Which Doctor Should I See for Cognitive Decline and Dementia?
Have you ever worried that you or a loved one may be losing cognitive abilities with age? If so, you are not alone – many adults over 65 have the type of cognitive decline or loss we regard as a ‘normal’ consequence of age.
Learn more about cognitive decline and dementia and how to differentiate between their symptoms as you age.
Normal Signs of Aging
According to HelpGuide.org, the following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:
- Becoming easily distracted or having trouble remembering what you’ve just read, or the details of a conversation.
- Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by your son’s name.
- Not quite being able to retrieve the information you have “on the tip of your tongue.”
- Occasionally forgetting an appointment or walking into a room and forgetting why you entered.
- Occasionally forgetting where you left things you use regularly, such as glasses or keys.
For many people, slight lapses in memory from time to time are a natural and normal part of the aging process; however if you find that you or a loved one are struggling with the ability to perform everyday activities, or any behavior, memory or thinking skills, then there may be a bigger issue at hand.
Symptoms of Cognitive Decline and Dementia
Cognitive decline and dementia are two common conditions that are not considered normal aspects of aging. According to the World Health Organization, about 50 million people worldwide have dementia and there are nearly ten million new cases every year.
Cognitive decline and dementia differ from age-related memory loss in that they are degenerative diseases that will gradually worsen over time. For many people, symptoms of cognitive decline start out subtly and may only be noticeable to the person experiencing them.
WHO describes the following early-stage symptoms of dementia:
- Becoming lost in familiar places
- Losing track of the time
When the disease progresses, the middle stage symptoms of dementia become “clearer and more restricting” including:
- Becoming forgetful of recent events and people’s names
- Becoming lost at home
- Experiencing behavioral changes, including wandering and repeated questioning
- Having increasing difficulty with communication
- Needing help with personal care
Symptoms eventually lead to “near total dependence and inactivity” during the late stage of dementia, including:
- Becoming unaware of the time and place
- Experiencing behavior changes that may include aggression
- Having an increasing need for assisted self-care
- Having difficulty recognizing relatives and friends
- Having difficulty walking
Ways to Choose the Right Healthcare Professional
Choosing the right healthcare professional is critical if you’re concerned that you or a loved one may be experiencing dementia or another cognitive disease.
Make an appointment with one of the appropriate healthcare providers below to address your concerns:
1. Family Doctor or Primary Care Physician
According to an article published by U.S. News, making an appointment with your primary care physician (PCP) is the best first step to receiving comprehensive care: “the PCP needs to get a complete medical history, family history, social history, current medication list and a review of any loss of abilities to perform day-to-day activities.”
During this initial visit, your physician will perform a full physical exam and “administer a cognitive assessment” to gain a better understanding of your symptoms and rule out other possible conditions. Your physician may also order lab tests, including blood work, a CT scan or an MRI, as well as make a referral to a dementia-specific specialist for further testing.
2. Geriatrician or Geriatric Psychiatrist
According to the University of North Carolina School of Medicine, your “best choice” for a dementia-specific specialist is a geriatrician with a special interest in dementia, or a geriatric psychiatrist.
A geriatrician is a “primary care internist or family practitioner who specializes in complex conditions of older people and can provide care for all of an older adult’s medical needs” whereas a geriatric psychiatrist “specializes in the emotional and mental needs of older individuals. They conduct thorough memory, mood, sleep and thinking evaluations, and are particularly good at assessing memory problems associated with life stress, anxiety, depression, excess drinking or family conflicts.”
If you are unable to obtain a referral to either one of these specialists (or your insurance will not cover the cost of these visits), your PCP may refer you to a neurologist.
The American Academy of Neurology defines a neurologist as “a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system.” Some neurologists are more specialized in cognitive decline and dementia than others, so it is important for you and your family to ask questions of your PCP and research neurologists to ensure you are being referred to the most appropriate specialist. During your initial consultation, the neurologist will perform more comprehensive tests to determine your mental fitness.
4. Psychiatrist, Psychologist and Social Worker
Many people struggle upon receiving a diagnosis of cognitive decline or dementia. A psychologist or social worker can “provide counseling and support” and also help to address behavioral issues. They can also offer support to the family unit in order to best support the newly diagnosed individual. As mentioned above, the University of North Carolina School of Medicine suggests visiting a geriatric psychiatrist because they focus solely on “the emotional and mental needs of older individuals.”
If you suspect that you or a loved one is experiencing cognitive decline or dementia then starting with your Primary Care Physician is the best first step. But, don’t feel restricted by their opinion.
U.S. News suggests that if you are not happy with the results of your PCP appointment, or “if the doctor does not seem to feel that an evaluation for diagnoses and treatment of the cognitive problem is that important, then it’s time to get a second opinion.”
Have you seen one of the healthcare professionals listed above about cognitive decline or dementia? We’d like to hear more about your experience in the comments below.
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