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Mental Health

Identifying Mild Dementia

11/30/2006

Question:

My 72 year old father was recently diagnosed by a neurologist as having mild dementia and was told to come back in six months to see how he his doing. My question is, when does he start taking any medication? When I talk to him, it certainly seems like much more than "mild dementia." I am very concerned and am trying to get a second opinion. Some simple tasks were given to him that he could not complete, i.e. draw a clock (he had to keep looking at his watch as reference) and have it read a certain time - could not complete this task and became extremely agitated. There are so many other signs that are typical of much more than "mild dementia", he is also extremely belligerent and I know that my mother is afraid of him. Getting him to go for a second opinion is going to be a battle. Please advise. Thank you for your time.

Answer:

Dementia is an umbrella term used to indicate a change in memory and thinking, behavior, and day to day functioning. It can be caused by a number of different medical conditions and neurological disorders. Alzheimer's disease is one form of dementia.

It is important for every patient with mild dementia to have  a thorough evaluation to look for signs of reversible dementia (hypothyroidism, b12 deficiency, depression, medications, systemic illness, etc).  If all reversible, or other causes of dementia, are ruled out, a person can be diagnosed with Alzheimer's disease.  If the diagnosis of Alzheimer's disease is made, the appropriate medications should be started. 

We cannot be sure what your father's diagnosis is based on email communication alone.  There are cases where a doctor is not sure of a diagnosis and will give it time, such as 6 months, to see how he does before starting medication.  However, it appears that you have many concerns.

Even though it may be a challenge to get your father to a doctor for a second opinion, we suggest that you have him see another doctor with more interest and experience in these problems.  It is essential for both you and your father to see a doctor who you are comfortable with and is able to address all of your concerns and questions. There are also medications available to treat the behavior and personality changes that accompany dementia, such as belligerence.

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Response by:

Robert P Friedland, MD Robert P Friedland, MD
Formerly, Professor of Neurology
School of Medicine
Case Western Reserve University

Paula K Ogrocki, PhD Paula K Ogrocki, PhD
Assistant Professor of Neurology
School of Medicine
Case Western Reserve University