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Family members and some employees of mine and my GP Doctor insist I
I get tested. I am reluctant, but I forget a lot now, trouble spelling, make bad decisions get confused in driving. I am 71. On antidepressives.


Any advice?

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Dear Cricket6901,
I write from the perspective of one who is now in Moderate to Severe level of ALZ. I was diagnosed 5 yrs ago with Early onset ALZ. The first mistake I made was not having a family member with me when the Neuropsych Exam was given. I wasn't told, I should have someone with me. I also got the follow up appointment and really wish I had someone with me. The Doctor said to me he was uncomfortable with me driving. My Neuro Doctor, told me when she saw the report that I still wasn't at the point where I shouldn't drive. Neurologically I was fine, and that we'd keep having the talk at each follow up appointment. Last year just as the lockdown for COVID 19 was happening, I came home from doing my errands, and I said to my DW it was time to hang up the keys. I wasn't able to surrender my license until August because it took 5 mos to get an appointment with the DMV to surrender it. Now, I haven't been behind the wheel in 17 mos., and I have never said, I wish I could drive since. When I had my most recent Neuropsych exam my DW was with me for both appointments.
When you are making bad decisions by driving it is time to hang up the keys.
I would suggest you have a have a Neuropsych Exam and after you have the results, if you are diagnosed with ALZ or another Dementia start having a discussions with your family about, what you want for treatment and don't want.
We all walk on a different journey, everyone is not the same. I was 57 when I was diagnosed, I was 61 when I turned in the keys and have no idea where they are.
I would engage with your Doctor and put together a Care Plan focusing on your needs. We all walk along the same trail, but have a different journey. I would get in touch with the ALZ Association and check in to a Local Caregivers Program for your family. Where I live, there is a group called the Forgetful Friends, Our group is unusual in that they allow Patients to be a part of the group and all Caregivers and Patients discuss their particular journey. I also began reading about Dementia on Agingcare and then after a month or so, I began replying to questions posed. I hope you find my comments of benefit to you. I'll remember you in my prayers. God Bless you.
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RedVanAnnie Jul 2021
Your message and advice from someone "on the inside" is most enlightening and helpful. I am immensely touched by your post.
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Please, CaregiverL, we cannot make recommendations for people to cut off medications.
We are not their doctor.

Any medication discontinuance should be made under a doctor’s care, especially in the case of an antidepressant. We must not, nor are we qualified here, make any determinations about someone’s mental health.
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KatyAdams Jul 2021
I was thinking this, too. And to my knowledge, anti-depressants do not usually cause cognitive impairment. In fact, depression can cause cognitive changes that may be helped by anti-depressant meds and therapy. Thanks for saying this!
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I have been thinking about this post, your question and I am wondering if your exam should not be with a Neuropsychologist or a Neurologist rather than your GP. I am not saying a GP would not give a good exam but I think a Neuropsychologist or Neurologist would be better and they can order more advanced test if they think it is called for. The worst thing would be for your GP to give you an exam and say, "come back in 6 months and we will repeat this and compare the two tests" . then you have to wait 6 months then possibly go for further testing.
I think that is a waste of time and can cause increased anxiety.
If it is not to late ask your doctor for the name of a Neuropsychologist or neurologist that he/she works with and set up an appointment with them.
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RedVanAnnie Jul 2021
I am always so impressed by your answers to all sorts of questions and dilemmas. You offer such well-articulated wisdom.
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Cricket - so sorry this is happening to you. It must be frightening to be facing this given all the responsibilities you're handling.

I recommend you see an attorney specializes in Elder care. You need to appoint someone(s) you trust to be your Power of Attorney to handle you finance and make medical decisions for you if/when you can't do those for yourself.

If you don't already have these done, you urgently need to make arrangements on who will step in/take over for you regarding your business, assets, etc. You also need to have your wishes written down as to what you want regarding your health such as DNR, feeding tubes, life support, etc.

Do these while you still can think and make decisions for yourself. Otherwise, someone else will, when time comes, decide for you and they may not make the choices that you would want.

Again, I am so sorry you're facing this.
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MaryKathleen Jul 2021
All of us need to do these things. Thanks for the reminder.
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Get tested by a neurologist, please. Before your appointment, make sure to get a full night's sleep and eat a good meal - then you should be at your best. Answer questions honestly.

The doctor is trying to discover what is causing your problems. Early diagnosis of Alzheimer's disease and early medication can "sharpen" your memory considerably. Early diagnosis and early medication can help with Parkinson's disease. Evaluation and treatment of micro strokes caused by clots with mild blood thinning medication can halt further insults. This will only happen with evaluation by a qualified doctor - the sooner, the better.
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My Mom died of Alzheimer’s in 1987. She was 72. I was her Caregiver for the last 13 years of her life, myself and my kids. She was a legally blind, hearing impaired diabetic. <~ (background). It was hard. We were very poor. WE SURVIVED.
I am now 76. I requested a more comprehensive test. I forget things, a lot now. I passed with flying colors but the professional doing the test said she felt I had “a major depressive disorder”. And wanted to prescribe meds. I refused.
I refused because she hadn’t asked a lot of pertinent questions.
Before I went to see her I had several deaths close to me. I told her I had just lost my best friend, husband and son, as well as several close friends, and while I knew I had some depression they were as far as I was concerned more “situational” than the symptoms of a disorder.
I feel rather strongly about these meds being prescribed when we are older: seen it. Docs are too quick to put us on meds that make us worse. Black box warnings about
cognitive changes in the elderly are common.
I am glad I took the test. I am a cancer survivor and knew some of my issues are related to the cancer treatment. Read: chemo brain. Fatigue. Etc.
Best of luck. But be your own advocate. Research everything.
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Please get the tests done, since you clearly have something going on that is not good. Should it be dementia, you want to start making some preparations and "get your ducks in a row."

Ignoring the situation will NOT make it go away. Surely, you want to know "what you are dealing with" - yes?

BTW - I am a former psychiatric nurse. Please do NOT stop your anti-depressive medication(S) unless your GP advises it; doing so might make things much worse.
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Tell your GP you're trusting him/her to consider all of the possible causes of recent change and not just head down the nearest diagnostic rabbit hole. Then do trust, and go for it. Better the devil you've identified.
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I worked as a Social Worker at a memory care center and was part of the team that performed testing and provided recommendations based on the outcome of the tests. I highly recommend that you go to a memory care center for testing if there is one in your area. If not, I would make certain that you engage a practitioner that will strongly consider your psychosocial state. Medication, emotional turmoil (grief, moving, depression, anxiety), illness, and vitamin deficiency can all render cognitive impairment and memory loss that mimics types of dementia. We would require that the person undergo a physical to determine things such as absence of UTI or low B12 in particular. We would ask questions that reveal state of mind and hardships. I now work as an independent caregiver/companion and had a client that was misdiagnosed with Alzheimers. It turns out it was a medically induced dementia! Best of luck to you in finding a caring and competent practitioner.
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Your GP can perform basic screening tests to see if you exhibit dementia symptoms. I see you're on antidepressants; depression alone can mimic dementia symptoms. Your GP may conduct a mini-cog test or even an MMSE, if time allows, which is used to evaluate mental skills. If dementia is suspected, you may be referred to a neurologist, gerontologist or neuropsychologist for further testing. Your GP can also perform certain blood tests to confirm or eliminate any treatable conditions that mimic dementia. If your GP suspects dementia, he/she is not trained to follow up with neurological tests. Make sure you're referred to one of the specialist above. Good luck.
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disgustedtoo Jul 2021
"...perform certain blood tests to confirm or eliminate any treatable conditions that mimic dementia."

AND a urine culture too. Best to rule out any treatable condition that might seem like dementia. UTIs, infections, imbalances in the blood can all cause conditions that might seem to be dementia, to others, but are treatable!

If all is ruled out, then proceed with memory testing. It would be scary to find out it is some form of dementia, but it's scarier if we ignore it!
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