cular problems from blood clots, aneurysms (causing blood to leak out of blood vessels), arteriosclerosis (causing blocked blood vessels), some forms of anemia, and various combinations can all be involved. Depression can play a big factor, as can just plain inattention. Medication can cause memory problems, sometimes severe. Metabolic, biological and/or endocrine dysfunction, such as thyroid or liver disease, electrolyte imbalance, infection, tumors, and nutritional disorders, including malabsorption, can all be involved. (Oh, I forgot to add trauma.) Also, chemical exposures may be involved, such as aluminum, mercury, alcohol, lead, etc. So, there's a lot to consider before just writing someone off to senile dementia, and that's a big reason why your doc should definitely be involved. Unfortunately, however, medical therapy for Alzheimer's type of memory impairment (senile dementia) just a few years ago was limited to what's called the ergot alkaloids, specifically hydergine. This is a pretty innocuous drug that much of the medical profession thought (and thinks) to be basically useless (though I'm not at all convinced for some individuals). More recently the FDA has approved the reversible cholinesterase and acetylcholinesterase inhibitors (Aricept/Donepezil, Cognex/Tacrine, others). These are not as innocuous, the costs are high, liver monitoring is needed, only about one-third of patients respond, and even then the degree of response is admittedly poor (but remember the term "acetylcholinesterase inhibitor" because we'll come back to it). Other than the above, managing depression and reassuring both patient and family are the mainstays of treatment, and that's pretty much what the hallowed halls of modern medicine have to offer for this type of memory loss. But don't dare think for a second that nothing else can be done. Modern medicine has been wrong before (like, uh, need I start a list?!). They seem to at least be getting starte...
