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My mom has been diagnosed with cognitive impairment. I was told this is not the same as dementia. She has very poor short term memory. Cannot be trusted to take medication or remember routines or appointments. She has not driven in almost a year but wants to. What does the future hold for her compared to a dementia diagnosis?

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What type of testing has your mom done?

Is she currently seeing a neurologist?
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[mutter mutter rhubarb grumble...]

I'm sorry this is being communicated to you so poorly. The broad subjects of cognitive impairment and its numerous causes on the one hand, and dementia and its many, many forms on the other, overlap and intertwine so that people end up trying to put simple labels on very very complex conditions.

But cognitive impairment doesn't just crop up on its own; so I should go back to the beginning and ask your mother's primary physician to explain your mother's situation to you with as much clarity as possible. You are looking for information about:

underlying disease. Alzheimer's Disease is one form of dementia, but there are many other types of dementia which generally have their roots in other causes. These might include for example heart or respiratory disease, diabetes, or many other physical conditions which can lead to problems with brain function.

memory issues and cognitive function. What tests have been done to assess your mother's current abilities? These tests should flag up any areas of brain function which might present challenges in your mother's day to day life. Memory loss is a blanket term, often used too loosely to cover the huge range of skills we rely on our healthy brains to exercise every day. Not remembering the name of the president doesn't actually matter most of the time, but not remembering your own address does. Not being able to solve a crossword puzzle in your usual time doesn't matter; but getting lost on the way to your own bedroom does.

You might find it more helpful to do an individual list of your mother's typical activities of daily living, and see if you can spot where she's having difficulties. Focus on what is normal and what is important for *her.*

Once you have a clearer picture of exactly what issues she is encountering, you have a better chance of understanding what factors are or might be affecting her, and from there you can potentially anticipate what her needs are likely to be in the future.
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NeedHelpWithMom Feb 2021
I agree that the OP deserves an explanation for specific behavior.

Thanks, CM for your wonderful response!
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Abell01, there are non-cognitive ailments that can mimic "cognitive impairment" and memory loss, like a UTI and thyroid dysfunction or thyroid medication overdosage (especially in women). Then of course there are the more serious ones, like brain tumors. So, please make sure your mom starts with a thorough physical with an internal medicine doctor or geriatrician to discount these physical health issues. Recently my cousin (only 68) was displaying dementia-like symptoms and it turns out she had lost weight which caused her to be inadvertently overdosing on her thyroid meds. The more she was overdosing, the less she ate and the more she overdosed -- it was a cyclical problem, but was corrected after her kids intervened by taking her to her doctor to check her and her medications.

UTIs are extremely common in the elderly, especially women. They can get them no matter how good their hygiene is or even if they're not wearing adult incontinence undies. It can come on sudden and drastically change their behaviors and personalities. But a test can diagnose it and some antibiotics can clear it up. Left untreated, it can turn into sepsis and be life-threatening.

My own MIL developed short-term memory loss to the point where she could make general chit-chat with you or others and you'd never suspect anything was amiss, yet she wasn't remembering to eat or take her meds accurately, among other things. She needed to go into a care community where she would be watched over and protected because, like you, my husband and I had 3 kids in school, a grandchild and were working full-time running our business.

Your profile says, "I still work full time - trying to take care of my elderly parents and still maintain my busy life with my husband kids and grandkids. Wanting to make good decisions for them without all the knowledge I feel I need."

I think you will find this forum an invaluable wealth of information, especially reading the posts by people who have become burnt out from caring. Respectfully, at this point you are not able to imagine how intense and draining it will become, especially for 2 parents. It is more than just "making good decisions for them" as the decline. And it sounds like they are both declining at the same time. Please go into this with your eyes wide open, understanding that what you have been assuming about their sunset care may not be a viable plan for anyone. I wish you much wisdom and peace in your heart as you begin this journey with your parents.
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Abell01 Feb 2021
Thank you. We went through several months of UTI issues and I had chalked all this up to that. But now we are in the clear and the confusion still exists.
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Your mom's medication and appointment issue certainly are indicative of some cognitive decline. But as CM states, memory decline is a blanket term that could mean most anything. If I forget an appointment do I show cognitive decline? Not necessarily. Cognitive decline refers to diminished brain function where someone may be slow responding to a question, or may not immediately recall recent events or discussions. Aging itself can bring on cognitive decline. We're not a “sharp” as we used to be, we process things more slowly. Cognitive decline can advance into mild cognitive impairment, MCI, which is more than typical aging issues and may be more noticeable. Neither of these are diagnoses. MCI may or may not progress into dementia. The difference between MCI and dementia is that dementia affects one's daily living routines and activities, MCI does not. Neither is normal aging. Someone with dementia may have a change in personality, or become lethargic or exhibit other unusual behaviors. They may have difficulty paying bills or be confused about where they are or even get lost. There are a multitude of reasons for dementia, some treatable and even reversible and some not. With progressive dementia a person continues to get worse in their day to day living which is normally indicative of an underlying disease like Alzheimer's . Dementia refers only to symptoms, it is not a clinical diagnosis. One needs to determine the cause of dementia the same as one needs to determine the reason for a headache- stress, a bad cold, a tumor? Without a specific diagnosis by a neurologist or gerontologist, you don't know what you're dealing with. There is no one indicator of any of these cognitive issues and many symptoms overlap.
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Abell01 Feb 2021
Thank you. I need to start with why before asking where we are going with this.
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No but I plan on changing that now. I feel I need a reason for her decline and I just keep getting cognitive decline to a moderate proportion.
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"Moderate Cognitive Decline" (if that is what the doctor is telling you) is pretty noticeable to all concerned. But there is often no "why".

Was brain imaging done?

On my mom's MRI, there was an old stroke that previous imaging had not picked up. It was responsible for her MCI and a later stroke was to blame for her progressive Vascular Dementia.
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I'd assume "cognitive decline" refers to the symptom, not the cause (dementia, UTI, tumor, etc.).

Think of it as a symptom, such as "leg pain" with the specific cause (broken leg) yet to be determined.
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