Oliver: Report urges addressing memory issues sooner rather than later

When my husband, Tony, started having memory issues, it was easy to make excuses.

I didn’t think twice when he started buying little notebooks so that he could write things down. This seemed exactly what an organized guy like Tony would do.

The problem was he was trying to address his memory issues and not burden me. No doubt he convinced himself that his forgetting things was just part of getting older.

Tony now is one of the 6.7 million people 65 and older living with Alzheimer’s dementia, according to the latest “Alzheimer’s Fact and Figures” report from the Alzheimer’s Association.

Tony’s reluctance to talk with his primary care physician about those memory issues is all too common. In fact, it’s something that is addressed in a special report that was released along with the “Alzheimer’s Facts and Figures” report. “The Patient Journey In an Era of New Treatments” talks about some of the things that get in the way of early discussions between patients and physicians.

In focus groups, many people who admit they have memory concerns don’t discuss their symptoms with their health care providers. Many believe that memory issues are just part of normal aging rather than an actual medical condition.

The report offers other reasons for not speaking with a health care provider:

• Patients lack knowledge and awareness of cognitive health issues.
• Patients have great tolerance for their symptoms, leading them to delay discussions with their doctors.
• Patients are waiting for the problem to have a meaningful impact on their life first, suggesting that the problem is serious and not part of normal aging.

In Tony’s case, his memory issues jeopardized his job. Only then did he take seriously my constant urging to get his issues checked out. Sadly, that led to tests that confirmed his early onset Alzheimer’s diagnosis in 2015.

Could more have been done for him if we had caught it sooner or if he had a conversation with his primary care physician earlier? That’s something I think about a lot.

The report found that different racial and ethnic groups have even more reluctance to speak about their memory concerns. Some prefer to handle medical concerns holistically rather than through medication and others question whether they receive competent care because of their race or background.

On the other side, the report found that many primary care physicians do not take the initiative to ask their patients about cognitive issues.

Why is that? According to the report:

• Primary care doctors say they hesitate to start conversations about cognitive decline and will wait until family members bring it to their attention.
• They expressed concern about how people will be cared for if an assessment uncovers Alzheimer’s disease or other dementia in light of specialist shortages and few referral options.
• Importantly, primary care physicians view family members as influential and critical partners in care, often relying on them to initiate conversations about memory and thinking problems they observe in their loved ones, making the role of caregivers ever more significant.

The takeaway: “Both physicians and patients need to make discussions about cognition a routine part of interactions,” said Nicole Purcell, D.O., M.S., a neurologist and senior director of clinical practice at the Alzheimer’s Association. “New treatments potentially treat mild cognitive impairment and early stage Alzheimer’s disease with confirmation of amyloid, so it’s really important conversations between patients and doctors happen early or as soon as symptoms occur while treatment is still possible and offers the greatest potential benefit.”

The sooner a problem is found, the more options you have.

If you or someone you know is having memory issues, the best course is not to wait.

• Joan Oliver is the former Northwest Herald assistant news editor. She has been associated with the Northwest Herald since 1990. She can be reached at jolivercolumn@gmail.com.