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Suggest treatment for dementia

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Practicing since : 2007
Answered : 2770 Questions
My sister is 65 years old and is having memory lapses and making what I consider to be irrational decisions such as choosing possible vision loss due to her refusal to have cataract surgery. She had a tramatic brain injury about 30 years ago due to an automobile accident. She has always had numerous "phobias". She feels that she is very healthy because she does not eat meat, eats blueberries with her cereal, and has only yogurt (non Greek) for lunch. She feels she gets enough exercise by taking the stairs at her work location where it's one flight of stairs and she is terrified of elevators among other things. She will not see and has never seen a doctor other than when she was in the hospital for her brain injury. The memory loss combined with confusion was progressing slowly until a few weeks ago when Dad died. He had numerous heart issues including 6 bypasses, congestive heart failure, afib,etc. combined with Alzheimer's disease. The cardiac issues have a very strong hereditary influence in our family. Since the death of Dad, her memory, confusion, irrational behavior, etc. has skyrocketed,e.g., a few days ago the family went out for breakfast and within 5 minutes after ordering she forgot what she ordered. The questions I have are (1) what are the possible causes of her behavior? and (2) how do my Mom and me convince her to see a doctor when she thinks she's fine other than she's just getting older and there's no need nor will she see a doctor?
Posted Mon, 14 Jul 2014 in General Health
Answered by Dr. Srikanth Reddy 4 hours later
Brief Answer:
Dementia could be one major cause

Detailed Answer:
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.

Your sister seems to be having either a dementia (true) or pseudo-dementia (depression related). 65 years is the age when the dementia generally creeps in. And this does start with trivial memory loss and then gradually progressing to more severe memory losses. And it needs to be treated early.

Donepezil and Memantin are two good drugs for such an illlness.

The other common cause could be depression leading to reduced concentration and perceived memory loss called pseudo dementia. This can be treated with using antidepressants like escitalopram. Other causes could be B12 deficiency or fol ate deficiency etc.

Basically she need to be taken to a psychiatrist or a neurologist for further detailed assessment.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
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