Dr. Laith Maali Neurology Clinic — Amman
Dr. Laith Maali is a consultant neurologist and vascular neurologist with American Board certification in both fields. He studied medicine at Jordan University …
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Treatment of memory disorders is a diagnostic pathway before it is a prescription. Forgetfulness is a symptom, not a diagnosis, and the first task is to identify why memory and thinking have declined. Some causes are fully correctable: vitamin B12 deficiency, thyroid dysfunction, depression, poor sleep and obstructive sleep apnoea, side effects of medicines the patient already takes, alcohol use, or disturbed sodium and hydration. Other causes are degenerative, such as Alzheimer's disease, or vascular, following repeated small strokes. Each of these leads to a different plan. Assessment therefore starts with a structured interview with the patient and with a close informant who can describe how the change unfolded over time, followed by office-based cognitive testing, targeted blood work, a full medication review, and brain imaging to exclude structural causes. The order matters. Imaging alone cannot diagnose the cause of memory loss, and a scan reported as normal does not rule out a genuine cognitive disorder. The goal of care must be stated honestly. For degenerative disease such as Alzheimer's there is no treatment today that cures the illness or restores neurons that have already been lost. The realistic aim is to slow the impact of the disease on daily life, preserve function and independence for as long as possible, manage associated symptoms such as agitation, anxiety and disturbed sleep, and support the caregiver. Where a correctable cause is found, cognition may improve substantially once it is treated, which is reason enough not to postpone evaluation. The limits deserve equal emphasis. Medicines used in dementia do not halt disease progression, over-the-counter supplements and memory-boosting products do not treat or prevent Alzheimer's disease, and no single test settles the diagnosis. What genuinely helps is control of blood pressure, diabetes and cholesterol, regular physical activity, treatment of sleep and hearing problems, and continued mental and social engagement. Whether any medication or cognitive rehabilitation programme is appropriate is decided by clinical examination and test results, not by reading about it online.
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Procedure steps
- 1
Clinical interview with patient and informant
The clinician documents when the change began and how it evolved: a gradual decline over months, an abrupt drop over days, or a stepwise deterioration after vascular events. Questions cover daily activities, medicines, mood and sleep, and an accompanying relative is essential because patients often underestimate the change.
- 2
Office-based cognitive testing
Short standardised tests assess recent memory, attention, language, executive function and visuospatial skills. The score is interpreted against age and education and serves as a baseline for follow-up; it is never read in isolation from the clinical history.
- 3
Targeted blood tests and medication review
Blood tests exclude treatable causes: vitamin B12, thyroid function, full blood count, glucose, kidney and liver function, sodium and vitamin D. In parallel every medicine and supplement is reviewed, since some blunt attention and memory, and the prescriber adjusts what can safely be adjusted.
- 4
Brain imaging when indicated
MRI or CT is requested to exclude structural causes such as old haemorrhage, a mass lesion, normal-pressure hydrocephalus or extensive vascular change. Imaging is interpreted together with the clinical picture, and additional specialised tests are added only in selected cases.
- 5
Treatment plan and structured follow-up
Correctable causes are treated first, then a plan is built around vascular risk-factor control, regular physical activity, cognitive rehabilitation, sleep hygiene, home, driving and medication safety, and caregiver training. Dementia-specific medicines are prescribed only when indicated, and review appointments are scheduled to measure change objectively.
Before the procedure
Bring a written list of every medicine and supplement you actually take, including doses as you take them, and bring a close relative who knows how your memory and behaviour have changed; their presence materially improves diagnostic accuracy. Before the visit, write down specific examples that worry you: forgetting familiar names, repeating the same question, getting lost on a known route, leaving the stove on, difficulty managing money. Bring previous reports, blood tests and scans if available, and do not stop any medication on your own beforehand. Sleep adequately the night before, and bring your glasses and hearing aid if you use them, because impaired vision or hearing distorts cognitive test results. Mention snoring, witnessed pauses in breathing during sleep, and any alcohol use openly.
After the procedure
Keep your follow-up appointments and record any new change in memory, behaviour or sleep in a small notebook; a written record is far more reliable than general impressions. Keep blood pressure, diabetes and cholesterol controlled, move or walk daily as much as you can, stay mentally and socially engaged, and keep regular sleep hours. Reduce fall hazards at home, use a weekly pill organiser, and discuss driving openly with your doctor. **Seek urgent care or call emergency services for sudden deterioration in awareness or thinking over hours to days, weakness or numbness on one side of the body, sudden slurred or difficult speech, a severe unusual headache, fever with confusion, a fall with a head injury, or new hallucinations, confusion or heavy drowsiness after starting a new medicine.**
Expected duration
The first diagnostic visit usually takes 45 to 60 minutes, is completed by blood and imaging results over one to three weeks, then reviewed every 3 to 6 months.
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