Trouble with Memory Recall
“I was teaching the graduate students,” says Hibbert, “and we were talking about the urea cycle, and I was saying that some bits of it occur in the mitochondria and some other bits occur in the…”
“I could not remember the word cytosol, I just said, oh well, you know, in the other part of the cell…”
“Afterward, I started to say something more and needed the word cytosol again, and I said, 'I can’t remember that word, will one of you please tell me?'
The person who answered seemed sad, and I just said ‘Oh, thank you,’ with a laugh,” says Hibbert chuckling at the memory, “and then they all lightened up.”
But, in reality, Hibbert was unable to recall simple words with which she was very familiar. She also was having problems recalling the names of people she knew very well.
Hibbert decided it was time to follow through on the testing she had let slide years earlier, scheduling an appointment with Mary Taylor, MD, internal medicine physician and neurologist.
“When she came in, you could see the anxiety on her face,” says Taylor, who has been seeing Hibbert as a patient for about a year now.
Taylor listened as Hibbert told her story, about the health fair, her first visit to a neurologist and how she was becoming increasingly forgetful. At first, Dr.Taylor was not particularly worried. Hibbert had no family history of dementia and had passed a basic neuro examination.
Taylor decided to perform a minicoginitive exam, during which the patient is asked to remember the names of several common objects and then repeat them back a few minutes later.
The patient is also asked to draw the face of the clock, placing the hands to the time specified by the examiner.
“She looked at the clock, became very confused and, finally, gave up in frustration. I was very surprised,” says Taylor.
“It was at that point, I began to suspect Alzheimer’s disease. She was highly educated, and has a high IQ, so I thought it may be more visible and easier to evaluate her as having the early stages of Alzheimer’s disease.”
“Here is a university professor who is really having problems. As a result, it not only furthered her anxiety, but also created some anxiety for me,” said Taylor, who decided to put Hibbert through a battery of tests.
“You want to make sure that when patients present with memory loss that they have no physical causes of memory loss, so we ordered an EEG and blood tests to rule out other causes; things like glandular studies and thyroid functions and cardiovascular disease, even Lyme disease,” she said. “All were negative, including MRI and ultrasound. When the opportunity arose to have her undergo a PET scan, I seized it.”
Taylor referred Hibbert to Trident Medical Imaging Center in Fayetteville, GA, USA, for amyloid imaging using PET/CT. At the time she referred Hibbert for the PET/CT scan, Taylor said that all signs pointed to Alzheimer’s disease.