Questioning dementia

How can I tell if my dad just has a bad memory because of his age or if he’s got Alzheimer’s? He has been acting strangely in his 67th year, but he says he’s always had a bad memory. How severe should his forgetfulness be before I take him to the doctor?
Concerned in Central Florida

Dear Concerned,
You should take him to the doctor now and discuss just the things you have asked. Often, if there is no change and someone just has a bad memory, they probably don’t have anything wrong. However, you indicated that there is some change, as he “has been acting strangely.” The other indicator that something may be wrong is the fact that he is 67, and you are taking him to the doctor – someone who is 67 is usually capable of making those decisions and taking himself to the doctor.

It is important for all of us to have an annual physical, so going to the doctor should be a relatively ordinary event. However, many times in annual physicals, memory isn’t discussed – and is often avoided by patients, as many people fear that memory problems may turn out to be Alzheimer’s. The diagnostic process for any of the dementias, regardless of their cause, is a process of rule-out. What that means is that the doctor will rule out all other illnesses that can be causing the problems, and determine if it is mild cognitive impairment, dementia, etc. It is possible that he could have something that is easily diagnosed and treatable, and has nothing to do with Alzheimer’s.

If it is Alzheimer’s, then acting now is critical – the medications that are available help keep the person at their current level for a longer period of time. The earlier one starts on the medication, the better. It is equally important to get his financial and legal house in order as soon as possible, and it’s often a good idea to at least initiate some legal counsel prior to the doctor visit. This is important so your dad can make decisions on his own behalf and provide you with instructions for his wishes, should he no longer be able to make decisions for himself.