Memory Problems

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Diagnosis

In people with memory problems, physicians often begin the diagnosis process by asking a number of questions about the patient's family and personal medical history and history of symptoms.

These questions may include the following:

• What types of information can the patient remember?
• What information has been lost?
• When did symptoms begin? Did they start gradually or suddenly? Are they getting worse?
• Does the patient use alcohol or drugs?
• Has the patient experienced a head injury, stroke, seizure, or traumatic event or had brain surgery?
• Has the patient started to neglect personal care issues (e.g., healthy eating, bathing)?
• Is there a family or personal history of depression or memory issues?
• Have loved ones or caregivers noticed changes in the patient's personality, judgment, or awareness?

Diagnosing memory problems also may involve imaging tests (e.g., CT scan, MRI scan) to detect bleeding in the brain, stroke, brain damage, or tumors. In July 2009, research showed that protein deposits in the brain, which can be detected by newer neuroimaging procedures, may damage neurons, disrupt memory formation, and lead to future memory loss. Research in this area is ongoing. Laboratory tests (e.g., blood tests) can be used to help diagnose vitamin deficiencies, infections, and thyroid problems, which can result in memory loss.

Other Tests
Additional screening tests can provide clues about the nature of memory issues. A neurological exam often is performed to check reflexes, eye movements, balance, and sensory functions.

In a mental status exam, the physician asks the patient general knowledge questions (e.g., What is the date? What is the name of the president of the United States?) and assesses his or her ability to perform certain tasks. For example, the patient may be asked to draw a clock or copy a geometric design, remember a list of three words, or count backwards by sevens. Patients also may be asked to follow a series of three-part oral instructions or a written instruction.

Diagnosis also may involve a more complicated mental status exam performed by a neuropsychologist (psychologist who specializes in the study of brain behavior relationships). These exams are standardized—they are administered to each patient the same way so that comparisons can be made among a larger group of people. For example, a 74-year-old patient's results can be compared to those of other 74-year-olds with similar educational backgrounds. This helps the physician determine if the degree of cognitive decline is within normal limits. Other types of psychological testing can provide information about changes in personality, mood, language, attention, and perception.

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