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Maybe it isn't dementia

by Carol Bradley Bursack, Editor-in-Chief

Dementia, particularly Alzheimer's disease, is so much in the news that many people worry they have the disease whenever they have the slightest memory slip. Most people needn't worry. However, there are people who have real reason to worry. They find that they lose things, they can't remember the drive home from work or they forget their best friend's name. These people do need to see a doctor, but they may not have dementia. A complete workup could reveal other physical issues that are reversible.

Decades ago, when I was growing up, a public health nurse would come to our home once a month to give my grandmother a vitamin B12 shot. This vitamin was known to help a type of anemia developed by many older people. It's well known now that vitamin B12 is not well absorbed my most aging bodies. A deficiency of B12 can not only result in anemia, it can cause problems with balance, memory, decision making and more. If you or a loved one is experiencing memory problems, or even trouble with balance, it's a good idea to have a checkup that includes blood work for B12 levels.

Low levels of B12 aren't the only culprit that can make a person feel that dementia is setting in. A infection in the body, particularly if a person is elderly and frail, can cause the elder to act confused, forgetful and even paranoid. And it doesn't have to be a raging infection, a low grade infection can do it just as well.

Urinary Tract Infections Can Be Low Grade But Cause Big Problems

Urinary tract infections, widely referred to as UTIs, can be low grade, but still can cause horrible reactions in elders. My mother-in-law was such a case. Alice was scheduled to see her doctor because of her dizziness. The doctor checked her inner ears and everything seemed fine. Alice didn't take a long list of mediations, which is unusual for a person her age, so medication interaction was ruled out. The doctor was puzzled, but decided to run a urine test.

This, in itself, was a challenge, as Alice froze up at the clinic and couldn't urinate. Also, she was extremely modest, so even my presence made her nervous, making the problem even worse. I asked the doctor if we could take home the needed supplies and try to get samples that way. I've got to say that never have I heard of such a circus as we went through to get urine samples, but eventually, after a couple of days of potty sitting, I managed. I dropped off the samples at the clinic. Sure enough, after tests were run, it was determined that Alice had a UTI. We got her antibiotics, and she did recover. Her dizziness improved, as did other health issues.

Alice did have dementia, but it was just developing at the time, and the UTI increased her problems. For many, treating a UTI will totally clear up their dementia symptoms.

Medications Can Cause Dementia Symptoms

I briefly touched on medication interactions, above. Most elderly folks take from three to five medications daily. Some take many more. Often, these medications are automatically renewed by their physicians during yearly physicals. It's a good idea for a family member to ask a pharmacist to run all the medications through a computer check to see if any interactions are possible. Of course the doctors should do this automatically, but they don't always catch things a pharmacist might catch. Drugs are their business.

I've personally heard several stories, and many geriatricians may tell you a number of their own, about taking elders off nearly all of their medications and letting their bodies adjust. Then the doctor re-introduces the ones that are really needed. Boom! Dementia symptoms disappear.

Medications save lives and many seniors need them to keep blood pressure and cholesterol levels in check. Many need pain medication for arthritis ailments or other chronic pain. There is no reason not to take these.

But over-medicating is not good. There should be a good reason for every medication taken, and care should be taken to make sure that one drug doesn't interact poorly with another. Most of the time, there are several options for whatever needs controlling, be it cholesterol or pain. A good doctor works with the patient to find a combination that has the least side effects.

Low levels of B12, infections and medication interactions are among the top three culprits when it comes to dementia symptoms occurring when dementia isn't present. There are others, however, so a complete physical and mental workup is necessary before any dementia diagnosis is attempted.

Get Tested Early As More Can Be Done

It's better to get tested sooner rather than later. One reason is that if a person is diagnosed with dementia he or she may be able to take medications that will slow the progress of the disease.

The other reason is that in situations such as low B12, the symptoms are reversible in the early stages, but if the damage is long standing, it's possible that even increasing B12 may not help. It could be too late.

Is it dementia? Maybe. Or maybe not. Either way, it's in your best interest to get checked out. There may be something you can do to improve your quality of life, if you have dementia. And if you don't wouldn't you like to know that? I would.