Dr Troye advises Rob on his concerns about his wife.
Rob’s wife is getting forgetful – enough to cause him concern. He asks Dr Troye Wallett if he should talk to her about visiting a GP to discuss the issue or whether that could harm her self-confidence.
I’m 76 and my wife seems to be getting more forgetful. What do you think I should do to find out if she has the start of some kind of dementia? I’m concerned that I may hurt her confidence and cause her to stress.
A. Investigating mild memory loss is considered screening for dementia. In medical circles, the discussion about screening for dementia splits the room. Five doctors would have six opinions on the matter.
The argument for screening is that it empowers people to plan for their futures. The counter-argument is an early diagnosis of dementia leads to stress and anxiety for an illness that has few treatment options.
I sit in the ‘concern about creating unnecessary anxiety’ camp with an important caveat. A diagnosis of dementia allows for planning for the future. Ensuring that your advanced-care directive, guardianship, power of attorney documents and will are up to date is vital. I am no lawyer but can assure you that I have seen first hand how these documents make people’s lives easier.
My caveat is it should not take a diagnosis of dementia to inspire you to action. Get your documents done today. Or this week if today is already jam-packed.
Your question, Rob, implies that your wife’s memory loss is significant. In this case, it is not about screening but rather about making a diagnosis.
There is no shortcut here and I would suggest bringing it to the attention your GP. She or he will be able to work with you, guide you through the diagnostic process and discuss future options. The steps taken will be to classify the cognitive decline, investigate a cause and make a diagnosis. Involving a geriatrician to help out with the diagnosis is very common.
Importantly, memory loss is not always dementia and many serious illnesses can present with cognitive decline. If there are symptoms in addition to memory loss, such as a sleepiness, a sudden change in condition or an event preceding the cognitive decline, then urgent medical workup is vital.
I send you strength and best wishes, as the road ahead is potentially hard. Please remember to look after yourself as you care for your wife. With some luck, this last piece of advice is mute and her memory loss turns out to be a hearing issue, solved with hearing aids.
Troye is happy to answer your questions. Simply send an email to: firstname.lastname@example.org
Dr Troye Wallett is a GP. He is a co-founder and part-owner of GenWise, an ethics-based, purpose-driven mobile general practice which supports health professionals working in aged care.
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