Preparing for a Memory Appointment: What to Bring and Ask

Bring three things: a short written log of specific memory changes with rough dates, a complete list of medicines and supplements, and if possible a family member or friend who knows the person well. Expect a brief thinking test, a physical exam and blood work. Ask what else could be causing the symptoms, what the next step is and when you'll hear back.

Why preparation matters

Most primary care visits are short, often 15 minutes or so. Memory problems are hard to show in that window. People tend to perform well under pressure, the "hostess effect," and then the family leaves frustrated that nothing was picked up. A bit of prep turns a vague worry into something the doctor can act on.

What should you write down beforehand?

Keep notes for a couple of weeks before the visit. Specific beats general. "Missed two bill payments in September, which she's never done" is much more useful than "she's getting forgetful."

Things worth noting:

• When you first noticed changes, and whether they came on slowly or suddenly
• Examples involving money, appointments, medicines, driving or getting lost
• Repeating questions or stories within the same conversation
• Changes in mood, sleep, personality or interest in hobbies
• Any falls, new health problems or recent hospital stays

A note on your phone works fine. If the person is comfortable with it, a shared notes app lets two siblings add things as they see them.

If the change came on over days rather than months, don't wait for a routine appointment. Sudden confusion needs same-day care.

What should you bring?

Bring every medication, including over-the-counter sleep aids, allergy pills and supplements. Bagging up the actual boxes works better than a list from memory. Also bring glasses and hearing aids, so poor sight or hearing isn't mistaken for poor thinking. If you've done any online memory tests, bring the scores, with the caveat that they don't replace a clinical assessment.

What happens during the appointment?

Usually a conversation about history, a short cognitive test such as the Mini-Cog, MoCA or similar, a physical exam and a medication review. Blood tests check for thyroid problems, B12 deficiency, infection, kidney and liver function and blood sugar, all of which can affect thinking.

Depending on what turns up, the doctor may refer to a neurologist, geriatrician or memory clinic for longer testing, brain imaging or newer biomarker tests. We've covered what Alzheimer's blood tests can and can't do.

What questions should you ask?

• What else could be causing this besides dementia?
• Do any of the current medicines affect memory?
• Is this consistent with mild cognitive impairment, dementia or neither?
• What's the next step, and how long will it take?
• Is it safe to keep driving and managing money for now?
• Who do we call if things change before the next visit?

Write the answers down during the visit. It's easy to forget half of it on the drive home, and that's true for everyone, not only the patient.

How do you talk to a parent who doesn't want to go?

Gently, and not in front of other people. Many people fear the word dementia more than anything else, so lead with what's fixable: "Let's rule out thyroid or vitamin problems." Some families book a general check-up and give the doctor a heads-up in writing beforehand. Most practices accept a note or message from a relative, even if privacy rules limit what they can tell you back.

Whatever the result, getting answers early gives you time. If a diagnosis does come, our guide to care documents and planning ahead covers what to sort out while the person can still take part in the decisions.