Determining the cause of memory loss in the elderly - From in-office screening to neuropsychological referral

Improved understanding of neurobehavior in normal aging, Alzheimer's diseas e, and late-life depression makes early detection of neurodegenerative cond itions possible. Primary care physicians can screen patients' mental status and mood states with simple in-office tests. When screening results or the clinical picture is ambiguous or complex, neuropsychological evaluation is useful in making an early, reliable differentiation between dementia and n ormal aging. Early identification of neurologic problems provides an opportunity to enha nce quality of life and long-term care. Medical interventions, such as a tr ial of donepezil hydrochloride (Aricept) or other memory-enhancing medicati ons as they become available, can be started when results are likely to be optimal. Common coexisting problems (eg, depression, falls) can be sought a nd managed. Additional important medical decisions (eg, elective surgeries) may be considered differently when dementia is diagnosed early.