Ask the Doctor: Sudden Memory Problems; Nighttime Headaches; Road Rage

Find out whether sudden memory loss is signal of dementia.

Q: My sister, who is 69, has always been mentally alert. Recently, however, she suddenly began showing signs of severe memory problems, such as frequent confusion about the date and time, constant forgetfulness, and even occasional trouble recognizing friends or relatives. Could this signal the beginning of dementia?

A: Any serious changes in memory performance should be assessed by a healthcare provider as soon as possible. This is especially important when these changes manifest suddenly. Often, memory lapses that come on abruptly are caused by underlying health problems and disappear once the primary cause is successfully treated. Your sister’s confusion may be related to any of a variety of reversible disorders, including vitamin B12 deficiency, depression, inflammation of the brain, metabolic disorders, lung problems, sleep disorders, too much stress, or the effects of drugs she is taking.

Another cause of sudden memory changes, which requires immediate medical attention, is stroke. A stroke is a rupture or blockage of blood vessels in the brain which causes cell injury or death by interrupting blood flow and starving brain cells of oxygen and nutrients. Strokes account for as many as 25 percent of cases of severe memory loss. Although it’s not possible to reverse the cellular damage caused by stroke, a person who has a stroke may be able to avoid further injury to brain cells through simple lifestyle changes and treatment for cardiovascular risk factors such as high blood pressure and high cholesterol.

Q: I am 64 and have no medical problems, but in the past month I have been waking up in the middle of the night with painful headaches. The pain usually passes after an hour or so. Should I be worried?

A: The majority of headaches are completely harmless. But although headaches are most often caused by benign conditions such as tension or stress, they may sometimes indicate a more serious underlying disorder. For this reason, I advise anyone who experiences the onset of new headaches, or headaches that differ from a usual headache pattern, to see a doctor.

Since your headaches are a new development and are interrupting your sleep, you should consider a medical assessment. Other instances in which I recommend seeing a doctor are when head pain follows recent head trauma; is very severe or acute; is accompanied by fever, stiff neck, nausea, seizures or other symptoms; occurs in an individual who has been diagnosed with cancer; or is accompanied by numbness, weakness, confusion, vertigo, vision changes, or other neurological symptoms. Many hospitals have units staffed by neurologists who specialize in headache treatment. An accurate diagnosis should result in a treatment program that can resolve the underlying cause of your headaches and help reduce or eliminate your head pain.

Q: My husband is normally a sociable individual, but behind the wheel he has a tendency to lose his temper. Can you suggest ways I can encourage him not to vent his road rage? I am afraid it might endanger him at some point.

A: Road rage is becoming increasingly common in the U.S., according to a July 14, 2016 news release from the AAA Foundation for Traffic Safety. Their recent study showed that nearly eight out of 10 American drivers engaged in behaviors that involved significant anger, aggression or other hostility in the past year. The AAA offered tips for drivers who easily lose their tempers that might be helpful to your husband. (1) Don’t offend: Avoid forcing other drivers to brake suddenly or swerve; (2) Be tolerant: Try not to take driving personally, and to understand that other drivers may be distracted, or having a bad day; and (3) Do not respond: When another driver behaves poorly, avoid eye contact, refrain from making rude gestures or yelling; and maintain a good distance between cars. MMM

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