Q: My mom lives with us, and I know she’s developing memory problems. I can’t get her to go to the doctor and get tested. Does it matter? Is there anything they can do anyway? — Alice B., Seattle
A. She’s lucky to have you as an advocate, even if she doesn’t recognize how valuable it is. Many older folks never get evaluated for cognition problems. Luckily, Medicare now provides a free annual checkup that includes evaluation of cognition, so perhaps you can arrange for that.
According to a new University of Michigan study, around 1.7 million Americans with cognition problems have not been evaluated or diagnosed. The study also found that only around 5 percent of folks with early memory problems get evaluated. That’s too bad, because people with memory or cognition problems who don’t get diagnosed miss the opportunity to slow their decline and to participate in their own care decisions. Plus, you don’t get alerted to potential problems that might call for your intervention, such as management of her medications.
The Cleveland Clinic Wellness Center has demonstrated that memory training; nutrition, including DHA supplements; stress management; and intense supervised physical activity can help improve or reverse cognitive deficits!
Furthermore, vascular dementia, caused by mini-strokes or blocked arteries to the brain, may be slowed by controlling blood pressure and reducing plaque buildup in the arteries with a proper diet and statins. These measures also address health issues that contribute to dementia, such as Type 2 diabetes or metabolic syndrome.
There are Alzheimer’s medications that slow progression of that disease for some people. Cholinesterase inhibitors can keep mild to moderate symptoms from becoming worse — for a limited amount of time. An N-methyl D-aspartate (NMDA) antagonist is available for moderate to severe Alzheimer’s symptoms and may extend certain abilities for several months. There also are clinical trials that your mom might qualify for; check www.ClinicalTrials.gov.
So discuss this column with Mom, and arrange for that free annual checkup with a cognition evaluation. You’re handling things very wisely.
Q: Recently my doctor gave me a prescription for an authorized generic medication (cheaper, but identical to the name brand I’d been taking). He wrote the NDC number on it so there would be no mistake at the pharmacy. But when I picked it up, I saw the wrong NDC number on the package. When the pharmacist looked things over, she replied, “Yep, they switched it on you.” She then said the chain could NOT get the designated NDC number from their distributor. I was able to get it elsewhere, but if I hadn’t noticed the switch they would have sold me the substitute without a word! Does this happen a lot? — John M., Bonita Springs, Florida
A: That happens more than we know. But first, to clarify two points for our readers: The “NDC number” is a national drug code assigned to every approved drug in the U.S. And an “authorized” generic is identical to the brand name in all ingredients and absorption rates. An “approved” generic is required to have the same active ingredient, strength, dosage form and type of administration as the brand name, but it can have an absorption rate that’s 3.5 percent more or less than the original drug and doesn’t have to contain identical inactive ingredients. That’s why some people can’t tolerate certain generics.
John, your experience highlights an important point for everyone. Even if you don’t request an authorized generic, you still need to be diligent about checking your prescriptions before you walk away from the counter. Distributors can automatically substitute one generic for another without alerting you.
When you’re on a medication, you want to be aware of exactly what you’re taking. Then, if you’re not getting the results you should, you can switch to another form to see if that works better. We hope you all make the effort to be as observant as John.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com.