Health Professional Guide to Memory Loss: Eliminating Reversible Causes

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Eliminate Reversible Causes

Some reversible causes of memory loss can masquerade as dementia.

They include:

  • nutritional conditions (see table below)
  • depression (see table below)
  • metabolic disorders
  • effects of some prescription drugs (Discontinue, change dosage, or substitute for a similar drug if possible.)

benzodiazepines

narcotics and other pain medications

antihistamines

antiemetics

anticholinergics

 

Other reversible causes

 

Signs and Symptoms

Diagnostic Tests

Findings

Recommendations

Vitamin B12 deficiency

Paresthesia

Loss of balance when walking

Extreme fatigue and weakness

Loss of vibration and position senses

Psychiatric symptoms:

    disorientation

    depression

    confusion

    irritability

    memory loss

    dementia

Paleness

Loss of appetite

Diarrhea

Blood test (CBC, LDH)

B12 level

Bone marrow findings

Schilling test

Macrocytic anemia (low hematocrits and high MCV)

High LDH

Low level of vitamin B12

Injections of vitamin B12

Prescription of B12 in a healthy diet

Depression

Depressed mood

Loss of concentration

Sleep problems

Anorexia

Irritability

Isolation

Unhappiness

Guilt, low self-esteem

The Geriatric Depression Scale was developed as a basic screening measure for depression in older adults.

Score:

0 to 9: normal

10 to 19: slightly depressed

20 to 30: severely depressed

Counseling or prescription of antidepressants with low anticholinergic (eg SSRIs) - 3 month trial

Hypothyroidism*

Cold intolerance

Exhaustion

Constipation

Depression

Dry skin

Weight gain

TSH

Thyroid antibodies

Ultrasound

 

 

 

 

Synthyroid

Brain tumor

Focal neurological signs: +/-

Headaches

CT or MRI of brain

 

 

* The clinical presentation of hypothyroidism varies considerably and may be dominated by cognitive deficits and psychological symptoms.

 

Next: Characteristics of Dementia

 

We are pleased to house this series of FAQs for health professionals, supervised by Cara Tannenbaum, from the Centre de recherche de l’Institut universitaire de gériatrie de Montréal.

Browse Contents of the Health Professional Guide to Memory Loss:

 

 

 

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