{"id":6224,"date":"2020-09-03T07:43:43","date_gmt":"2020-09-03T11:43:43","guid":{"rendered":"http:\/\/www.silvercentury.org\/?p=6224"},"modified":"2020-09-04T07:12:12","modified_gmt":"2020-09-04T11:12:12","slug":"pursuing-the-diagnosis-no-one-wants-to-hear","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2020\/09\/pursuing-the-diagnosis-no-one-wants-to-hear\/","title":{"rendered":"Pursuing the Diagnosis No One Wants to Hear"},"content":{"rendered":"

Frank told his caregivers\u2019 support group, \u201cI finally got my wife, Millie, to agree to see the doctor about her forgetfulness. He gave her a quiz to test her memory. Millie didn\u2019t do so well, but the doctor said, \u2018It\u2019s just a little dementia.\u2019\u201d<\/span><\/p>\n

He continued, \u201cI feel better. Thank goodness, it isn\u2019t Alzheimer\u2019s!\u201d <\/span><\/p>\n

Frank\u2019s dread of Alzheimer\u2019s is very common. Common too is his doctor\u2019s avoidance of the \u201cA word.\u201d He instead couched the diagnosis in terms he deemed easier to take.<\/span><\/p>\n

Or perhaps he was just being honest. If the only test the doctor performed was a Mini-Mental, a widely used screening exam that measures a decline in cognitive function, \u201ca little dementia\u201d is all he would know at this point. <\/span><\/p>\n

But to halt the diagnostic process there is<\/span> unethical, not only because the patient and family have a right to a definitive diagnosis, but also because some forms of dementia are <\/span>reversible<\/span><\/i>. You want to identify one of them right away. The sooner you treat them, the better.<\/span><\/p>\n

It helps to be clear about what \u201cdementia\u201d is and is not. It\u2019s not merely a euphemism for Alzheimer\u2019s disease (even if it is used that way). It\u2019s not a milder form of forgetfulness. <\/span><\/p>\n

Dementia is a decline in cognitive skills: thinking, memory and perception. The symptoms can be caused by many different diseases. Alzheimer\u2019s disease is one\u2014the most common. Vascular disease, dementia with Lewy bodies and frontotemporal disorders are other common causes of dementia. (Other problems\u2014like thyroid disorders or a vitamin B12 deficiency\u2014can cause similar symptoms.)<\/span><\/p>\n

So while Alzheimer\u2019s <\/span>is<\/span><\/i> dementia, dementia isn\u2019t always Alzheimer\u2019s.<\/span><\/p>\n

(In my blogs, I alternate using \u201cAlzheimer\u2019s disease\u201d and \u201cdementia\u201d to avoid annoying repetition. I also do it to make clear that the situations and problems I discuss pertain not only to Alzheimer\u2019s but to all the diseases that cause the collection of symptoms we call \u201cdementia.\u201d) <\/span><\/p>\n

Because there are many possibilities, a thorough assessment is essential to find out what is causing the symptoms. People frequently ask, \u201cWhat does it matter when nothing can be done about it anyway?\u201d <\/span><\/p>\n

It does matter. Here\u2019s why:<\/span><\/p>\n