CityView Magazine

housekeeping, laundry, using the telephone and managing medications. Dr. Elizabeth Gamble, a Fayetteville neuropsychologist, uses age and education “norms” to assess memory decline. After an initial clinical interview, she will schedule a three-hour testing session with follow-up testing as needed. Dr. Gamble’s tests are important because self reports of memory often don’t correlate with objective measures of memory. When conducting her clinical interview, Dr. Gamble gathers input from family members plus the patient. Denial is a powerful tool, and sometimes even family members don’t recognize or won’t face obvious problems. People with mild cognitive impairment (MCI) are identified by neuropsychological testing. Addie (not her real name), another patient of mine, was concerned because her grandchildren told her she asked the same questions over and over. She also experienced problems remembering telephone numbers and friend’s names. Many people with mild cognitive impairment are still able to perform daily tasks at home and work, and in fact, in one study, 24 percent of those diagnosed with MCI eventually returned to normal memory. In other words, MCI is not necessarily the first step in an inevitable decline to Alzheimer’s disease. However, it is reported that 10 to 15 percent of patients with MCI progress toward Alzheimer’s each year after diagnosis. The single greatest risk factor for Alzheimer’s is age. About five percent of people over 65 have some form of dementia, and the number doubles every five years after that. Up to 50 percent of people aged 85 have Alzheimer’s. A small percentage of Alzheimer’s cases can occur in people younger than 50, but when this occurs there is usually a strong family history of early dementia. Family history of Alzheimer’s is important after age 65, but you are not genetically fated to get it. If you or your family member is concerned about memory, what should you do? See your doctor. Your doctor will order tests to see if there are any reversible and easily treatable causes of memory impairment. Some medications (including those commonly sold over the counter without prescription) may be causing memory difficulties. Depression and thyroid disorders may mimic Alzheimer’s and can be treated. Marcie’s memory problems are most likely age-related and normal, but she may have MCI. She does have diabetes, high blood pressure and high cholesterol, all of which may contribute to memory problems if left untreated. She is working to lower her blood pressure, and we discussed exercise for her mind and body. Both of these improve memory. Exercising your mind can be as simple as doing Sudoku or crossword puzzles, or as complicated as taking a class at a local college. Addie, unfortunately, probably has early Alzheimer’s. We’ll know more after she finishes testing with Dr. Gamble.CV Dr. Lenny Salzberg sees patients and teaches at the Southern Regional AHEC Family Medicine Center. 58|April/May • 2009

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