Subjective memory lapses (such as walking into a room and forgetting why), word-finding difficulties and poor concentration are common experiences and usually do not signify the beginnings of dementia. An important question is whether other people have noticed that you don’t appear quite as good cognitively as in the past.
If you are concerned about your memory or other cognitive functions, or those of a family member or friend, you should see your GP who can address your concerns, arrange a follow up at a later date or refer you for further investigations. If possible, take someone with you who has observed the changes that you’re worried about or make a note of examples of behavior or particular incidents that are a concern. You and the person who comes with you might find a diagnostic questionnaire helpful as a way of summarizing things for your GP.
Your GP will decide whether you simply need reassurance, treatment for a non-neurological condition such as anxiety, blood tests, or referral to a specialist. If you do need onward referral, then the service you are seen by will vary from area to area;
• In some areas, the local memory clinic will see people of all ages.
• In other places, the memory clinic only sees patients aged 65 and over.
• You may be referred to a general neurology service, or possibly to a specialist cognitive neurology clinic like the one at St George’s Hospital.
You can find information about the St George’s Hospital Cognitive Neurology service here.
It’s always helpful to bring someone who knows you well to a specialist assessment. You and they will be asked questions about your memory and other cognitive functions. You’ll be asked about how you get on in everyday life, your educational and occupational history, your mood, medication and previous medical history, whether you have any family history of dementia, and you lifestyle, such as your alcohol consumption.
The clinician seeing you may do a physical examination and she or he may perform some memory tests. An assessment of this type typically takes about one hour. At the end, the specialist will offer an initial explanation for your symptoms and explain whether any tests are needed. Your GP or referrer will provide information about the types of tests or investigations you are being referred for and what to expect.
What happens next?
Most young people who are referred to memory clinics have benign explanations for their symptoms, and often all that’s needed is reassurance and/or attention to factors such as mood or lifestyle. However, occasionally memory or other cognitive symptoms can be the first signs of a problem with the brain, such as dementia.
If the specialist is concerned then she or he will order further tests, which might include a brain scan or a detailed neuropsychological assessment. Your health care professional will support you through the process, explain what the results mean for you and what happens next. If you have received a diagnosis of young onset dementia or another condition, they will arrange for a follow up appointment and a referral to support organisations whilst you are in clinic. Receiving a diagnosis can be very distressing and you may need time to come to terms with what has happened before looking at what happens after diagnosis.