Maybe It’s Something Else


Maybe It’s Something Else [from the May 2019 issue of Caregiver, published by the Alzheimer’s Association]

By Marcy Maher, MA

Maybe it’s something else: That’s what might come to mind if an older person begins to lose her memory, repeat herself, see things that aren’t there, lose her way on routes she’s traveled for decades. Maybe it’s not dementia. And sometimes, thankfully, it is indeed some other problem, something that mimics the cognitive destruction of Alzheimer’s disease or another dementia—but, unlike dementia, is treatable and fixable.

 Sudden changes in a person’s mental state in the course of a few days or weeks, are not typical of a degenerative disease.

  • Depression and anxiety are among the leading culprits. Like dementia, they can interfere with the ability to concentrate and remember.
  • Thyroid problems are suspect as well. The thyroid has a huge effect on the brain and can be relatively easily tested for and relatively easily fixed with daily medication.
  • Vitamin deficiencies probably qualify as the most hoped-for scenario. Cognitive problems caused by lack of vitamin B1 (thiamine) or B12 are reversible with pills or injections.
  • Heavy drinking also causes memory loss. After years of alcoholism, one may not be able to repair the damage, but one can prevent it from getting worse.

Older people can suffer from any of these problems along with the actual symptoms of dementia. Treating secondary causes may at least slow, although not stop, the progression of cognitive decline. Often medical professionals will scan the brain, do blood tests, and look for other conditions that may be causing dementia-like symptoms in the event that treatment of these can be effective.

On the other hand, realistically, it might not be something else. Even though the list of other possible explanations is long, so are the odds against restoring a patient to normal functioning. When it looks like dementia, most of the time it is.

Almost 40 percent of people over the age of 65 experience some form of memory loss. When there is no underlying medical condition causing the memory loss, it is known as “age-associated memory impairment,” which is considered a part of the normal aging process. However, diseases like Alzheimer’s and other dementias are different and they progress very slowly over time.

The first symptoms of progressive dementia may vary from person to person. Memory loss is typically among the first signs of cognitive impairment related to progressive dementia. As the disease progresses, people experience even greater memory loss as well as other cognitive difficulties.