I often get asked two very important questions. How do I know when I should seek a memory evaluation and who do I see? This is a more complicated question than it sounds. If you have concerns early in the stages of memory decline you will easily pass all of the brief screening tests now in use and be told that you are fine. I have interviewed hundreds of clients worried about their memory and I have a set of questions that I ask. If you answer yes to one of more of these issues listed below, seek further evaluation no matter what you score on screening tests.

  • Frequently repetitive
  • Trouble remembering recent conversations
  • Trouble remembering recent events
  • Trouble remembering appointments
  • Frequently misplace objects
  • Trouble performing tasks that require many steps such as balancing a checkbook, cooking a meal, using the computer
  • Trouble organizing objects around the house
  • Trouble finding his or her way around familiar and/or unfamiliar places
  • Increasing difficulty with finding the words to express what he or she wants to say
  • Someone who knows you well is concerned
  • You are concerned about your self

Who do you see if you have any of these concerns? The most obvious answer is if you have concerns about your memory; consult with your primary care physician. This is a good place to start but there are problems with this approach for those with mild changes in memory. Your primary care physician has little time with you and is not trained to do memory evaluations. Many physicians believe that as there are no effective drug therapies there is nothing that can be done. Finally, there is a fear that they will make an incorrect diagnosis of dementia which stigmatizes the patient.

These beliefs among physicians make it difficult to help persons who are very early in memory loss seek adequate evaluation and start effective environmental and psychological treatments (such as more effective use of external memory supports and groups like the Minders Keepers that is run by the Alzheimer’s Support Network in Naples). We have made all of this too complicated. Don’t wait until you can be diagnosed with dementia – the medical goal. Seek evaluation and guidance when there are changes in your memory. Not all persons with declining memory will go on to develop a dementia but they are at higher risk. Be proactive and seek evaluation early. Talk to your primary care physician and ask for a through memory evaluation not just a screening. Alternatively, seek the council of a memory expert who can provide you with a detailed evaluation and description of your memory and related mental skills and can guide you toward an effective treatment plan.