How is it different from age-related forgetfulness and dementia?
With age, the speed of information processing naturally slows down and it is more difficult to remember a name or word, but then it comes up. With mild cognitive impairment, changes go beyond the age norm: a person forgets recent conversations and agreements, repeats questions, gets lost in new places, but copes with everyday life, perhaps with great effort. In dementia, impairments make it difficult to independently run a household, manage money, or take medications.
- Amnestic type - memory is predominantly affected
- Non-amnestic - attention, speech, planning suffer
- Age-related forgetfulness - no impact on life
- Dementia - loss of independence
Possible reasons
In older people, the main causes are neurodegenerative diseases, primarily Alzheimer's disease, and vascular lesions of the brain. However, the doctor is sure to look for potentially reversible factors. Depression in the elderly often manifests itself as memory complaints. Some medications, such as sleeping pills, sedatives, and anticholinergic drugs, significantly impair thinking. Chronic lack of sleep and sleep apnea, vitamin B12 deficiency, hypothyroidism, and hearing loss also affect cognitive function.
- Early stage Alzheimer's disease
- Vascular changes in the brain
- Depression and anxiety disorders
- Vitamin B12 deficiency, hypothyroidism
- Sleep apnea, chronic sleep deprivation
- Side effects of medications, alcohol
Signs
Relatives are often the first to notice changes. It is useful to write down specific situations: what was forgotten and when, how long ago difficulties appeared, how they are changing. This information helps the doctor. If a person himself does not notice problems, but relatives see a clear deterioration, this is a reason for examination.
- Forgetting recent events and conversations
- Repeating the same questions
- Difficulty finding words
- Losing things, forgetting appointments
- Difficulty with planning and new tasks
- Difficulty navigating in an unfamiliar place
What examinations are needed
The neurologist finds out how the disorders developed, what medications the patient is taking, whether there is depression and sleep problems. To assess thinking, short tests are used, for example the Montreal Cognitive Rating Scale, and, if necessary, a comprehensive neuropsychological examination. MRI of the brain shows vascular lesions, atrophy of individual parts, and excludes tumor and hydrocephalus. Tests for vitamin B12, TSH, complete blood count, glucose, liver and kidney parameters reveal reversible causes. Hearing and vision are checked.
- Interview and neurological examination
- Montreal Cognitive Rating Scale
- Neuropsychological testing
- MRI of the brain
- Vitamin B12, TSH, complete blood count, glucose
- Hearing test, sleep and mood assessment
What to do and treatment
Treatment begins with eliminating the identified causes: replenishing vitamin B12 deficiency, treating hypothyroidism, depression and sleep apnea, and reviewing medications. There are no drugs proven to prevent the transition of a mild disorder to dementia, so nootropics and dietary supplements are not recommended as treatment. Proven benefits come from regular exercise, blood pressure and sugar control, smoking cessation, moderation in alcohol, hearing correction with a hearing aid, active communication and learning new things. The condition should be re-evaluated by a neurologist approximately once a year, or sooner if it worsens.
- Treatment of reversible causes
- Reviewing medications with your doctor
- Aerobic exercise several times a week
- Control blood pressure, sugar and cholesterol
- Hearing aid for hearing loss
- Communication, reading, learning new things, annual observation