Memory loss is a frequent patient complaint that I see in my office. Patients with this complaint are generally over the age of 65 but occasionally I will see someone in their 40s or 50s with this problem. For all patients, it is important to get a detailed history of when they first noticed the problem and has it been getting worse. What kinds of things do they forget. Does it happen all the time. A brief memory test, the MMPI can be performed. This simple test can give the physician a general idea on the degree of memory loss. Further tests should be performed such as a CT or MRI brain scan to look for stroke, hydrocephalus or other abnormalities. Simple lab screening for diabetes, low thyroid and vitamin deficiencies are commonly ordered.
Once testing has been completed, treatment can be started. For many younger patients, memory loss is due to a combination of stress, depression and other situational problems. It is rarely due to dementia or some other progressive neurodegenerative problem. Antidepressant medications are frequently helpful in these situations. By alleviating anxiety and depression, a patient’s “memory loss” can be cleared. Patient’s with persistent memory problems may need to undergo a further course of memory testing by a psychologist. This 4-6 hour testing session gives a detailed analysis of what type of memory problems a patient may be experiencing. This can range anywhere from depression to Minimal Cognitive Impairment to Alzheimer’s disease.
Minimal cognitive impairment is characterized by simple memory loss. Affected patient’s have difficulty remembering certain things, without having their global memory function and other aspects of thinking impaired. There is commonly underlying depression, but this is not the specific cause of their memory loss. In patients with Alzheimer’s disease or other dementias, short and intermediate term memory is more commonly affected. These patients can also have trouble with finding words, commonly misplacing objects and loss of social graces.
There are several medications that are used in treating memory loss. Aricept, Exelon and Razadyne are all similar in the was that they work to help slow down the progression of memory loss and dementia. Namenda is another memory loss medication that works differently than the other 3 medications. It can be used alone or in combination with one of the other memory drugs. The combination therapy has been shown to have a very significant, beneficial effect in some patients in improving their cognitive processing and memory function. It is important that a patient be evaluated as soon as a problem is suspected. Studies have shown that the earlier one of these medications is started, the better the patient does over the long run. While these medications do not have FDA approval for minimal cognitive impairment, some studies have shown that the memory loss medications are helpful in these cases as well.