Ask the Doctor: Neurologists; New Year’s Resolutions; Focusing
Q: I feel as though my memory struggles are more than just age-related lapses. Should I seek out a neurologist or some other type of health-care provider?
A: As with most health-related concerns, you may be better off telling your primary care physician about your memory concerns. Your doctor may be able to perform a simple assessment to see if you’re showing signs of mild cognitive impairment or dementia. If so, you may be directed to a specialist.
Neurologists usually have some training in diagnosing and treating Alzheimer’s disease and other dementias, but not all of them do so. Some neurologists focus more on nervous system disorders affecting the brain, spinal cord and peripheral nerves. If you are referred to a neurologist, ask whether he or she treats patients with dementia.
Prior to seeing a neurologist, you may instead be referred to a geriatrician, who has training in the treatment of many conditions common among older adults. A geriatric psychiatrist may also be a good person to consult with, as he or she can often determine if your memory lapses may be due to depression or other underlying mental health concerns.
Lastly, if you exhibit changes in memory, thinking skills, and attention, your doctor may advise you to see a neuropsychologist, who can administer a range of tests to assess your cognition. Paying attention to symptoms and finding the right doctor should start sooner than later. Dementia can’t be cured yet, but some symptoms can be slowed or managed, especially if the condition is diagnosed in its early stages.
Q: Are New Year’s resolutions a good idea if you’re likely to break them?
A: Even if you suspect you’re going to break your New Year’s resolutions, there are some reasons to at least start out the year with some hopeful intentions. Eagerly pursuing a specific goal can activate your brain’s pleasure centers, giving your mood a boost, at least temporarily. Also, if you make the same resolutions year after year, it’s clear that those goals (finishing your novel, losing 20 pounds, visiting Hawaii, etc.) are important to you. And if you haven’t accomplished them yet, then maybe try to go after them in a different way this year.
The argument against making resolutions is that you may already have an effective way of achieving your goals. You may not need an artificial framework to set and accomplish a new set of goals. And if you stop and think about it, you know you can achieve goals or start working on them at any time of year. There’s nothing special about the first of the year other than the convenience of a new calendar. And lastly, if you break your resolutions and have excuses or reasons why every year, try focusing on what’s keeping you from sticking to your resolutions rather than the resolutions themselves. Identifying your barriers may pave the way for a big year of achievement.
Q: I seem to have more trouble concentrating and focusing my attention in conversations and at other times throughout the day. Is that just a sign of getting older?
A: It’s perfectly normal to notice a little change in your ability to concentrate as you get older. It may be an age-related change, but it could be the result of many other factors. You may not sleep as well as you once did, and that can affect focus and attention. Medications you take could have the same effect. Medical conditions such as thyroid disease, migraines, anemia, dehydration and depression can also cause fuzzy thinking and reduce attentiveness. A study published in 2018 found that older adults under stress show less activity in the part of the brain that enables us to pay attention. Think about these factors or other recent changes in your life that may affect your ability to concentrate, and talk things over with your doctor.
-Editor-in-Chief, Maurizio Fava, MD
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