Memory Loss

As our population gets older we’re forced to face the issue of memory loss. Many of our patients and their families come in asking if they or their loved one’s memory is within the normal range or if they are indeed experiencing more problems than usual with their memory. The next question is usually what’s causing this—followed by what can be done about it. Family members often want to know what their chances of experiencing the same fate are and what steps can they take now to protect and improve their memory. We’re going to take a look at all of these issues.

There are different types of memory loss—some may begin suddenly, but much of the time memory problems are the result of a gradual decline—years in the making. Here are some of the different classifications.

Mild Cognitive Impairment is a transition stage between the memory loss of normal aging and the more serious condition of dementia. Approximately 1 out of 5 people over the age of 70 in this country are affected by mild cognitive impairment. Many of them will go on to develop dementia, some will continue at their same level of functioning, and others will improve and restore their memory to normal levels.

Dementia is a slow decline in memory, problem-solving ability, learning ability, and judgment that may occur over several months to several years. Many health conditions can cause dementia or symptoms similar to dementia. In some cases dementia may be reversible. Alzheimer's disease is the most common cause of dementia in people older than age 65.

Delirium is a sudden change in how well a person's brain is working (mental status). Delirium can cause confusion, change the sleep-wake cycles, and cause unusual behavior. Delirium can have many causes, such as withdrawal from alcohol or drugs or medicines or the development or worsening of an infection or other health problem.

Amnesia is memory loss that may be caused by a head injury, a stroke, substance abuse, or a severe emotional event, such as from combat or a motor vehicle accident. Depending upon the cause, amnesia may be either temporary or permanent.

There are many different causes of dementia. Alzheimer’s disease is the one you hear about most often. It is the most common cause, making up about 50% of all dementias.

What is dementia?

Many older people have a slight loss of memory that does not affect their daily lives. But memory loss that gets worse may indicate dementia.

Dementia is a loss of mental skills that affects your daily life. It can cause problems with your memory and how well you can think and plan. Usually dementia gets worse over time. How long this takes is different for each person. Some people stay the same for years. Others lose skills quickly.

Your chances of having dementia rise as you get older. But this does not mean that everyone will get it. Many older adults never get it. By age 85, about 35 out of 100 people have it. That means that 65 out of 100 people this age do not have dementia. Around 50% of people over age 85 will get dementia,

What causes dementia?

Dementia is caused by damage to or changes in the brain. Things that can cause dementia include:

After Alzheimer's disease, strokes are the most common cause of dementia. This type of dementia is called vascular dementia. After Alzheimer's disease, dementia caused by strokes (vascular dementia) is the most common type of dementia. Many people have mixed types of dementia. Mental function lost to vascular dementia cannot be restored, but future damage may be prevented with the right lifestyle changes and treatment plan.

More causes of dementia...

  • Tumors and head injuries.
  • Parkinson's disease, which is a movement disorder. Dementia is common in people with this condition.
  • Dementia with Lewy bodies, which causes protein deposits in brain cells. It can cause short-term memory loss like some other brain diseases, but it can also cause the person to fall often and to see things that aren't there (hallucinations).
  • Frontotemporal dementia, a group of diseases that includes Pick's disease. These diseases can cause changes in personality, behavior, or language.
  • Huntington's disease, which is a rare, inherited illness.
  • Leukoencephalopathies, which are diseases that affect the deeper, white-matter brain tissue.
  • Vascular dementia that may occur in people with long-term high blood pressure or severe hardening of the arteries (atherosclerosis).
  • Creutzfeldt-Jakob disease, a rare and fatal condition that destroys brain tissue.
  • Brain injuries from accidents or boxing.
  • Some cases of multiple sclerosis (MS) or amyotrophic lateral sclerosis (ALS).
  • Multiple-system atrophy (a group of degenerative brain diseases affecting speech, movement, and autonomic functions).
  • Infections such as mad cow disease and late-stage syphilis. Antibiotics can effectively treat syphilis at any stage, but they cannot reverse the brain damage already done.

Doctors can treat some causes of dementia and restore mental function. These include...

  • Underactive thyroid gland (hypothyroidism).
  • Vitamin B12 deficiency.
  • Heavy-metal poisoning, such as from lead.
  • Side effects of medicines or drug interactions.
  • Some brain tumors.
  • Normal-pressure hydrocephalus, which occurs when fluid builds up in the brain, creating pressure.
  • Some cases of chronic alcoholism.
  • Some cases of encephalitis, an infection of the brain.

In some people, depression can cause memory loss that seems like dementia. This is termed “pseudodementia.” Thankfully, depression can be treated.

As you age, medicines may affect you more. Taking some medicines together may cause symptoms that look like dementia. Be sure your doctor knows about all of the medicines you take. This means all prescription medicines and all over-the-counter medicines, herbs, vitamins, and supplements.

Some disorders that cause dementia can run in families. Doctors often suspect an inherited cause if someone younger than 50 has symptoms of dementia.

SPECT imaging can help differentiate types of dementia:

  • Alzheimer’s disease
  • Vascular dementia
  • Frontal temporal lobe dementia
  • Pseudodementia (dementia caused from depression)
  • Brain trauma
  • Normal Pressure Hydrocephalus (NPH)
  • Lewy Body Dementia