Reversible Causes of Memory Problems

Earlier in my nurse practitioner career I worked for a geriatric practice. This practice provided primary care to people residing in nursing homes. I admitted a woman from the hospital with a diagnosis of dementia. The first thing I did was look over her medications. Holy shit! She had been prescribed multiple medications that all slowed down brain functioning. As I looked over her history, I immediately knew what had happened. She had been living independently and developed pneumonia. She became sick enough to need hospitalization. While in the hospital, she developed a problem called delirium. The physician overseeing her care mistakenly diagnosed dementia; this is a pretty common occurrence. She must have been a bit feisty at the hospital because she was prescribed benzodiazipines (drugs like Xanax or alprazolam) and some serious antipsychotic medication. No wonder she was confused!!!

The first thing I did was stop 80% of her medications. Two weeks later, she was showing less confusion. Within 2 months, she showed no memory problems. Her family claimed that I had “cured” her dementia and treated me like a miracle worker. Nope. I successfully treated her delirium and removed a ton of pharmaceutical crap. She never had true dementia.

In fact, memory problems can be caused by a multiple of problems and medicines. This is why there are people all over the internet claiming they have “cured” dementia. The majority of these claims are outright horseshit. Pure fucking scams. A few of these claimers likely did what I did—fixed a fixable problem—except these claimers have no idea what a delirium is.

One of the annoying things about social media is that if you are a family caregiver for someone with dementia, regardless of type, well-meaning family and friends will start tagging you every time they encounter a dementia “cure.” You may find yourself wanting to try all sorts of things to cure your loved one. That is understandable. Please be assured, that as of 2021, there are NO cures for dementia. If anyone advertises that they “cured” dementia, they are WRONG. If the person claiming to have cured Alzheimer’s dementia or some other dementia is a healthcare provider, run. This person should know better, and if they do not, you do not want to be trusting your care to them. If the person claiming is friend or family caregiver, they mean well but were fooled by one of the dementia fakers–other health or substances that can cause REVERSIBLE memory loss.

Here are some culprits that can cause memory problems and are sometimes responsible for an incorrect diagnosis of dementia, especially in older adults:

Depression/Anxiety

Persons with depression can have problems with memory retrieval and completing activities that require thinking. There is some controversy, though. If the memory problems are mild then treatment with an appropriate medication may improve memory performance. On the other hand, there is some emerging evidence that people whose brains are starting to change due to dementia may be more sensitive to becoming depressed. That is, the depression is an early-warning sign that neurons are dying (neurodegeneration); the depression is really “unmasking” the dementia.

Low oxygen levels

Neurons, or brain cells, need oxygen to function. If there is not enough oxygen getting to the brain because of sleep apnea, not enough red blood cells to carry the oxygen (anemia) or lung disease, you will see more confusion and memory problems.

Poor blood flow to the brain

 If blood is not getting to the neurons, neither is oxygen (see above). Poor blood flow can be causes by a variety of medical problems (low blood pressure, abnormally low heart rate, or unusual heart rhythms [atrial fibrillation]).

Medications

Some medications change the chemistry in the brain. Brain cells use certain chemicals, like acetylcholine, to make and hold memories. Medicines that interfere with acetylcholine levels can create temporary memory loss. Other medications, like dapsone, can interfere with oxygen getting to the brain.  Narcotics, certain seizure medications, and a class of drugs known as benzodiazepines (drugs like Xanax, also known as alprazolam) cause slow mental functioning.

Thyroid problems

The thyroid gland, located in your neck, is the thermostat of your body. If the gland is not running up to speed, everything in your body slows down–including your thinking. People with low levels of thyroid hormone may also gain weight and be very sensitive to the cold. If the thyroid levels drop dangerously low, the person can go into a coma.

Artificial sweeteners

This is very controversial right now. There are links between certain artificial sweeteners, like aspartame, and headaches or migraines. Some people are just more sensitive to artificial sweeteners than others. I have a family history of sensitivity to artificial sweeteners, so I stopped using them.

Liver problems

 The liver is responsible for breaking down medications and foods. If the liver is not working properly, some toxic substances stay in the body and tiredness and mental confusion can happen. There are usually other signs first, like a swollen abdomen, dark urine, light-colored stools, and lack of appetite.

Sleep Problems

The brain needs a certain quantity of quality sleep. Untreated sleep apnea can cause thinking and memory problems. Fatigue interferes with brain functioning. Sleep deprivation can cause the same level of impairment as heavy drinking!

Pain

Pain itself can cause memory problems because the pain becomes the focus of your attention and concentration. Opiates used to treat pain also cause memory problems.

Vitamin deficiencies

Low vitamin D can cause memory and thinking problems. Vitamin B12 can make existing memory problems much worse.

Delirium

This is a sudden-onset of confusion that usually occurs during severe illness or hospitalization. It can get better and worse, meaning it fluctuates, over the course of several hours. Once the illness is addressed and the person’s health becomes better, the delirium USUALLY clears. It can take up to 3 months for some people. Based on current research studies, delirium may be another “warning” sign that the person is already have neurodegenerative brain changes consistent with Alzheimer’s dementia or one of the other dementias. In other words, the delirium is “unmasking” the dementia.

If your loved one does have dementia, you can help keep their brain functioning at optimal levels by addressing any and all of the issues above.

Bottom line: If you or someone you know is having problems with thinking and/or memory, the first place to start is the primary care provider. He or she should provide a thorough examination, check blood oxygen levels, and examine laboratory results. Depending on the results, the next step may be a neurology appointment for a more in-depth evaluation.

But what about claims that certain things “cause” dementia?

Sometimes, two events consistently happen together. This is called “correlation.” I had a statistics prof who used to show the class an impressive graph comparing national ice cream sales with drownings. Both ice cream sales and drownings steadily increased in April, peaked in July, then slowly dwindled by October. Does this mean that ice cream eaters were more likely to drown than non-ice cream eaters? Nope. Both ice cream sales and drownings occur more frequently in summer months. Neither was related to each other. There are ways to show “correlation” mathematically, using statistics. But here is where it gets fun. Just because two things tend to happen together, it does not mean one is causing the other. As my statistics prof was fond of saying, “Correlation does not equal causation.”

Researchers love to take large sets of data and look for correlations between life events, health problems, and Alzheimer’s disease. One topic that seems to come up a lot is gum disease and dementia. In some correlation studies, gum disease and Alzheimer’s disease follow the ice cream and drowning pattern. They exist together. I would not argue that dementia causes gum disease. HOWEVER, I know from my own research that people living with AD and other dementias often stop brushing their teeth. They fight the efforts of others to provide mouth care. Without consistent mouth care, plaque builds up on teeth and along the gum line and pretty soon, gum disease develops. The dementia did NOT cause the gum disease; lack of mouth care caused the gum disease. By the way my y team and I have tested a whole slew of ways to get people with dementia to accept mouth care in order to fix this issue. You can click here to read the publication.

There are also some studies, again looking at correlations, that suggest that people with gum disease may be more likely to develop Alzheimer’s disease and other dementias. One has to be careful here. People who develop gum disease usually have other health problems, like heart disease and diabetes. Some scientists have suggested that long-standing gum disease MAY cause heart disease. Other scientists have documented that diabetes and gum disease may aggravate each other. People with diabetes and heart disease are also at greater risk for developing dementia as they age. Diabetes and heart disease contribute to vascular dementia which IS preventable.

Bottom Line. These relationships (like many relationships!) are very complicated. Reporters who push exciting headlines are more interested in getting readers, not explaining the truth.


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