Memory Loss or Behavioral Changes (including MCI, MBI, Alzheimer’s disease, and dementia)
Many people experience mild declines in their physical and mental abilities during the course of their lives, including changes in memory, mood, and their social interactions. Not all changes are inevitable consequences of aging, and not all changes reflect dangerous diseases. It makes sense to find out if the changes reflect a disease of the brain or of the body, that may influence the way the brain is working.
In a significant proportion of cases it is possible to identify a reversible or modifiable cause, which, if addressed, will permit recovery. In other cases, a clear diagnosis permits establishing a treatment plan to slow down potential worsening, and to maximize abilities.
Dr. Armon has been medical director of the Memory and Cognitive Disorders Clinic at Shamir (Assaf Harofeh) Medical Center since 2015. During you first appointment he will hear about the memory and cognitive difficulties you have encountered, including the perspectives of your close ones, will learn about your medical history, and will sample-check your cognitive abilities. Based on the findings, we will establish a plan to evaluate the source of the difficulties. The plan will often include some tests. We will go over the results of the tests in a follow-up visit to make a diagnosis, understand its meaning, and develop a treatment plan.
It is helpful to be joined by a healthy family member to provide an additional perspective to understanding your difficulties, and to help understand the plans and follow through on them.
Effects of a Combined Transcranial Magnetic Stimulation (TMS) and Cognitive Training Intervention in Patients With Alzheimer’s Disease.
Alzheimers Dement. 2020 Apr;16:641-650
Frequently Asked Questions
It makes sense to get a neurological consultation if you or someone close has memory difficulties to try to find out why this is happening. Sometimes the cause is reversible or readily treatable.
Occasionally, you may be experiencing the start of a more serious disease, such as Alzheimer’s disease. Early diagnosis permits amelioration of factors that may accelerate its course and administration of treatments that might extend the mild phase of the disease. Early diagnosis gives patients and their families the opportunity to prepare for the future while maximizing their use of the present.
We become aware of a behavioral change if an individual changes for the worse in character, moodiness, or social interactions (the way they treat others). Personality traits which previously were perceived as odd or irritating may evolve to become troublesome or disruptive. Patients may become more withdrawn and appear depressed, or without initiative. Conversely, an individual previously courteous may become short-tempered, irascible, and less inhibited. Loss of empathy, or decreased appreciation of the feelings of those around them, are characteristic of this group of conditions.
When the changes are early and mild they are called “Mild Behavioral Impairment” (MBI).
It makes sense to get evaluated, or to get you loved one to be evaluated, because often there are reversible causes for these changes, and the sooner they are found and removed the sooner the individual will get better.
Occasionally the mild change is the harbinger of future worsening to the point of developing a dementia which presents with changes in behavior and judgement, affecting language abilities and memory only at a later stage. It helps to know early on what is going on, because it spares the patient and family a great deal of heartache if they understand that this is a process outside of the patient’s control. Early diagnosis can help in management. It also permits maximizing behaviors that will support brain health.
Dementia is a disease of the brain, resulting from dismantling of one or more of the neuronal super-networks that enable it to do its job. It is expressed as a decline in cognitive abilities that prevent individuals from doing that which they used to do in the past, to need to do currently.
The specific expression in individual patients depends on the network affected primarily, the location where the disease begins, and the speed with which the process progresses. The most common cause of dementia is Alzheimer’s disease.
Most dementias cause a gradual decline in memory, in the ability to understand (“hear”) spoken language and use language at a complex level, in orientation and in the ability to plan, but some dementias have other presenting features.
There is a form of dementia that expresses itself in changes in an individual’s personality, mood, initiative, and interpersonal interactions many years before the appearance of the characteristics of most dementia, such as memory difficulties. The name of this dementia is (behavioral-variant) Frontotemporal Dementia.
There are other dementias, and the treatment needs to be tailored to the specifics of the process and its expression in the affected individual.
If you notice, in yourself or in a loved one, changes for the worse in cognition, mood or personality – it makes sense to get evaluated to search for a cause; to see if it is reversible, and if that is not the cases to take steps to ameliorate the condition.
We suspect someone might be experiencing “Mild Cognitive Impairment” (MCI) when they are finding it difficult to keep up with activities they have done for many years, due to changes in cognitive abilities, such as concentration, memory, understanding speech, orientation, planning and persistence. Memory difficulties are often the first changes that bring the difficulties to the forefront.
It is important to be evaluated, because frequently a reversible cause can be found for the changes, the sooner the better. Sometimes the mild decline suggests there is a risk for future worsening, which may lead to dementia. It makes sense to do everything possible to maintain the brain’s health and adopt a healthy lifestyle in order not to accelerate the process.
Alzheimer’s disease is the most frequent disease that causes cognitive decline that prevents a person from doing what they could do in the past or need to do currently. It is the most common cause of dementia. It usually leads to memory loss, difficulties understanding (“hearing”) what is being said or using language well, and to difficulties with orientation and planning.
If you think you or a loved one have developed the disease, it makes sense to be evaluated in order to determine if there is an alternative explanation for the difficulties. Even if the final diagnosis is Alzheimer’s disease, it makes sense to find out as early as possible.
The treatment objectives are to remove or mitigate factors that may accelerate the course of the disease, to deliver treatments that permit some of the patients to hold their own and occasionally improve for a while, and to enable patients and families to prepare for the future, while prioritizing what they do with the present.
Dementia is the overriding term for all the diseases that take away peoples’ ability to think, or change their personality and mood, through a destructive process that dismantles the neural super-networks in their brains. The change has to be sufficiently severe, so as to prevent a person from doing what they were able to do in the past or needs to do currently. The specifics in each patient depend on the network affected primarily, the location where the disease begins, and the speed with which the process progresses.
Alzheimer’s disease is the most common cause of dementia. The term “Alzheimer’s disease” has a dual meaning. It refers both to the biological process and to its clinical effect. This can be confusing. The biological process is at work several decades before the disease begins to express itself clinically. This gives hope, that early detection may provide an opportunity for intervention to slow its progression in its earliest stages.