Low vitamin B12, an underactive thyroid, poor sleep, depression and everyday medicines can all cloud your thinking. A Free check that looks for the treatable causes first.
Forgetting names, losing the thread mid-sentence, or feeling as though you are thinking through fog is frightening, and most people assume the worst. Often it is something else.
Before anyone talks about dementia, NICE requires a set of blood tests to rule out causes that can be treated. The check starts there, in the same order a memory clinic would.
Memory loss that gets clearly worse week by week — not year by year — is a red flag. It can point to a rare brain infection or inflammation that needs treating quickly.
Source: NICE NG128 (acute cognitive decline — urgent referral) · NICE NG97
Do it now. Every minute makes a difference.
These are common, they are easy to test for, and they are treatable.
Low vitamin B12. Especially if you take metformin for diabetes, or a stomach acid tablet such as omeprazole or lansoprazole, both of which reduce how much B12 you absorb. Also common if you eat little or no meat, fish, eggs or dairy.
Thyroid problems. An underactive thyroid slows thinking, and an overactive one makes you scattered and anxious.
Depression. Low mood can affect concentration and memory so much that it looks like dementia. It gets better when the depression is treated.
Medicines. Sleeping tablets, diazepam-type medicines, older antihistamines, bladder tablets and topiramate all affect memory.
Poor sleep. Untreated sleep apnoea — heavy snoring with pauses in breathing — is a common and very treatable cause of brain fog.
Source: NICE NG97 — exclude reversible causes before diagnosing dementia
NICE NG97 sets out the blood tests that should be done before anyone is diagnosed with dementia:
1- Full blood count
2- Urea and electrolytes (kidney function)
3- Liver function tests
4- Thyroid function tests
5- Fasting glucose
6- Vitamin B12 and folate
All six are included in the Bronze memory package. A syphilis test is added where there is a reason to check for it.
Source: NICE NG97 — recommended blood screen
There is a type of dementia called dementia with Lewy bodies. People with it often see things that are not there, and their alertness swings dramatically from one hour to the next.
In these people, antipsychotic medicines can cause severe harm and can be fatal. This includes medicines that most people would not think of as antipsychotics — metoclopramide for sickness and prochlorperazine for dizziness both act in the same way.
If your answers suggest this pattern, the report says so clearly, so that anyone prescribing for you knows.
Safer options exist. NICE recommends rivastigmine and donepezil for the thinking and behaviour symptoms in this condition.
Source: MHRA Drug Safety Update — antipsychotics in dementia with Lewy bodies · NICE NG97
Bring someone who knows you well. What has changed, and when, is often clearer to the people around you than to you — and that account is one of the most valuable parts of the assessment.
Also bring a full list of everything you take, including things you buy yourself, and any hearing aids or glasses you use. Poor hearing on its own can look a lot like poor memory.
Source: NICE NG97 — history from an informant
We ask about mood, memory, motor skills, and sensory changes to tailor your diagnosis and treatment.
Video appointments start at £399 and include the full NICE NG97 blood panel.
In-person appointments start at £849 and include formal cognitive testing.