Hello everyone,

My father is 75yrs old and has been showing signs of cognitive decline.

I say that broadly because I don't know much about these topics and don't know whether these would be signs of dementia or just aging or other.

Here is what's happening.

He has no problems having a conversation, or remembering your name or things like that, but he has a lot of trouble focusing on tasks that involve following directions like finding addresses, when you explain how to do something in the computer it's like he is literally a 1 yr old and does not listen to you, he has trouble organizing paperwork from his business, etc..

To me it's like he shuts down and does not listen and thinks of anything else while you are explaining something to him or show him how to do something. Simple stuff, like printing an email, or sending a message on whatsapp, despite having done these things in the past.

I am not sure if this is just him not wanting to use his brain and make an effort to focus on what you are helping him with out of being lazy or if he really may have an issue with thinking and focusing.

He also has pre-diabetes, high blood pressure, does not want to want for the life of him, total couch potato and sometimes goes days without showering or grooming. He eats a lot of junk food that he gets himself from the grocery store and will not cook or clean or do anything since he has a nanny that does theses things Mon-Friday. He wants everything done for him, although he still drives (scares the @$# out of us) and goes to places by himself or takes an uber.

So, how do we find out if we are in the presence of a spoiled child or a combination of that and real cognitive issues?

Is a neurologist in order and what kind of tests will tell us more scientifically what is going on with his abilities?

Also, he does not like doctors and taking him to see a neurologist will be difficult.

Thanks for any insight. If you need more info, please let me know.

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Get dad a geriatrician not a family general practitioner. You may have a long wait for a neurologist that specializes in elderly cognitive decline. A geriatrician can do the basic memory testing and blood work. My mom, diagnosed with Alzheimer's, never saw a neurologist. It just did not make sense as there was nothing that the neurologist could do that the geriatrician couldn't. In Alzheimer's there is no treatment, there is no cure. A lot of expensive testing is just difficult for those being tested and they may strongly object to any testing.
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You might be better off to go to a neurologist, whatever you feel that your dad can handle and get the help he needs--that is what matters!

I wish you Good Luck!
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Thank you very much for all the replies and kind words.

I will work with my sisters and mother to find a good primary care doctor or a neurologist. Where he lives, you do not need a referral to see a specialist and we may just cut to the chase and go straight to a Neurologist. He can do all the bloodwork as well, so wouldn't that be better ?

Also, my older sister insists that he needs to go to a psychiatrist because he has depression and he may benefit from taking something to uplift his mood and attitude. She says that her husband's 92 yrs old takes some kind of SRI that keeps her happy and she even does gardening and whatnot.

I have been against SRI just as much as I am against opioids, but at this point I don't know if at his age it may just be more beneficial than whatever risk of side effects the SRI may produce.
Thoughts on this?
(by the way, we will have an easier time taking him to a neurologist than a psychiatrist for sure. He doesn't believe in that you know :) )

Thanks again!
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I know a few people who don't have dementia who have some of those same traits. I wouldn't jump to any conclusions. Maybe, he's depressed or just isn't into modern technology. Plenty of smart people aren't computer savvy. I might make a list of your observations and share them with his primary. They can do a mini office eval and order MRI to determine status and see if he needs to be referred to neurologist.

It's good to be concerned, but, I'd try to lower the expectations on some things. Maybe, his and your interest just aren't the same.
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Okay, this does sound like the beginning signs of dementia; however, DO NOT be alarm yet! There could be many other causes!

You need to get your father into see his Dr first so, he/she can rule somethings out.

His Dr should order the following test:
Bloodwork should include the following:
Comprehension Panel (not the basic one)
His Dr may order other bloodtest.

Depening what the labs show the Dr might want a CT and/or MRI

This is where I would start if I was you. Your dad could have an infection, it could be medications, it could be his sugar level is off (to high or to low), it could be many other things!

Can you pen point when the changes happen?
How long have you notice this behavior?
Does he have any heart problems?
Did he fall or bump his head?
Is there a family history of dementia?
Is there a family history of cancer?
Have you notice at any point slur speech and/or eyes just didn't look right to you than eveything seem normal within a few minutes to a few hours?

If you can answer yes to any of these questions than make sure you tell his Dr.

Don't panic, just get him into his Dr and explain what you are concern with. Do Not be afraid to ask for bloodwork if his Dr doesn't order it.

Just take one step at a time. His Dr may refer him to see a specialist but don't worry about that until you cross that bridge.

I know your scared, and that it is ok to be afraid.

Just tell your dad that he needs to see a Dr for a routine check up. This is another reason to see a M.D or if possible a D.O than your dad is only being seen by one Dr at a time.

We are here for you.
I will pray for you.

Good luck
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Do you have a major university medical center nearby? What you want is a workup with a team (usually a neurologist, neuopsychologist and psychiatric nurse practioner) who will review his medical history, obtain or review brain imaging, and do some cognitive and neurological testing. We got this sort of evaluation for my mom at a rehab hospital that was connected with a teaching hospital.

You tell dad that it's needed to get a baseline so that his doctors can base judgements about anything that happens in the future (like strokes or mental changes) on what good health he's in right now.

In my mom's case, she had no memory issues, but had terrible anxiety, could no longer figure out bill paying or filling her weekly pill containers accurately. It turned out that she'd had an undiagnosed stroke and developed Mild Cognitive Impairment. After a second stroke, she developed Vascular Dementia. It was very useful having the baseline evaluation.
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