Degenerative illness or "just" getting older?

[mrsmalcolmreynolds]

Hello. My DM is 64 and has always been very switched on. She has a PhD and worked in a highly technical and challenging profession before retirement. She keeps nicely busy now with a combination of walking, art and music events, U3A etc.

Over the past few years she has definitely become less confident in unfamiliar situations, which I've put down to simply getting older. However she is now demonstrating some behaviour which makes me wonder if a specific condition might be present - thoughts or experience would be really welcome.

The symptoms are:

1. Searching for words. This doesn't happen that often - maybe a couple of times a day - but is often for a really basic word. For instance yesterday it was "button".

1. Difficulty with spatial tasks. For example she had a few weeks when she couldn't get her duvet into her duvet cover because she had forgotten the technique she used to do it and couldn't work it out again despite multiple attempts. She also mentioned yesterday that she recently "lost" her memory of how to operate a tin opener and had to work it out again from first principles.

1. Depression. She has suffered from this on and off reasonably mildly for a number of years, sparked by the death of my DSis. However these spells seem to be more frequent and lasting longer recently.

[CMOTDibbler]

I think that it would be well worth a trip with her to her GP to do some tests.

Unfortunatly, my mum has a type of dementia (and that started to be apparent in her early 60s) that starts with loss of language and also affects the ability to plan tasks, rather than straight memory issues - though that has become more and more of an issue.

[mrsmalcolmreynolds]

Thanks. She is very self-analytical and if anything over-conscious of her own behaviours and has mentioned the possibility of dementia before but I have been a bit wary of encouraging thoughts of a worst case scenario.Sounds though as if a discussion with the GP might be a good idea.

Any other experiences out there?

[PolkaDotsandPumpkin]

Hi. I don't have direct personal experience, but have worked in a professional capacity with the elderly. I second the suggestion that some investigation is in order.
The "just getting older" variety of forgetfulness isn't really what you have described.
Problems with ability to complete previously known tasks especially seems more worrying.

[mrsmalcolmreynolds]

Hi. Interim update in case it's of interest. I've had a chat about this to my Mil who is a MH nurse. Her feeling is that this is most likely an escalation of DM's depression/anxiety which has been an ongoing fairly low level issue since Dsis' death 8 yrs ago. Mil's experience of degenerative memory loss is that sufferers can't reteach themselves the lost tasks, which DM has been able to.

So, I am going to see if I can get DM to talk to her GP about either counselling or medication - she has never had either for her depression (her choice) and will certainly resist medication but counselling might be more of a runner. We shall see...

[HoopHopes]

How soon is she to be 65? I only ask as there are two ways to get counselling on NHS usually... The short term ( usually 6-8 sessions, often group - which I would think your dm may not like?) access after assessment, which often has a long wait. The other is a referral to a CMHT for assessment. They tend to only accept referrals from people displaying serious mental health issues as very small teams serving 18-64 yr olds but each area with have a mental health team of under 18's and for the elderly, which may be helpful for your dm is near 65? As the issues of depression for the elderly are often different for those aged 30 say and their team will have more specialist support. They can also assess if there are signs of early dementia or other illnesses as well.

[mrsmalcolmreynolds]

Hoop many thanks. She is 65 in December so the timing issue is very relevant. And you're absolutely right, group counselling sessions would not suit her at all - as much as anything I suspect she just wouldn't expect it to be useful and would therefore not be willing to put herself out there.

[HoopHopes]

Yes, much of the counselling the gp can access without a referral to a CMHT is often group led ( good but ...), or even telephone based. However, if she was a long way from 65 she would have to be referred to an 18-64 CMHT and they only really assess and treat people with severe mental health issues and who have usually already gone through primary care treatments. However, she may at least get seen by the elderly care team for assessment etc. one person I know really resented being out under the elderly care CMHT until it was pointed out she would not have had any support from the adult CMHT!

I hope you can persuade your dm to go to the gp and ask to be referred to the CMHT for older people. If she is assessed then at least it will be by specialists in dealing with issues older people face, including retirement, bereavement, physical and degenerative illnesses.

[ParsingFancy]

I wouldn't start by assuming it's depression.

For one reason, it may substantially delay investigations into other causes.

For another, while I don't know anything about specific old age depression, what you're saying about the tin-opener doesn't sound like depression generally. You describe someone highly motivated, putting a lot of effort in to find a new way to do something when they can't access the old way. It may well be that most people suffering degenerative memory loss don't reteach themselves skills, but your DM's background isn't "most people". She's used to thinking technically, solving problems and to continually teaching herself new things. This is precisely how you'd expect her to respond to a loss of capacity in one area - reengineering things to solve the problem.

Good luck, however things go.

[LadyMedea]

Loss of cognitive function is not a natural part of ageing.... Get you Mum to her GP. My mum has early onset lewey body dementia and was diagnosed at 64. Depression. Loss of confidence, loss of spatial task performance and problems with words (aphasia) have all been part of that disease for her in the early stages.... it doesn't have to be one thing or another - depression or dementia - they often come together. I think you need another input other than a MH nurse as she is only a specialist on hr field.

I hope it's not dementia or another degenerative illness but it's worth getting it checked out.

[HoopHopes]

Yes a gp should be confident in ruling out physical causes and would need to be concerned enough about mental health issues to refer to other MH agencies. The only advantage of being referred to older people's CMHT instead of a counselling service is they will also be able to diagnose, assess with doctors if it is a physical rather than a mental health issue as for elderly people there are common physical illnesses that can manifest itself as MH issues or have MH issues as part of it and they can help rule things in or out and get the right dh's involved.

And if a gp makes a referral to a physical specialist area they can equally say whether the MH symptoms are part of it and hopefully get a package of care.

Only a gp can start to get assessment that they consider correct out in place, so if you can encourage your dm to see her gp that would help.

All the best.

[BillyBanter]

If your mother is resistant to going to the gp you can contact the gp yourself with your concerns. The gp can then call her in for a general health check, they could say prompted by her 65 th birthday and have it include investigating your concerns.

[MiniMonty]

Degenerative illness - are you kidding?
I'm 47 and have all the symptoms everyday habits you describe your 65yr old Mother having.
So do 90% of people over 40.

You could medicalise almost anything if you put your mind to it.
You fart a lot I hear - so you must be on the brink of incontinence.
You sometimes say - "you know, that, the thing, that urrrrm - thing... " because you can't quite bring the word to mind - obviously you are on the brink of umm, what's that thing that people get... y'know that syndrome.
(any number of mental health issues for you...)

Chill out.
Play cards with her - I bet you'll lose.

[mrsmalcolmreynolds]

Thanks to all, as I said I am definitely going to encourage her to go to the GP.

MiniMonty I take your point and I am absolutely certain I would lose a game of cards or indeed any other game of logic with my DM! However I don't believe I am over medicalising in the way you suggest - in particular I don't think that losing the ability to use something as basic as a tin opener is something that happens to "90% of people over 40".