What to Do with Your Concerns: A Step-by-Step Guide

Noticing one or more of these signs can be frightening, but taking action is the most empowering thing you can do. A timely and thorough evaluation can identify a treatable condition, provide an accurate diagnosis, and open the door to support, resources, and potential treatments that can improve quality of life.

Step 1: Document Your Observations

Use the checklist above as a guide to organize your thoughts. For 2-4 weeks, keep a simple log of specific examples. Instead of writing “Mom was confused,” write “On Tuesday at 4 PM, Mom couldn’t remember how to get to the grocery store we’ve been going to for 10 years.” Factual, specific details are much more helpful to a doctor than general statements.

Step 2: Schedule a Comprehensive Medical Evaluation

The first stop should be a primary care physician (PCP). They can conduct an initial assessment and, crucially, rule out other potential causes for the symptoms. Do not be afraid to state your concerns directly: “I’ve noticed some changes in my memory, and I’d like to have it evaluated.” If you are a caregiver, you might say, “I’ve noticed some changes in my father’s thinking and behavior, and I’m concerned.” Depending on the initial findings, the PCP may refer you to a specialist, such as a neurologist, a geriatrician, or a neuropsychologist, for more detailed testing.

Step 3: Prepare for the Appointment

A little preparation can make the appointment much more effective. Be ready to bring:

Your symptom log: The detailed notes you’ve been keeping.

A full medication list: Include all prescription drugs, over-the-counter medications, vitamins, and herbal supplements.

Medical history: A list of past and present health conditions.

Your questions: Write down what you want to know. Examples include: “What do you think could be causing these symptoms?” “What tests do you recommend, and what do they involve?” “Are there any conditions we need to rule out?” “What are the next steps after this appointment?”

Step 4: Understand the Process of Ruling Out Reversible Causes

One of the most important outcomes of a medical evaluation is to identify conditions that can cause dementia-like symptoms but are reversible with treatment. A doctor will likely run tests to check for:

Medication Side Effects: Polypharmacy (taking multiple medications) is common in older adults, and the interaction between drugs can cause cognitive impairment.

Metabolic and Endocrine Abnormalities: Issues like a thyroid imbalance or a Vitamin B12 deficiency can directly affect brain function.

Depression: Severe depression can sometimes cause cognitive changes so significant that it’s referred to as “pseudodementia.” Treating the depression often resolves the memory issues.

Infections: A urinary tract infection (UTI) is a common culprit for sudden confusion and behavioral changes in older adults.

Dehydration and Malnutrition: Not getting enough fluids or nutrients can easily lead to confusion and lethargy.