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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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My dad is 64 years old he had a bypass

Answered by
Dr.
Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2429 Questions

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Posted on Sun, 17 Feb 2019 in Brain and Spine
Question: My dad is 64 years old he had a bypass surgery 7 years ago and he had a total hip prosthetic due to a car accident he has hypertension as long as i can remember and i noticed that he sometimes forgets some words but remembers them later and i was immeadiatly afraid he might be developping alzheimers and being a doctor and a little bit hypocondriac he also feared(fears) it.But it doesnt interfere with his daily life he still works as a doctor sometimes drives to work and sometimes uses the subway he doesnt misplace things and he remembers events and conversations he doesnt have mood swings am i imagining a diesease is it normal to sometimes forget words but remember them later what would we have seen if he had alzheimers what would be a manifestation.
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Follow up: Dr. Dariush Saghafi 0 minute later
My dad is 64 years old he had a bypass surgery 7 years ago and he had a total hip prosthetic due to a car accident he has hypertension as long as i can remember and i noticed that he sometimes forgets some words but remembers them later and i was immeadiatly afraid he might be developping alzheimers and being a doctor and a little bit hypocondriac he also feared(fears) it.But it doesnt interfere with his daily life he still works as a doctor sometimes drives to work and sometimes uses the subway he doesnt misplace things and he remembers events and conversations he doesnt have mood swings am i imagining a diesease is it normal to sometimes forget words but remember them later what would we have seen if he had alzheimers what would be a manifestation.
doctor
Answered by Dr. Dariush Saghafi 43 minutes later
Brief Answer:
Detection of AD

Detailed Answer:
Thank you for your question on this network.

To be quite direct about your precise question let me state the following:

1. It is considered within the realm of "normal" to occasionally forget words or even names of familiar people so long as this does not become habitual or more than just INFREQUENT. The yardstick we use to measure whether such behavior is within the realm of normal for an individual is whether or not a person's daily activities (both work as well as social) are being affected.

2. Therefore, if your father has been forgetting words and then, remembering them later and this dates back many years and during that time he was otherwise, functional and gainfully working and appropriate with the family, colleagues, patients, etc. then, it sounds as if that is not unusual for him and for any person such a behavior may be considered part and parcel of how their brain works.

3. However, in your father's case if what you're saying is that this behavior of forgetting things and then, remembering them later actually started around or just after the time of his bypass surgery then, this could be a different story. It is known that one of the risks of CABG (bypass surgery) is in fact, a reduction of cognitive capacity though it may not rise to the level of an Alzheimerian type of disease. The problem is we don't typically perform neuropsychological tests prior to such procedure and then, after to discover if in fact, things are "changed" and there have been recommendations put out that perhaps such testing should be instituted as commonplace given the number of similar cases where people go in for a procedure such as this and then, at some shortly thereafter manifest cognitive problems.

4. Your father may very well have features (at least risk factors) for a neurodegenerative disease such as Alzheimers. First of all, I would recommend he get a metabolic workup performed looking for treatable or reversible causes of cognitive decline such as VITAMIN B12 and D levels in serum since these are vitally important to normal or for him as a doctor (above average) levels of cognitive capacity. I would also make sure other parameters such as renal function, diabetes (if he has this in the first place), and electrolytes are in balance and/or well controlled. I would also perform at least an FT4 and TSH looking for telltale signs of thyroid disease that could also be affecting him.

If all these parameters are negative for pathology or NORMAL (be advised that B12 levels are best when they are >400 and better yet closer to 450+--and Vitamin D levels are also better when at least 40 if not closer to 60-80) THEN, the next step I'd advise would be a formal neuropsychological evaluation which can then, help tease out the differences between different for of dementing illness from other issues that impair or affect memory such as stress, anxiety, depressive mood disorder, etc. I might even opt for an MRI of the brain if neuropsych parameters suggested good reason to suspect cortical volume reductions which then, could be correlated to other imaging studies down the line for corroboration if necessary.

Alzheimer's disease COULD look like this picture....it is a great mimicker especially since most of us are ready to pass off mild trip ups and stumbles of memory or other cognitive domains to a lot of life's daily stresses and pressures especially in a doctor who may have other personal health issues to worry about or things on his mind. I know because I'm a doctor and not too far away from his age....I can imagine the things he may be thinking.... :)

Many thanks for the opportunity to answer your questions. I hope your father's outcomes are healthy and expedited! If I've provided useful information could you do me the favor of CLOSING THIS QUERY with a 5 STAR rating and positive feedback?

Time spent on assessing and researching patient's question and synthesizing a response was 25 minutes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi 0 minute later
Brief Answer:
Detection of AD

Detailed Answer:
Thank you for your question on this network.

To be quite direct about your precise question let me state the following:

1. It is considered within the realm of "normal" to occasionally forget words or even names of familiar people so long as this does not become habitual or more than just INFREQUENT. The yardstick we use to measure whether such behavior is within the realm of normal for an individual is whether or not a person's daily activities (both work as well as social) are being affected.

2. Therefore, if your father has been forgetting words and then, remembering them later and this dates back many years and during that time he was otherwise, functional and gainfully working and appropriate with the family, colleagues, patients, etc. then, it sounds as if that is not unusual for him and for any person such a behavior may be considered part and parcel of how their brain works.

3. However, in your father's case if what you're saying is that this behavior of forgetting things and then, remembering them later actually started around or just after the time of his bypass surgery then, this could be a different story. It is known that one of the risks of CABG (bypass surgery) is in fact, a reduction of cognitive capacity though it may not rise to the level of an Alzheimerian type of disease. The problem is we don't typically perform neuropsychological tests prior to such procedure and then, after to discover if in fact, things are "changed" and there have been recommendations put out that perhaps such testing should be instituted as commonplace given the number of similar cases where people go in for a procedure such as this and then, at some shortly thereafter manifest cognitive problems.

4. Your father may very well have features (at least risk factors) for a neurodegenerative disease such as Alzheimers. First of all, I would recommend he get a metabolic workup performed looking for treatable or reversible causes of cognitive decline such as VITAMIN B12 and D levels in serum since these are vitally important to normal or for him as a doctor (above average) levels of cognitive capacity. I would also make sure other parameters such as renal function, diabetes (if he has this in the first place), and electrolytes are in balance and/or well controlled. I would also perform at least an FT4 and TSH looking for telltale signs of thyroid disease that could also be affecting him.

If all these parameters are negative for pathology or NORMAL (be advised that B12 levels are best when they are >400 and better yet closer to 450+--and Vitamin D levels are also better when at least 40 if not closer to 60-80) THEN, the next step I'd advise would be a formal neuropsychological evaluation which can then, help tease out the differences between different for of dementing illness from other issues that impair or affect memory such as stress, anxiety, depressive mood disorder, etc. I might even opt for an MRI of the brain if neuropsych parameters suggested good reason to suspect cortical volume reductions which then, could be correlated to other imaging studies down the line for corroboration if necessary.

Alzheimer's disease COULD look like this picture....it is a great mimicker especially since most of us are ready to pass off mild trip ups and stumbles of memory or other cognitive domains to a lot of life's daily stresses and pressures especially in a doctor who may have other personal health issues to worry about or things on his mind. I know because I'm a doctor and not too far away from his age....I can imagine the things he may be thinking.... :)

Many thanks for the opportunity to answer your questions. I hope your father's outcomes are healthy and expedited! If I've provided useful information could you do me the favor of CLOSING THIS QUERY with a 5 STAR rating and positive feedback?

Time spent on assessing and researching patient's question and synthesizing a response was 25 minutes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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