You're likely to start by seeing your family doctor. If your doctor suspects you have cognitive changes, you may be referred to a specialist with expertise in evaluating mental function. The specialist may be a neurologist, psychiatrist or neuropsychologist.
Because appointments can be brief and there's often a lot to talk about, it's good to be well prepared. Here are some suggestions to help you get ready for your appointment and know what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for blood work or if you need to do anything else to prepare for diagnostic tests.
- Write down all of your symptoms. Your doctor will want to know details about what's causing your concern about your memory or mental function. Make notes about some of the most important examples of forgetfulness or other lapses you want to mention. Try to remember when you first started to suspect that something might be wrong. If you think your difficulties are getting worse, be ready to explain why.
- Take along a family member or friend, if possible. Corroboration from a relative or trusted friend can play a key role in confirming that your memory difficulties are apparent to others. Having someone along can also help you retain all the information provided during your appointment.
- Make a list of your other medical conditions. Your doctor will want to know if you're currently being treated for diabetes, heart disease, past strokes or any other conditions.
- Make a list of all your medications. Your doctor will want to know about any over-the-counter drugs, vitamins or supplements you're taking.
Questions to ask your doctor
Because time with your doctor is limited, writing down a list of questions will help you make the most of your appointment. List your questions from most pressing to least important in case time runs out. For cognitive changes, some questions to ask your doctor include:
- Do I have a memory problem?
- What's causing my difficulties?
- What tests do I need?
- Do I need to see a specialist? What will that cost? Will my insurance cover it?
- Are treatments available?
- Are there any clinical trials of experimental treatments I should consider?
- Should I expect any long-term complications?
- Will my new symptoms affect how I manage my other health conditions?
- Do I need to follow any restrictions?
- Is there a generic alternative to the medicine you're giving me?
- Do you have any brochures or other printed material I can take home with me? What websites do you recommend?
In addition to the questions you've prepared ahead of time, don't hesitate to ask your doctor to clarify anything you don't understand.
What to expect from your doctor
Your doctor is also likely to have questions for you. Being ready to respond may free up time to focus on any points you want to talk about in-depth. Your doctor may ask:
Aug. 21, 2012
- What kinds of memory difficulties are you having? When did they first appear?
- Are they steadily getting worse, or are they sometimes better and sometimes worse?
- Do you feel any sadder or more anxious than usual?
- Have you noticed any changes in the way you react to people or events?
- Have you noticed any changes in how well or how long you sleep? Do you snore?
- Do you have more energy than usual, less than usual or about the same?
- What medications are you taking? Are you taking any vitamins or supplements?
- Do you drink alcohol? How much?
- What other medical conditions are you being treated for?
- Have you noticed any trembling or trouble walking?
- Are you having any trouble remembering your medical appointments or when to take your medication?
- Have you had your hearing and vision tested recently?
- Did anyone else in your family ever have memory trouble? Was anyone ever diagnosed with Alzheimer's disease or dementia?
- McDade EM, et al. Mild cognitive impairment: Epidemiology, pathology, and clinical assessment. http://www.uptodate.com/index. Accessed June 12, 2012.
- McDade EM, et al. Mild cognitive impairment: Prognosis and treatment. http://www.uptodate.com/index. Accessed June 12, 2012.
- Petersen RC. Mild cognitive impairment. The New England Journal of Medicine. 2011;364:2227.
- Shadlen MF, et al. Evaluation of cognitive impairment and dementia. http://www.uptodate.com/index. Accessed June 12, 2012.
- Petersen RC, et al. Mild cognitive impairment: Ten years later. Archives of Neurology. 2009;66:1447.
- Preventing Alzheimer's disease and cognitive decline. National Institutes of Health State-of-the-Science Conference Statement. April 26-28, 2010. http://consensus.nih.gov/2010/docs/alz/ALZ_Final_Statement.pdf. Accessed June 12, 2012.
- Geda YE, et al. Computer activities, physical exercise, aging, and mild cognitive impairment: A population-based study. Mayo Clinic Proceedings. 2012;87:437.
- Press D, et al. Prevention of dementia. http://www.uptodate.com/index. Accessed June 12, 2012.
- Essentials of a diagnostic work-up. Alzheimer's Association. http://www.alz.org/professionals_and_researchers_14902.asp. June 14, 2012.
- What is sleep apnea? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea. Accessed June 14, 2012.
- Ahlskog JE, et al. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings. 2011;86:876.