Seven Reasons Why We Should Diagnose and Treat Memory Loss, Alzheimer’s Disease, and Dementia

Article by Andrew E. Budson, MD

A physician colleague of mine at a Boston hospital recently criticized me for diagnosing and treating her patient. “Wouldn’t it have been better to not tell him?” she said. “Wouldn’t it be better not to make him worried and depressed about having Alzheimer’s disease?”

On the one hand, I was outraged. As a cognitive behavioral neurologist I have spent my life diagnosing and treating people with Alzheimer’s disease and other causes of memory loss and dementia. But as I thought more about it, I realized that many physicians, nurses, and other healthcare professionals may not know the reasons as to why it is worthwhile to diagnose and treat memory disorders. Here are seven reasons as to why one should diagnose and treat individuals with memory loss.

1. Knowledge is power. Help your patients to understand what is happening to their memory. The pattern of memory changes that occur with healthy aging are different from those due to Alzheimer’s. Rather than assuming your patient’s memory loss is due to normal aging, it is much better to sort out what the memory problems are due to. I can honestly say that almost every patient I see comes away pleased that they now understand what their memory problems are due to—even if Alzheimer’s disease is the answer.

2. Current treatments for memory loss work. Cholinesterase inhibitors, such as donepezil (Aricept), have been show to turn the clock back on the memory loss by six to twelve months. That means that you will generally see an improvement in your patients’ thinking and memory. And they don’t stop working—even as the Alzheimer’s disease progress and thinking and memory deteriorate over time, that six-to-twelve-month improvement in memory is still present.

3. Future treatments may significantly slow down Alzheimer’s disease. Over the past ten years, our improved understanding of Alzheimer’s disease has generated new potential treatments that may further improve memory, stop the formation of the amyloid plaques that damage brain cells, or even remove those plaques altogether. These new medications are available now in clinical trials.

4. Treatments work best when started early. Many studies have shown that the magnitude of improvement that one sees with memory medications is larger when the medications are started early, in the mild cognitive impairment (MCI) or mild dementia stage of disease, rather than waiting until the moderate or severe dementia stages. Additionally, most clinical trials of new medications are only open to those with MCI or mild dementia.

5. Physical exercise and proper diet can help. Everyone knows that exercise is good for you, but few people realize how important it is for their memory and brain health. In addition to reducing the risk of strokes, aerobic exercise improves sleep, mood, and memory—and it can even promote the growth of new cells in the hippocampus. In addition, many studies have found that the Mediterranean diet can reduce memory loss and even improve memory. Diagnosing memory problems is the first step towards helping your patients to make these beneficial lifestyle changes.

6. Strategies and memory aids can help everyone. Whether memory loss is due to normal aging or the start of a brain disease such as Alzheimer’s, all of your patients can improve their memories using strategies and external memory aids, such as mnemonics, notebooks, calendars, pillboxes, and smartphones. A better understanding of the changes in their memories is the first step.

7. Participating in memory research or advocacy work can help future generations. Help your patients to confront their memory problems and find out if they are due to Alzheimer’s disease or just a part of normal aging. Empowered with this knowledge, they may be interested in participating in research, advocacy work, or another endeavor that can help them and the next generation.

For more information see our book, Memory Loss, Alzheimer’s Disease and Dementia: A Practical Guide for Clinicians.