• What To Look For
• What You Can Do
• Needed Care

Many people are afraid that growing old means losing the ability to think, reason, or remember. They worry when they feel confused or forgetful that these feelings are the first signs of senility. About 10% of older patients worry about this a lot. Fortunately, most of them do not have the diagnosis they have heard about the most - Alzheimer's disease (pronounced ALTZ-hi-merz). On the other hand, feeling that your thinking is not very good can be bothersome.

Some older people have emotional problems that are mistaken for dementia. Feeling depressed, sad, lonely, anxious, or bored may be more common for people facing retirement or handling the death of a relative or friend. Adapting to changes can leave persons feeling confused or forgetful. Emotional problems can be helped by supportive friends and family, or by professional help from others.

If you are worried about your thinking, your doctor will talk to you about this feeling and order some tests. Your doctor also needs to know if you regularly feel "down" or depressed.

• doing new things at a time of day when you do not feel fatigued
• keeping a door-side list of things to take when leaving the house
• using calendars
• avoiding alcohol and some medications
  

The term dementia is used to describe a group of symptoms that are caused by changes in the normal activity of very sensitive brain cells. Dementia seriously interferes with a person's ability to carry out his or her daily activities. Dementia is irreversible-- it cannot be cured. The two most common forms of dementia are vascular dementia (sometimes called multi-infarct dementia) and Alzheimer's disease.

In vascular dementia changes in the brain's blood vessels result in widespread death of brain tissue. Telltale signs of vascular dementia include vision or speech problems, and/or numbness or weakness on one side of the body. People with vascular dementia are likely to show signs of improvement or remain stable for long periods of time, then quickly develop new symptoms.

In Alzheimer's disease nerve cell changes in certain regions of the brain result in the death of a large number of cells. Symptoms begin slowly and become steadily worse.

Both forms of dementia can exist together which makes it hard for the doctor to diagnose either. The diagnosis, however, is less important than management. If we diagnose an irreversible disorder, there is still much that can be done to treat the patient and to help the family cope.

Family members and friends can help people with dementia maintain their daily routines, physical activities, and social contacts. However, they should not be allowed to drive.

People with dementia should be kept informed about the details of their life -- the time of day, where they live, and what is happening at home or in the world. This may help stop brain activity from failing at a more rapid pace. Memory aids can help in day-to-day living. Some families find that a big calendar, a list of daily plans, notes about simple safety measures, and written directions describing how to use common household items can be very helpful.

Proper diet is important, although special diets or supplements are usually not necessary. Medications are usually not needed; but for some people, the careful use of drugs can reduce agitation, anxiety, and depression, and can help the person sleep. Estrogen, vitamin E, ginko, and donezepil may also have some benefit for some people, but they do not slow done the progression of the illness.

Although family and friends can help, your doctor will also watch the patient, treat the patient's physical and emotional problems, and answer the many questions that the person or family may ask.

Dementia patients lose their abilities at different rates. Even so, there is enough common experience for patients and their families (loneliness, frustrations, lack of information, and resources) to have led to the development of family support groups around the country. Call your Area Agency on Aging for the group closest to you.

Tips for Communicating with Someone when Memory is a Problem:

Do:

• Introduce yourself. This puts the person at ease.
• Make eye contact.
• Use short, simple sentences.
• Ask one question at a time. Do one task at a time.
• Give suggestions if the person is unable to make a choice.
• When bad moments happen, give compliments. Compliments are pleasant distractions.

Don't:

• Talk about your problems.
• Correct the person if he or she misidentifies you or drifts into the past.
• Argue. You will never win.
• Use "he or she" when talking about the person when the person is present.

For resources check out the web at www.healthfinder.gov or www.medlineplus.gov and type in "dementia" or www.alz.org.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.