Your poor memory may not be dementia

Qn. “Is there a specific age when one needs to start looking out for dementia? I am 25 but I have developed some serious levels of forgetfulness and my friends have warned me to consider seeing a doctor for dementia tests”

At the age of 25, the forgetfulness you complain about is not likely to be due to dementia and although you will need a medical evaluation, dementia will be way down in the possible causes of forgetfulness.

At your age, forgetfulness is more likely to be due to other causes that would, in your case include anxiety, depression, Attention Deficit Hyperactivity Disorder (ADHD) and in other cases, the excess use of alcohol and other drugs. Stress and burnout could also be the cause.

The process of remembering is similar to the way your computer works. If you are for example working on a document, it will remain visible to you, but until you press the button “save” the document will be lost if you switch off the computer or if for some other reason the process is interfered with before the function “save” is activated.

A young man was brought to our attention a few months ago because he had lost memory on a number of occasions.

In the most recent episode, he had gone to a party and at about 1am. When the music was in full blast, and all were in high spirits he is said to have touched a friend’s girlfriend inappropriately. A fight ensued and both men sustained injuries.

Neither required medical attention for the injuries, but sadly, neither could remember why they had the injuries. When told they were in a fight with each other, they denied any such possibility saying they were the best of friends and could not possibly fight over a woman!

During the fight, the girl’s friend had taken a video of the entire incident and this proved to be most useful. It then turned out that the two young men had drank so much alcohol that the brain was soaked in alcohol and could not activate the “save” button in their brains during the fight!

On further evaluation, the young man confirmed that in the last few months he had been forgetting things. On a number of nights, he had found himself in his flat but could not remember the last few hours at the drinking joint. He was alarmed that he could not remember the scores in the football game he was told he had enjoyed so much!

Things came to a head when he “forgot” which girl he had taken home the night before. He had woken up on Saturday morning to a note that simply stated, “Do not set fires you cannot put off”. He knew it was from a girl but did not know which one.

In the course of his evaluation for the memory loss, a number of facts were to emerge.

The first was the fact that he was, following the death of his father, doing badly at work. He had been close to his father who he had worshipped as his hero all his life.

His death through cancer at the age of 55 had left the young man with a big void in his life. He had graduated from a good university and was rising fast in a big bank where he had been employed as a financial analyst.

During his father’s terminal illness, he had received two warning letters on account of serious errors of judgment in the course of his work.

After the death of his father, he was put on a performance improvement programme but he failed to show any changes.

It was during this period of great stress that his memory deteriorated. A combination of the stress of his father’s illness (and later death) with alcohol abuse made his memory worse, and his work performance even worse.

He had a good employer who made contact with a local clinic to find out what might have gone wrong with his otherwise bright 25-year old!

A diagnosis of depression with alcohol use disorder was made. He was hospitalised for two weeks and with a combination of Cognitive Behaviour Therapy (CBT) and medication went back to work the following month.

His memory came back. He stopped drinking and is back on his original career path. In conclusion, he had poor memory when he came to us but did not have dementia.