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Ten reasons for early screening, diagnosis

Citrus County Chronicle - 8/1/2017

Debbie Selsavage

Coping with Dementia

People have asked me, "Why bother getting a memory screening and diagnosis for Alzheimer's? If it is irreversible and incurable, why bother?"

The best reason for early screening and diagnosis is to learn that you don't have dementia. There are correctible medical conditions that create symptoms similar to dementia. Under these circumstances, you may be showing signs of dementia, which you don't actually have.

When people have degraded hearing, they sometimes adopt behaviors similar to a person with dementia. This may include social and conversational withdrawal, a catatonic gaze, or tentative physical movement. All of us, as we age, should have our hearing tested. Your condition may be easily correctable.

Normal pressure hydrocephalus is a buildup of spinal fluid in the brain, and it can cause "Alzheimer's gait," loss of balance, and memory problems. It is a serious condition, but can be corrected with surgery and the implant of a stint.

Binge drinking and heavy alcohol use can result in dementia. It is a double-edged sword. Alcohol can destroy brain cells, but heavy use can also lead to poor dietary practices that result in thiamine (vitamin B-1) deficiency. This can result in Wernicke-Korsakoff Syndrome which causes memory loss, confusion, and hostile behavior. But WKS is treatable. It is not an irreversible dementia.

Over-medication can cause dementia-like symptoms. Sad to say, but sometimes doctors prescribe drugs on drugs, seeking to mask specific symptoms without adequate consideration for the effect of drug combinations. If you are taking "a lot" of different drugs, ask your doctor to review your whole regimen, or seek a second opinion. Look up the Beers Criteria on the internet. It is a list of drugs that should be used with caution or not at all by older people.

Diabetes can contribute to irreversible dementia because too much or too little glucose can damage blood vessels in the brain. It is important to detect diabetes early and manage it faithfully. It does not have to lead to dementia.

Depression can affect memory, mood, reasoning and behavior. A psychiatrist or neurologist is qualified to determine whether your problem is depression or dementia. Mood-altering medication and lifestyle changes can be prescribed to deal with the depression.

Vitamin B-12 deficiency can also result in dementia-like behavior. Such deficiency can be corrected with medication taken orally or by injection.

One of the most common, and often overlooked causes of "false dementia" is a urinary tract infection. UTIs, especially in elders, can lead to dizziness, confusion, delirium and hallucinations. Good hygiene can help avoid UTIs, and antibiotics, rest and lots of liquids - specifically cranberry juice - can cure them.

Thyroid imbalance - either too little or too much - can cause dementia-like symptoms. This can be determined with a simple blood test, and corrected with medication and sometimes surgery.

Even if you are not experiencing symptoms of dementia, it is a good idea to get a screening to establish a medical baseline from which any future decline in memory can be measured. We establish baselines for breast cancer, even when we have no reason to believe we have it. We establish baselines for bone density that will help us identify problems at a later date. Why not take the same precautions toward dementia?

So, these are 10 good reasons early screening and diagnosis. Many research companies involved in the study of Alzheimer's will give you a screening at no charge. Because it is their business, these screenings will be a far more thorough process than you will receive from most general practitioners. Even if your doctor is not an expert in dementia, you will be helping him or her by submitting a dementia screening report to your medical file.

A neurologist or psychiatrist is qualified to diagnose Alzheimer's and other causes of dementia, but again, you may be able to facilitate this process by providing them your memory screening report. Because it is right on the doorstep of Citrus County, and because my own company has had good experience with them, I often recommend Meridien Research, located in Brooksville.

Finally, let me reiterate that if you have the slightest concern about whether you or a loved one are developing memory problems or other symptoms of dementia, do not remain in a state of fear and uncertainty. Early diagnosis may very well determine that you have dementia-like symptoms that are correctable. This can bring relief to you and your own family.

You should take precautionary steps early because we all deserve the best.

Debbie Selsavage is a certified dementia practitioner and trainer in The Positive Approach to care, a licensed assisted living administrator, president of the Alzheimer's Family Organization, and president of Coping with dementia LLC, a company dedicated to making life better for those with dementia and their caregivers. Contact her at deb@coping.today.

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