignancies, neurosyphilis, and certain infections
EXAMPLE
----
When Meg, the housecleaner, arrived at Theresa’s apartment for her weekly visit, she found Theresa in bed and quite confused. When Meg asked Theresa whether she had had breakfast, Theresa said she wasn’t sure. Also, she could not remember Meg’s name or exactly why Meg was there. Since Theresa had never been confused in the past, Meg consulted with a neighbor, who agreed that Theresa should go to the emergency room. The physicians at the hospital discovered that she had a serious urinary tract infection and admitted her to the hospital. When Theresa’s infection cleared up, her confusion disappeared, and she returned home feeling mentally and physically well.
----
Some Medications
Prescription and over-the-counter medications can affect your memory, because they can slow your thinking and make you feel drowsy or foggy. They can diminish your attention or concentration, making it harder to register information in your working memory.
Most, but not all, of the time, memory is affected within days after starting a new medication or increasing the dose. Sometimes the change is noticed by the person taking the
On the one hand, conditions such as infection, fever, dehydration, and thyroid problems can cause temporary changes in memory that improve when the condition is treated. Urinary tract infections are notorious for causing memory problems and confusion in older people.
On the other hand, some types of diseases or injuries that cause damage to the brain may not be reversible. Alzheimer’s disease is the most common cause of irreversible memory loss. (For more information on Alzheimer’s disease and other causes of dementia, see the appendix.)
Strokes and traumatic injury to the head often cause memory problems that show improvement in the months after the trauma but frequently leave some irreversible changes.
If you are concerned about your memory and want to rule out a physical cause, the first step is to see your doctor, who is familiar with your medical history. Some physicians receive little training in assessing the mental status of older people. In that case it may be worthwhile to consult a physician with specific training in geriatrics or neurology, who has the diagnosticskills to distinguish among a wide assortment of possible causes of memory loss. A medical assessment often includes
• A social and medical history taken from both the patient and a relative or friend
• A thorough physical exam
• A neuropsychological exam, which is a series of tests that provides information about the thought processes
• Blood tests, which are used to detect thyroid, kidney, and liver malfunctions; certain nutritional deficiencies, such as pernicious anemia or vitamin B 12 deficiency; infections; and metabolic and chemical imbalances
• Urinalysis, which is used to detect infections in the urinary tract
Other tests that may be indicated include
• A CT scan of the brain (computerized axial tomogram), which is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal images (often called slices) of the brain
• An MRI of the brain (magnetic resonance imaging), which is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body, including the brain
• A PET scan of the brain (positron emission tomogram), which is a nuclear medicine scan that shows how the brain and its tissues are working (Other imaging tests, such as MRI and CT scans, only reveal the structure of the brain.)
• An EEG (electroencephalogram), which is a measurement of electrical activity (brain waves) in the brain
• A lumbar puncture (spinal tap), which is an analysis of spinal fluid that can detect malignancies, neurosyphilis, and certain infections
EXAMPLE
----
When Meg, the housecleaner, arrived at Theresa’s apartment for her weekly visit, she found Theresa in bed and quite confused. When Meg asked Theresa whether she had had breakfast, Theresa said she wasn’t sure. Also, she could not remember Meg’s name or exactly why Meg was there. Since Theresa had never been confused in the past, Meg consulted with a neighbor, who agreed that Theresa should go to the emergency room. The physicians at the hospital discovered that she had a serious urinary tract infection and admitted her to the hospital. When Theresa’s infection cleared up, her confusion disappeared, and she returned home feeling mentally and physically well.
----
Some Medications
Prescription and over-the-counter medications can affect your memory, because they can slow your thinking and make you feel drowsy or foggy. They can diminish your attention or concentration, making it harder to register information in your working memory.
Most, but not all, of the time, memory is affected within days after starting a new medication or increasing the dose. Sometimes the change is noticed by the person taking the
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