Cognitive concerns / memory issues
Your doctor will talk with you and someone who knows you well about how your memory and thinking have changed. They may do a short test – such as remembering three words and drawing a clock – to see if you might have memory loss. They'll review your medications and health problems and do a brief physical exam. To make sure nothing else is causing your symptoms, they may check your blood for things like anemia, vitamin and thyroid problems, or uncontrolled blood sugar and may order a CT or MRI scan to look for strokes, bleeding or tumors. If the screening shows more serious problems, you may be referred for detailed memory testing or to a specialist.
Medicines cannot cure dementia, but some can slow memory loss and help with thinking. Drugs called cholinesterase inhibitors – such as donepezil, rivastigmine and galantamine – keep more of a chemical in the brain that helps nerve cells communicate. Another medicine called memantine works on a different brain chemical and is added for more serious memory problems. New antibody infusions that target amyloid protein are only available through specialists. If tests show that depression, thyroid disease, vitamin deficiencies or sleep apnea are causing memory problems, those conditions are treated first.
Typical blood tests look for treatable causes of memory problems. A complete blood count (CBC) checks for anemia or infection; a comprehensive metabolic panel (CMP) checks liver, kidney and electrolyte levels; thyroid hormone tests (TSH) check for under‑ or overactive thyroid; and vitamin B12 levels check for deficiency. Doctors may also test for infections such as syphilis (RPR) and HIV and check blood sugar to see if diabetes is poorly controlled.
A non‑contrast CT scan is usually done first to look for strokes, bleeding, tumors or fluid buildup. An MRI provides a more detailed picture of the brain’s structure and may be done if more detail is needed. Sometimes functional scans such as SPECT or PET are used to see how different parts of the brain are working. These tests are not needed for everyone.
Call your doctor if memory problems are affecting your daily life. Warning signs include forgetting recent events, poor judgment, confusion, difficulty speaking or understanding words, getting lost in familiar places, trouble handling money, repeating questions, taking much longer to do familiar tasks, losing interest in favorite activities, seeing or hearing things that aren’t there, or acting impulsively. Sudden changes in memory, new severe headaches, numbness or weakness should also be checked right away.
After the first evaluation, your doctor may repeat memory tests and lab work every 6 to 12 months or sooner if symptoms change. Early diagnosis helps plan treatment and support. You should also keep regular appointments for any medications or other health problems.
You can help protect your brain by making healthy choices. Stay physically active – adults should get at least 150 minutes of moderate exercise a week. Keep your blood sugar and blood pressure under control, diabetes, and treat hearing loss. Eat a balanced diet rich in fruits, vegetables, whole grains and healthy fats, get enough sleep, stay socially and mentally active, and avoid smoking and heavy drinking. A positive attitude and learning new skills may also help keep your mind sharp.
Your primary care doctor works closely with you and your family to coordinate care. They may refer you to specialists such as neurologists, geriatric psychiatrists, neuropsychologists or geriatricians for further evaluationt. Social workers, support groups and community services can help with caregiver education and support. If you develop behavioral symptoms, a psychiatrist can offer additional treatment. The goal is to provide a team of professionals and resources to support you and your caregivers.