DEAR MAYO CLINIC: My father, who is 79 years old and in good health, has become quite forgetful. He seems to recognize that it's happening, but laughs it off and chalks it up to old age. I know memory problems are common as people get older, but I'm worried. Should I have him see his doctor?
ANSWER: Although memory lapses are a normal part of aging, they can be a sign of an underlying medical problem. In older adults, memory problems are of concern when they affect information that is particularly important or familiar, when the lapses become more frequent, or when difficulty with memory interferes with daily activities. If your father's situation falls into any of these categories, it would be a good idea for him to see his doctor.
As we grow older, our brains undergo numerous aging-related changes that can make it harder to learn new things or remember familiar words. Older adults may have difficulty coming up with names of acquaintances, for example, or they may have trouble finding reading glasses or car keys. In most cases, these memory lapses do not signal a problem.
The type of forgetfulness that is worrisome involves forgetting information that a person formerly would always have remembered. For example, a favorite social event gets missed, like a tee time for a weekly golf game. Or, a calendar item that an individual would usually make a priority, such as a doctor's appointment, goes unnoticed. If this happens once in a while, it probably isn't a problem. If a person starts to have trouble making these connections regularly, then it's time to see a doctor.
A medical evaluation also is in order if memory lapses lead to problems in a person's day-to-day life or if someone begins to have trouble with mental tasks. Examples include becoming overwhelmed or confused when faced with decisions, having a hard time driving, getting irritated or upset when mental concentration is required to complete a task, getting lost on the way to a familiar location, or having trouble following step-by-step instructions.
If your father goes to his doctor, an evaluation likely would include a review of his medical history and a physical exam. In addition, tests that measure cognitive function -- attention, memory, language and spatial skills, among others -- may be part of the assessment. In some cases, a neurological evaluation and brain scans also may be useful. The doctor may want to talk with you or other family members about your perspective on your father's cognitive skills, functional abilities and daily behaviors, and how they have changed over time.
The purpose of this evaluation would be to screen for signs and symptoms of dementia. The doctor also will rule out reversible causes of memory loss. Keep in mind that dementia isn't a specific disease; it's a clinical syndrome. That means it's a term used to describe a group of symptoms, such as memory loss, difficulty reasoning, inability to learn or remember new information, personality changes or inappropriate behavior, that affect a person's intellectual and social abilities enough to make it hard to perform daily activities.
Dementia has a variety of possible causes, including progressive disorders such as Alzheimer's disease and dementia with Lewy bodies. Other conditions also can mimic the symptoms of dementia, such as depression, thyroid abnormalities, infections, immune disorders and nutritional deficiencies, among many others. Prompt evaluation of a symptom such as persistent forgetfulness that could point to dementia is important for early diagnosis and identifying management strategies.
It is possible, too, that your father's memory lapses may be just what he thinks they are: a normal part of aging. If they seem to be problematic, though, encourage him to see his doctor. A thorough assessment should be able to identify if there is a need for concern. -- Ericka Tung, M.D., M.P.H., Primary Care Internal Medicine, Mayo Clinic, Rochester, Minn.
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