Brain fog … Can’t clear the cobwebs … I know I know this … Wait, wait, don’t tell me … Really, it’s on the tip of my tongue.
What did I do yesterday? (Hmmm. Good question).
If this sounds like your state of mind (or lack thereof), you may have dementia.
Hold on. Don’t panic.
Dementia, defined as problems with memory or thinking and changes in personality or behavior, can be reversible.
In fact, more than 50 conditions can cause or mimic the symptoms of dementia.
“Short-term memory loss, like difficulty remembering recent events, is often the most pronounced symptom of both reversible and non-reversible dementias,” said Maegan Hatfield-Eldred, PhD, a clinical neuropsychologist with Spectrum Health Medical Group Neurology.
Common causes of reversible dementia include depression, vitamin B12 deficiency, drug or alcohol abuse and underactive thyroid.
“We associate the word ‘dementia’ with permanence, something that’s going to get worse or is incurable,” Dr. Hatfield said. “But with these conditions, symptoms subside, or are reversed, when the underlying problem is treated.”
Many medications can also cause dementia-like symptoms.
As we age, the liver and kidneys don’t work as efficiently so drugs tend to accumulate in the body, become toxic and cause problems. Elderly people in poor health and those taking several different medications are especially vulnerable.
Stressed-out caregivers beware
Another increasingly common cause for scary dementia symptoms is stress. And those overwhelmed by caring for others are particularly at risk.
“So-called ‘caregiver dementia’—cognitive and memory issues brought on by the stress of caring for a loved one—is a very real phenomenon,” Dr. Hatfield said.
Fortunately, caregiver dementia is reversible. Symptoms go away when the stress and depression are resolved, which can be particularly reassuring for those immersed in primary caregiving for a loved one with Alzheimer’s.
“These folks start to notice similar symptoms in themselves and think, ‘I have this, too,’” Dr. Hatfield said. “But it’s because they see and experience (the dementia) day in and day out. And that’s extremely stressful. It’s tough managing their own lives and caring for someone else, too.”
What’s typically at work here is the stress hormone, cortisol, she said. Chronic stress can affect the ways in which our brains function in the present, and may seriously alter our brain health in the years to come.
Chronic anxiety and depression also affect brain function and behavior.
“It’s so important to get help, to be proactive in overcoming these feelings and address any issues,” Dr. Hatfield said. “Don’t let things go or build up. Stress reduction is something to take very seriously.”
Younger people are not immune either, she said. Pronounced and dramatic memory issues due to extreme stress can happen to people in their 20s and 30s.
Is it dementia or something else?
Some reversible dementias are easier to diagnose than irreversible dementias because they can be identified by medical tests. Others are more difficult to pin down.
To tell for certain, Dr. Hatfield advises seeing a neuropsychologist for testing. She suggests using age to help determine when, or if, testing is necessary.
“If you’re under age 50, we tend to be less concerned about a non-reversible dementia like Alzheimer’s disease because they’re incredibly uncommon in younger adults,” she said. “Instead, we look at stress, depression or other medical conditions first.”
But if you’re over age 65 and notice memory problems it’s a good idea to get it checked out with a full neuropsychological evaluation.
“Everyone has challenges with memory and thinking at one time or another,” Dr. Hatfield said. “Neuropsychological assessment measures how your brain is functioning compared to others your same age. It’s also very good at differentiating cognitive problems caused by stress or depression from problems caused by a non-reversible dementia.”
If your test scores fall outside the normal range, she said, doctors have key information to help identify a cause.