Despite popular notions (and fears), many, if not most incidences of memory loss or confusion in aging people are either temporary and/or treatable. A great variety of medical, physical, and environmental causes can produce these symptoms—what is needed is a correct diagnosis once these symptoms appear, rather than jumping to the conclusion that a more serious, and inevitable, condition exists. Of course, a thorough diagnosis will also give an indication of a more serious condition, if one exists.

Did you know that over a hundred conditions can produce symptoms of dementia (confusion, disorientation, memory loss)? Many, if not most, of these conditions are not the result of organic brain disease but of other medical conditions or causes that are reversible with intervention. These include infections, over-medication or medication interactions, poor nutrition, anesthesia and its after effects, uncontrolled pain, substance or alcohol abuse, metal poisonings (arsenic, lead, mercury), carbon monoxide inhalation, depression, insulin imbalance, and trauma, to name a few.

The diagnosis of an organic brain disease such as Alzheimer's can only be arrived at by first excluding any medical or environmental causes of symptoms. A diagnosis of Alzheimer's dementia can never rest on a mental status exam alone but requires a thorough physical work-up with appropriate lab work, medication review, and other tests as indicated. Many, many times in my own clinical work the dementia presented was the result of a bladder inflection, or multiple drug interactions, or uncontrolled pain, or post surgical delirium from anesthesia, or other medical factors. Once these conditions were treated medically the person's mental status gradually returned to normal.

If you notice a loved one experiencing confusion and some memory loss, check things like their nutrition and medication use first. Aging persons, especially those who live alone, often do not eat well nor do they take necessary medications as directed. Encourage them to see a physician (accompany them if possible) for a physical check up to rule out infections or other medical conditions. Don’t assume memory loss and confusion are a normal part of aging—they are not. More often than not, there will be medical, physical, and environmental causes of these symptoms. There are physicians who specialize in geriatric medicine as well as older adult mental health agencies with expertise in helping sort out what is medical, mental, and behavioral. The Alzheimer's Association is also an excellent resource for helping families and individuals connect with appropriate physicians and support services. They can be reached at (503) 413-7115. They also have a 24-hour help line at (800) 733-0402.

Many everyday memory problems are due to lack of attention or other controllable factors. So before you panic when you can't find your car keys, have trouble remembering names, "lose" your car in the mall parking lot, or see similar conditions in a loved one, consider the following: 1) You're in good company. 2) Some forms of memory may even improve with age. According to Dr. Cynthia Adams from the University of Oregon, practical and emotional intelligence grows in adulthood and memory can be improved at any age.

Copyright © 2000 Ruth Hayes-Barba

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Ruth Hayes-Barba, LCSW is the Director of the Ministry to the Aging Office for the Archdiocese of Portland Oregon. She is also the editor of the Growing in Wisdom, Age & Grace Newsletter, a semi-annual publication of Ministry to the Aging Office. Her article Substance Abuse and the Elderly was originally published in the Winter 2000 (Vol. 2, No. 2) issue of Growing. For more information about Growing, or the work of the Ministry to the Aging Office, please visit the Archdiocese of Portland in Oregon’s Web site at www.archdpdx.org..