Patient: My wife is 52 and generally healthy. She recently became confused at a Walmart and could not figure out how to get to the front of the store. She became very scared and nearly panicked. She managed to return home but was crying and very upset. She then told me that she had a couple of similar instances two months previously while driving on a very busy road she frequently drives on near our house.
Doctor: Hello,Thanks for writing to us.I have read your case and can understand your concern.There can be causes for forge tting directions which range from being totally benign to causes of concern.1) It can be ignored if there is no associated mood problems, forgetfulness in daily matters, hypertension, personality changes, episodes of disorientation, difficulty completing familiar task.2) Such instances can be seen in day to day life specially during midlife (50 yrs onwards) as part of midlife crisis. This can be accompanied by easy irritability, sadness of mood, sleep disturbances and appetite disturbances. This is called Pseudo dementia. This requires treatment with Anxiolytics and vitamin supplements (B12 mainly)3) It can also be as serious as dementia however there should be accompanying symptoms like :a) personality changes and age group of 50-60 years : Fronto temporalb) following stroke or weakness of any limb : vascularc) Parkinsonism and autonomic symptoms (hypotension) : lewy bodyd) difficulty with calculation,reading ,recognising faces) : Alzheimer’sIt is advisable for you to get serum level of B12 and random blood sugar checked apart from vitals like Blood pressure and pulse rate.In order to rule out something serious like dementia , simple tests like MMSE scoring is available for which you can see your doctor.Hope this helps.Feel free to write back.regards