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labbydog Asked December 2013

What questions to ask at the Neurologist's?

My mother, who is 97, just saw her PCP. He has been recommending the last few visits that she see a neurologist, as she is getting quite forgetful. However, at her advanced age, I would expect her to be! She had a fall and fractured her hip in October, and it seems that, after that, her memory really started deteriorating. When the VNA asked her what year it was, she started to say, "19....." Her PCP quizzed her a little, like what's my name, who am I, which she got right, but she tries to "mask" that she really doesn't remember. What questions should I ask the neurologist? I'm wondering if it is really even worth the visit. At her retirement facility, they said there are certain drugs they can put her on to improve her memory (Aricept was one of the ones they mentioned), but I'm not really sure if the neurologist visit is just another inconclusive doctor visit. Anyone have an advanced age parent who has seen one?

FloraSteele Dec 2013
Yes, yes, pls do check ALL the bases. What Jinx said, and other possible causes. Not just 'causes of dementia' but 'causes of dementia-like symptoms'. IE forgetfulness, irritation, poor attention span, drowsiness, even delusions, etc etc. Even just poor sleep can cause fogginess for maybe more than one day afterwards. So can skipping a meal. Test for diabetes: either too low BG or too high may cause such poor mental functioning; often a GOOD meal will fix it for a few hours. Low blood pressure from heart failure can cause passivity, forgetfulness, etc; even what looks like stroke (mumbling etc). Do test for stroke too; not curable, but it doesn't progress like dementia would. Stumbling and clumsiness and poor balance (confusion, not knowing which way is up) may be caused by poor nutrition or something like neuropathy -- or even wax in the ears (disturbing teh inner ear balance center).

Or of course emotional stress can cause absentmindedness, forgetfulness, slow mental processes or slow speech, etc etc.

There may be other treatable things that MIMIC dementia. Nutrition etc. It's worth some study and persistence and second opinions from 'alternative' practiioners too.

labbydog Dec 2013
Thanks pstiegman and Jinx for your replies to my question. I certainly don't want my mom getting steroid shots at her age. I guess we'll just go for the initial consult and see what neurologist says....she doesn't have to "do" anything if she doesn't want to.

Jinx, she, fortunately, did not have to have surgery to repair her hip fracture. I remember when my Dad had surgery several years ago, the anesthesia really did a number on him right afterwards, but he soon went back to regular mental functioning. Right now she only takes one prescription med for hypertension. She has enough trouble as it is remembering to take that pill.

Thanks again for your suggestions and support.

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Jinx4740 Dec 2013
One important thing to do is to rule out treatable causes like vitamin deficiency and low thyroid, drug interactions, infections and normal pressure hydrocephalus.

Did she have surgery for her hip? Anesthesia can speed dementia.

I'm sort of with you about getting a new doctor to visit every 6 months. Make sure the dementia isn't reversible. Perhaps try an appropriate medication or two. Then say goodbye to the neurologist and let nature take its course.

pamstegma Dec 2013
I would definitely want a brain CT done. If the brain has deteriorated significantly, medications aren't the answer, they can't work on neurons that are no longer there. I will tell you from experience that all Neurologists are not created equal and many are just idiots giving out steroid shots. Where I live we have the Dent Institute with MD's who specialize in the aging brain. Get an expert or you are wasting your time.

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