Memory Loss:  Figuring Out What Is Normal and What Is Not
- Helping Your Family Physician Screen for Dementia -

February 21, 2008

Whether it happens to you or you witness it in an aging family member, it’s not uncommon to wonder “is that normal” when it comes to a lapse in memory.  As people get older, they often begin to forget things like why they walked into a particular room, the name of the person they recently met or where they set down their reading glasses.

“It’s not so much a “loss” of memory, as it is a slowing in the aging brain’s ability to absorb, store and retrieve information,” said Dr. Paul Chlebeck, a family physician with Family Health Services - Gorman Clinic., in West St. Paul. “In other words, it takes more time to recall what it was you were doing or where you put the item you’re looking for.”

This kind of age-related forgetfulness is typically normal, Dr. Chlebeck added.  What’s not normal is when a person’s memory loss begins to affect their daily life such as completely forgetting entire experiences, how to get somewhere you’ve gone often or how to perform familiar tasks.  This kind of severe memory loss is called dementia - a condition caused by the destruction of brain cells.  A person with dementia undergoes a decline in higher cognitive functioning making it difficult for them to remember, learn and communicate.

There are many causes of dementia, including head injury, stroke, side effects of drugs and depression, but the most common cause is Alzheimer’s disease.  This fatal and progressive brain disease accounts for 50 to 60 percent of all cases of dementia in people over age 65.  According to the Alzheimer’s Association, more than 5 million Americans have been diagnosed with the disease.  Alzheimer’s disease gradually destroys a person’s memory causing disorientation, lack of judgment, problems with language and even changes in personality.  Eventually, patients with Alzheimer’s will not be able to take care of themselves and will need round-the-clock care.

“The chance of developing dementia increases with age,” Chlebeck said.  “If there’s a history of dementia or Alzheimer’s disease in your family, your risk of developing it also increases.”

A person with mild memory lapses could be in the early stages of dementia, but it also could be part of the normal aging process.  So how does one differentiate between normal memory loss and dementia?  Questions to consider include how often do the memory lapses occur, are there signs of confusion, and is the memory loss getting worse.

 More specifically, common signs of someone with dementia include asking the same questions over and over, having difficulty performing everyday tasks - like cooking or balancing the checkbook, forgetting simple words or using the wrong words, putting items in wrong places - such as the car keys in the refrigerator, extreme mood swings, and forgetting how to find familiar places - like how to get home.

Despite these common signs, it can often be hard for an individual to figure out on their own whether there is a more serious problem.  That’s why it is important to be evaluated by your family doctor.  Family physicians will diagnose dementia and its cause using the results of a patient’s medical history, physical examination, mental status exam, lab tests and imaging tests.  Often times, family members will also need to be interviewed since a physician will not see all the symptoms during an office visit. 

“While the possibility of Alzheimer’s disease or another kind of dementia is scary, it shouldn’t keep a person from seeking help for themselves or a loved one,” Dr. Chlebeck said.  “Some cases of dementia are treatable and memory loss can be reversed. When it can not, medications can still help control some of the symptoms.” In addition, Dr. Chlebeck said early diagnosis allows families time to come to grips with the situation and make plans for the future.

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If needed, the MAFP is always willing to help locate a family physician in a specific geographic area for an interview.

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, the largest medical specialty organization in the United States with more than 94,000 members.