1d • General discussion
10 Brain Questions Your Doctor Isn't Asking
Most doctors run a memory checklist. Day. Date. Three words.
I ask a different set of questions.
These are the ones that tell me far more about what's happening in someone's brain than any standardized cognitive test. None of them are in the textbook. All of them came from sitting with thousands of dementia patients and their families.
1. When did you last try something new?
↳ The brain that has stopped exploring is often a brain that has stopped repairing itself
↳ When the answer is "I can't remember," that's already part of my answer
2. What's your sense of smell been like?
↳ Loss of smell can precede dementia by years
↳ Most patients have never been asked this
↳ It is one of the earliest signals of Parkinson's and Alzheimer's (in the right context)
3. Do you act out your dreams?
↳ Punching, kicking, screaming, falling out of bed
↳ REM sleep behavior disorder strongly predicts Lewy body and Parkinson's dementias
↳ Most patients don't realize this is a problem worth flagging
4. Who initiates plans in your social life?
↳ The patient who used to call friends but doesn't anymore
↳ The patient whose calendar has emptied without explanation
↳ Apathy is one of the earliest signs of frontal involvement
5. Has your driving changed?
↳ Minor scrapes on bumpers no one can explain
↳ Getting lost on familiar routes
↳ Family taking the wheel without asking
↳ Driving tells me about visuospatial and executive function
6. What does the afternoon feel like?
↳ "Sundowning" is when confusion peaks in the late afternoon
↳ Long before it's obvious, families notice "she's just not herself by dinner"
↳ A subtle pattern worth catching early
7. Can you taste your food the way you used to?
↳ Like smell, taste degrades early in some dementias
↳ Patients often blame their cooking or their seasoning
↳ The real signal is that the receptors are changing
8. How is your handwriting?
↳ Smaller, cramped writing can be an early Parkinson's sign
↳ Looser, less organized writing can signal frontotemporal involvement
↳ Old letters and birthday cards become diagnostic tools
9. Are you sleeping straight through?
↳ Frequent waking, breathing pauses, restless legs
↳ Sleep architecture changes early in neurodegeneration
10. What worries your spouse?
↳ The most underused question in medicine
↳ The spouse sees the changes nobody else does
↳ The spouse is usually right
Most of these will come back negative for any individual patient. But over a 30-minute conversation, the pattern they form gives me a far richer picture than any standardized test.
If you have someone you love who might be slipping, these are the questions worth asking.
Then bring the answers to a doctor who will listen.
💬 Comment with the one that surprised you most
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10 Brain Questions Your Doctor Isn't Asking
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