Ask the GP: Will a memory clinic help my husband?

According to your longer letter, your husband scored poorly on a standard memory test
Dr Martin Scurr

A story from the Daily Mail - 11-06-2019




Recently, my husband was given a memory test by his GP and he failed one question.

I asked the doctor about any potential medications and was told that what was available was little more than a placebo. The doctor also mentioned a memory clinic — can this help my husband?

S. Alexander, Stamford Bridge, E. Yorks.

From what you have said, it appears your husband has mild cognitive impairment (MCI), a spectrum of inevitable changes in cognition that typically occur as part of the ageing process.

Up to 20 per cent of over-65s have some degree of MCI and, as well as memory loss, it may lead to depression, irritability and anxiety. Around 10 to 15 per cent of MCI patients will go on to develop dementia at some point.

When a patient seeks medical help for impaired memory, their GP must initially ask them about their history to assess if there are any reversible causes, such as depression, sleep disturbance or side-effects of medication.

Once these have been ruled out, the patient will be given a brief test to check their cognitive function — usually either the Mini-Mental State Examination (also called the Folstein test) or the General Practitioner Assessment of Cognition.

These are similar tests of short-term memory and consist of questions and tasks, such as telling the doctor a seven-digit number, or a name and address, and then having to recall it a few minutes later.

According to the details in your longer letter, your husband scored poorly on this.

A low score can be an indication of cognitive impairment, so the patient will typically be referred for further investigations.

Often, this involves attending a memory clinic — these are staffed by a doctor, a psychologist and a specialised nurse or occupational therapist, who will work together in order to investigate the cause of the memory problems and provide appropriate information and treatment.

Typically, the assessment will involve a brain scan and detailed psychological and blood tests. The clinics per se cannot improve memory — there is insufficient research to give definitive guidelines on how to do this.

And, sadly, no medications or dietary supplements have yet been proven either to help improve memory or prevent its loss in the first place — despite the positive stories you hear about ginkgo biloba and vitamins (the supplements your husband takes, as you set out in your longer letter).

However, we do know that exercise programmes have shown — in small trials — to have some benefit in cognitive function.

These have included ballroom dancing, table tennis, weightlifting and Tai Chi.

And there is more hope on the horizon: for example, research is suggesting that electric brain stimulation — which involves electrodes being placed on the scalp — can improve memory function, although there is much still to learn before this becomes a practical treatment proposition.

Your husband could well benefit from being referred to the memory clinic. Coming under the care of a team of experts of different professional disciplines can only be of value.

© Daily Mail


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