Mild brain injuries from an old fall may show up years later.
Do you remember?
If that's starting to be a touchy, frustrating, panicky question, dementia is not necessarily nipping at your heels. "Many times when I'm dealing with patients who fear they have Alzheimer's, I find they have a history of head injuries," says Jonathan Canick, PhD, a neuropsychologist and the codirector of the Memory Clinic at California Pacific Medical Center in San Francisco. In fact, researchers at the Mount Sinai School of Medicine in New York City have been investigating the effects of unidentified traumatic brain injuries (TBI)—long-forgotten falls, sports injuries, or any accident that resulted in a blow to the head—since the early 1990s. One of their recent studies referred to TBI as a hidden epidemic, because often the symptoms, which can include both cognitive and behavioral problems, are attributed to other causes. Even mild TBIs cause noticeable brain tissue loss, according to a study in Neurology. Normal aging, Canick stresses, is not a process of mental decline, but changes in the brain can unmask the effects of prior injuries.
It's time for a brain check...
Red Flags Are you easily able to multitask? Can you cope with everyday chores, like balancing a checkbook, without making elementary mistakes? Are you able to keep track of information? If you answer no to any of these, think back to whether you've ever had a hard knock to your head that left you disoriented, suggests Wayne A. Gordon, PhD, professor of rehabilitation medicine at Mount Sinai School of Medicine.
"Patients go misdiagnosed because their practitioners often rely on a test like the Mini Mental State Exam that may miss more subtle and vexing problems," Canick says. The best specialists are neuropsychologists (the National Academy of Neuropsychologists at www.nanonline.org has a directory).
Options include stimulants (such as Ritalin and Provigil), dementia drugs (Aricept, Exelon), and cognitive rehabilitation programs. None of these treatments are cure-alls, says Canick; nor do they work for everyone. But with a proper diagnosis, he says, "they can either significantly improve a person's cognition or increase mental functioning in general."