Are you worried about your memory, or concerned about a relative or friend?

If you are worried about your memory, or if other changes in cognition are causing difficulties, a visit to the GP is the first step on the journey.

A GP will carry out initial screening tests to determine whether the presenting symptoms suggest that a type of dementia is developing. The GP is the gateway for referral for a specialist assessment, which is necessary to determine whether a person has dementia.

At the initial consultation, the GP will ask you questions about your medical history, lifestyle and recent concerns, and will undertake some preliminary investigations, including blood tests, to establish whether there might be another explanation for the problems you are experiencing. 

It is usual, at this stage for the GP to carry out some simple cognitive tests, which might be verbal, or pen and paper tasks. They may also ask you about significant life events, for example, bereavement, redundancy, illness, and explore whether there are links with how you are feeling in general. It may be that you have been feeling anxious or low in mood. There are many reasons why a person may experience difficulties with memory. 

The GP may wish to speak with a close family relative or friend (with your permission) to gain a fuller picture of your history and any observations of recent changes in behaviour and cognitive function.

People who are concerned about their memory will often delay making this first appointment with their GP, perhaps because they are worried about what might happen, or, sometimes, because they dismiss their symptoms as being the kind of forgetfulness that occurs as a normal part of ageing.

It is, indeed, true that our memory does not function quite as well as we grow older, however, memory loss caused by dementia is significantly different from normal forgetfulness: memory difficulties get progressively worse over time and a wide range of other cognitive problems might be experienced. These might include difficulties with language, organisational ability, decision-making, judgement, spatial awareness, vision and balance.

Early investigation is important because memory difficulties can be symptomatic of other conditions that are treatable, for example, anxiety, depression, physical conditions, such as anaemia, thyroid problems, vitamin deficiency. They might also be the result of side effects of certain medications. These different potential causes of the person’s difficulties need to be eliminated out as part of the screening process.

If the GP concludes, from these initial tests, that you might be showing early signs of dementia, they will make a referral to the local Memory Assessment Service, where a more comprehensive investigation will be carried out to determine whether your symptoms do indicate the early stages of dementia. The Memory Assessment Service will also be able to determine what type of dementia you have and whether medications will help. 

Dementia is an umbrella term that is used generically to describe a set of symptoms caused by an underlying disease.

There are many different types of dementia. Alzheimer’s disease is the most common form of dementia, characterised by abnormal protein deposits in the brain that cause brain cells to die. Alzheimer’s is a progressive condition; an early sign is difficulty with short-term memory recall.

Vascular dementia is the second most common type of dementia, caused by small strokes that cause localised areas of the brain o die. Vascular dementia progresses in a ‘step-wise’ fashion, and the symptoms will vary depending on which the parts of the brain affected.

In about 10% of cases, the diagnosis is of a mix of Alzheimer’s disease and vascular dementia, this is known as ‘mixed dementia’.

There are many rarer types of dementia, including Dementia with Lewy Bodies, Frontotemporal Dementia, Posterior Cortical Atrophy, Parkinson’s Disease, Semantic Dementia.

Following a diagnosis, the Memory Assessment Service will refer you back to your GP and also put you in touch with community based services locally that can support you and your family and provide relevant information on matters such as Lasting Powers of Attorney and welfare benefits.

It is important for people with dementia to remain active and socially engaged. There are many opportunities to meet other people with dementia. There are benefits in sharing experiences. Peer support groups are proven to help people with dementia to feel less alone and more confident and positive about the future.

 

For more information about support following diagnosis, please get in touch: barbara@livebetterwith.com