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Marijke Boers Church St Surgery April 2017

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1 Marijke Boers Church St Surgery April 2017
Memory Loss & The GP Marijke Boers Church St Surgery April 2017

2 Role of the G. P. Is this NORMAL age related memory loss
OR…..Something Else….. REFERENCE: Having a Senior Moment ? Best Practice Journal of BPAC NZ WEBSITE Number 36, Issue 23

3 We All Have Age Related Memory Loss
Starts in our 20’s Accelerates from age 50 Neurones Reduce, Brain volume shrinks, synapses less efficient Names/words/laying down new information Genetics, hormones, other illness, environmental factors

4 4 Types of Memory Episodic Memory- For significant events
Learning and recall Declines from middle age Semantic Memory – factual and conceptual knowledge Volume increases from middle age to young elderly, then declines Procedural Memory- how to of skills and procedures… normally retained into late life Working memory – learning new information, retaining and then manipulating it- eg- following a map, new person’s name, learning a new procedure… with age, the span often becomes shorter

5 Mild Dementia Frequently Misplaces Items
Forgets names , slow to recall them Word finding difficulties Forget recent events or newly learned information Temporarily becomes lost, trouble understanding or following a map Worries about memory loss. Friends and family are noticing Forgets use of an item, or puts in wrong place Forgets knowing someone Begins to lose language skills Loses sense of time, not sure what day it is Working memory seriously impaired. Difficulty learning or remembering new information Becomes easily disorientated or lost in familiar places Little or now awareness of thinking /problem solving difficulties

6 1. Confirm Memory and Thinking Problems
Memory Tests Family Informant Questionnaire (Helpful to have information from family and loved ones) Consider repeating, different times, different questionnaires or versions of a questionnaire

7 2. Rule out other causes Infections Heart or Breathing problems
Nutritional or Hormonal (eg Diabetes) Mood or anxiety problems …. So , MUST INCLUDE A physical examination Blood Tests

8 Once Cognitive Impairment Confirmed
Any REVERSIBLE Causes ?- FIX THOSE Check Safety at home, driving, etc See if patient needs support in their home- REFER to ICM or support services If Mild, attend to diet, lifestyle, stimulation If moderate, Consider CHOLINE ESTERASE INHIBITOR- or similar

9 CHOLINESTERASE INHIBITOR, BPJ Issue 30, P28
Acetyl Choline- important in brain for memory and other functions Medication MAY be helpful in moderate or advanced Alzheimers…. Slows decline or even brief improvement Does not prevent Decline, Sadly Discuss Pros and Cons, consider side effects (Nausea , slowed heart rate, slow to wee…) Side effects short lived, dose dependent Monitor response carefully, get Specialist input , wean off when no longer helpful


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