Have you misplaced your keys again or forgotten your neighbor’s dog’s name? Don’t worry, occasional forgetfulness is a normal part of aging. However, if you suspect that your memory lapses may be a sign of dementia, it’s crucial to listen to your instincts and consult your doctor. Laura D. Baker, Ph.D., a professor specializing in gerontology and geriatric medicine at Wake Forest University, emphasizes the importance of seeking medical care promptly to enhance your quality of life and long-term outlook. Early intervention through lifestyle changes like stress management can help delay cognitive decline, making it essential to address any concerns promptly.
Furthermore, cognitive symptoms can be triggered by various conditions besides dementia, such as sleep apnea or nutrient deficiencies. Cognitive screening tests can assist in identifying the root cause of your symptoms and guide appropriate treatment.
Understanding the warning signs of dementia is crucial. Any memory changes that significantly disrupt your daily activities should not be ignored. Symptoms like difficulty managing finances, confusion about time or date, personality changes, social withdrawal, or challenges in communication warrant a discussion with your doctor. Karlene Ball, Ph.D., an expert in gerontology, highlights the importance of monitoring driving abilities, as difficulties in navigation can also indicate cognitive issues.
While there is no specific test for dementia, your primary care doctor can assess physical symptoms and conduct inquiries about your memory concerns. Questions about recent memory lapses, observations from others, and any worries about forgetting are common in these evaluations. Additionally, inquiries about daily living activities may be made to gauge your independence and safety at home. Blood tests may be ordered to rule out other underlying conditions contributing to cognitive symptoms, such as hormonal imbalances or nutrient deficiencies, as well as to evaluate for depression. Regular monitoring and proactive communication with your healthcare provider are key in managing cognitive health.
As simple as a prescription drug interaction,” she adds. “That can be easily corrected, and then you could be back to normal.” At your Medicare annual wellness visit, you may start to be screened for cognitive function, even if you don’t have any memory complaints. For example, you may be given a quick timed test to evaluate your executive function and short-term memory, says Baker. “A nurse might administer it, or you might sit in the waiting room and do it on an iPad,” she says. “It can detect moderate memory impairment, but it usually won’t pick up on the beginning stages of impairment,” she says.
Would getting evaluated by a specialist be helpful? If your doctor thinks you need further cognitive evaluation, they will likely refer you to a neurologist, geriatrician, or neuropsychologist, Ball says. “It’s also your right to ask for it,” says Baker. “If your doctor isn’t concerned but you are, push for it.” At your appointment, which is typically about an hour long, you’ll be observed while you take a series of cognitive tests designed to evaluate skills such as: Focus, Language comprehension, List learning, Problem solving.
“You might be asked to count backward from seven or list as many types of fruit as possible in 90 seconds,” Ball says. “A lot of the tests are timed,” Baker adds. “They want to see how quickly you can work, whether you’re able to stay on task, and how many errors you make.” The tests have all been standardized in terms of how they’re administered, scored, and interpreted. “This allows us to compare you to other people your age and determine what’s normal cognitive aging and what isn’t,” notes Baker.
What other cognitive tests might be helpful? Although they aren’t routinely used, you could also get these additional cognitive tests: Brain scan. A positron emission tomography (PET) scan can look for a buildup of beta-amyloid proteins in the brain, which is a hallmark of Alzheimer’s disease. “Amyloid in the brain can accumulate before obvious cognitive symptoms appear,” says Baker. But PET scans are expensive and are often not covered by insurance or Medicare, she notes. Genetic testing. The apolipoprotein E (APOE) genotype is a risk factor for dementia and Alzheimer’s disease, Baker says. This type of testing is becoming more commonplace, and you can pay for it out of pocket through a service like 23andMe, she says.
Bottom line: While there may not be a “dementia test” your doctor can give you, cognitive screening tests are the next best thing. They can help your doctor determine whether your symptoms are normal or not. And if it turns out that you are in fact dealing with the early stages of dementia, getting an assessment now gives you the best chance to prevent or slow the progression of more serious memory problems later. One thing you don’t need to ask your doctor for
