Beware Hasty Dementia Diagnoses
Is it Alzheimer’s, Parkinson’s or something else?
Alzheimer’s disease and dementia have gradually become household words over the past 10 years. While growing public awareness of these diseases that diminish our mental abilities is important, it also carries a huge caveat.
As the saying goes, a little knowledge is a dangerous thing.
Many well-read baby boomers observe Mom’s odd behavior and make a lot of assumptions. Forgoing a thorough medical evaluation, they cruise the Internet for information, blithely give Mom a Folstein Mini-Mental State Examination and arrive in my office proclaiming, “My mom has Alzheimer’s.”
If only it were so simple. Memory loss, confusion, inability to provide self-care, and bizarre behaviors result from a variety of conditions. Some conditions or illnesses, unlike Alzheimer’s, can be halted or significantly improved.
- First case in point: A friend of mine recently rescued her mother from a life sentence of severe progressive dementia. Her mother, who lives in another state, had been placed in a skilled nursing home due to severe memory loss, confusion and an inability to care for herself. It turned out that Mom was taking an array of unnecessary medications. Taken off these medications, Mom’s memory and independent living skills bounced back, and she moved back to her apartment.
- Second case in point: Normal pressure hydrocephalus is a little-known condition that generally afflicts adults 60 and older and is easily confused with Parkinson’s disease or dementia. NPH presents as a cluster of symptoms that combine a shuffling, stuttering walk; urinary incontinence; and dementia. NPH is characterized by an abnormal accumulation of cerebrospinal fluid in the ventricles of the brain, resulting in hydrocephalus. Of the approximately four million Americans with dementia, it is thought that 5 percent to 10 percent—or approximately 250,000 people—actually have NPH. This is very important because treating and relieving the hydrocephalus often results in a disappearance of symptoms and a resumption of previous abilities.
To diagnose NPH, a neurologist will perform a complete neurological work-up that includes a clinical assessment, CT and/or MRI scans, a lumbar puncture, cerebrospinal fluid flow studies and more. One successful treatment for NPH is the surgical placement of a shunt to divert the cerebrospinal fluid away from the brain. Not everyone with NPH is a good candidate for the shunt, so after the neurologist visits, consulting with a neurosurgeon is key.
For information that includes patient stories of diagnosis and recovery, an online library, links to other sites, lists of local neurologists and neurosurgeons, visit www.allaboutnph.com. For more information, call (866) 543-3674.
Please remember that the causes of dementia are not easily deciphered. I have observed medical doctors, trained in internal medicine or general practice, struggle for diagnostic accuracy and treatment.
If you are concerned about your mom, find her a respected neurologist and refrain from a layman’s diagnosis.