Part 2 – Is it “Brain Fog” or Dementia?

Let’s regroup about my patient, Linda, who is concerned that her forgetfulness and lack of clarity – worried that it might be early-onset dementia.

Let’s review some of the conditions that may also lead to brain fog and correlate them with Linda’s final blood results.

• Vitamin B Deficiency, especially Vitamin B1, B6, B9, and B12 – She had low Vitamin B9 and B12 levels. I recommended that she start a Multi-Vitamin with complete B complex vitamins, PhytoMulti with Iron.
• Thyroid Disorder – such as hypothyroidism. Linda’s free T3, free T4, and TSH were in the normal ranges. 
• Mineral Deficiencies: Calcium, Magnesium, and Zinc – all normal ranges.
• Inflammatory conditions such as Chronic Fatigue Syndrome, Lupus, Fibromyalgia, or Rheumatoid Arthritis – Linda tested negative for Rheumatoid Factor and Lupus.
• Medications – blood pressure medications, anti-anxiety/depression medications, chemotherapy, etc. – All of Linda’s medications were reviewed and she was not on any medications that could be causing her change in mental cognitive skills.

I did speak with Linda about her interrupted sleep over the past few months and we discussed possible options such as melatonin, nightly progesterone cream, or herbal remedies with valerian root and chamomile. Sleep is critical for proper mental function and the cumulative loss of sleep can lead to brain fog, lack of clarity, and difficulty processing. At present, Linda would like to monitor her symptoms and give yoga and meditation a try.  

Assessing for Dementia

I did offer to give Linda a Mini-Mental Status Exam (MMSE), which is one of the most reliable tools to assess for cognitive decline. The MMSE quantifies a person’s cognitive function by testing orientation, attention, calculation, recall, language, and motor skills. After reviewing some of the initial questions, it was clear to both me and Linda that she was not suffering from early dementia.

To download the pdf of the Mini-Mental Status Exam, please click HERE. Credit for this is given to the dementiacentral.com site.

It was also important that I evaluated Linda for depression. Depression and early dementia can have overlapping symptoms such as memory problems, social withdrawal, and trouble concentrating. In women with depression, they can have slowed movement and speech as well as sadness and fatigue. With depression, there may be memory lapses but women will be able to remember things when asked. Impaired judgment in depressed women is usually due to a lack of concentration and not due to cognitive decline.

Linda was very happy that she was not suffering from depression or showing early signs of dementia. During the upcoming weeks, Linda will keep track of her symptoms and start a Zoom yoga class.

As you can see, it is very important to seek medical attention. If you’re experiencing any of these symptoms to determine the cause and develop the best treatment strategy.

In health and happiness,

- Dr. Diana