This is a condition of gradual loss of memory and other functions of awareness or thinking such as concentration over time. There are several types of dementia including Alzheimer’s disease and vascular dementia, which is due to the same sort of illnesses that cause stroke.

There are several types of memory problems people can have. If you are referred because of memory concerns it is very helpful to bring along a family member. It is also very important to bring all of your medications with you as these can often affect memory. A full medical examination will be done and you will be asked some questions to test your memory and concentration as well as mood. You are likely to have blood tests looking for some causes of memory loss and depending on your history you may be referred for a CT scan of your brain. This is a computerised X-ray, which involves you lying down for about 15 minutes while a machine passes over you.

Parkinson's disease is a disorder of the brain characterised by shaking (tremor), slowing of movement and difficulty with walking and coordination. The disease is due to progressive deterioration of the cells in the part of the brain that controls muscle movement. The disorder may affect one or both sides of the body, with varying degrees of loss of function. Symptoms include: shaking (not always present), stiffness, loss of balance, shuffling walk, slow movements, difficulty initiating any voluntary movement, muscle aches and pains, reduced ability to show facial expressions, voice or speech changes, difficulty writing (may be small and hard to read), difficulty with any activity that requires small movements. Diagnosis is usually made on the history and with an examination, with no need for further testing unless there is some uncertainty. There are some diseases that can mimic Parkinson’s disease. There is no known cure for Parkinson's disease. Treatment is aimed at controlling the symptoms and maintaining quality of life for as long as possible and may include supportive therapies such as physiotherapy and occupational therapy, medication and deep brain stimulation. Monitoring and follow-up by doctors is important. For more information about Parkinson’s disease and related conditions as well as support groups in New Zealand visit www.parkinsons.org.nz

A stroke is where the blood supply to an area of the brain is interrupted causing damage to brain cells. This happens either with a clot in the blood vessel or the blood vessel bursting. The effects of a stroke depend on where in the brain, and how big, the interruption to blood flow is. Most people who have had a stroke are admitted to hospital. Rehabilitation after a stroke is aimed at increasing your independence, preventing complications from stroke and preventing further strokes. For more information on stroke a very useful website is the Stroke Aotearoa New Zealand site www.stroke.org.nz

Heart failure refers to the heart failing to pump efficiently. There are many diseases that cause this including cardiovascular disease, high blood pressure, viral infections, alcohol, and diseases affecting the valves of the heart. When the heart is inefficient a number of symptoms occur depending on the cause and severity of the condition. The main symptoms are tiredness, breathlessness on exertion or lying flat, and ankle swelling. Doctors often refer to oedema, which means fluid retention usually in your feet or lungs as a result of the heart not pumping efficiently. Tests looking for possible causes of heart failure include: Chest X-ray Electrocardiogram (ECG) Echocardiogram (Cardiac ultrasound) Angiogram Your are likely to have several medications over time, started and monitored by your cardiologist and GP. These include medication to control the amount of fluid that builds up (diuretics), medication to protect your heart and slow it down as well as to thin your blood. You will often be referred to a dietitian or given advice about restricting the amount of fluid and salt you take as this can contribute to symptoms. You can also be involved in cardiac rehabilitation programmes run by trained physiotherapists. You will be given reading material to learn more about your disease.

These are not a natural part of aging. There are many reasons why people fall over and a review of your medical problems and medications may well reveal some reasons for falling that can be fixed. If you have lots of falls, seeing a specialist as well as the physiotherapist and occupational therapist can reduce your chances of falling again. You will be asked about the circumstances surrounding your falls and it is helpful if family or friends who witnessed your falls come into the clinic with you. You will have an examination looking at your general health as well as strength, balance, vision and memory. An occupational therapist may come to your home to look into any changes that can be made to improve safety. For more information on falls prevention the ACC website has information on Staying safe from trips and falls

This is a syndrome of widespread aches, pains and fatigue. There may be morning stiffness and sleep problems. The diagnosis is made on the history of the pain and accompanying symptoms as well as the presence of tender points at specific sites on the body. There are a number of different theories and reasons for this condition. There will often be blood tests and maybe x-rays to exclude other diagnoses. Treatment involves pain killers, exercises, rest and sometimes antidepressant medication. For more information see www.arthritis.org.nz

Osteoporosis is a disease that weakens your bones. Osteoporosis is not painful but it makes your bones more prone to breaking (fracture). Women are more likely than men to suffer from osteoporosis and as you get older you are more likely to have it. Tests Osteoporosis can be diagnosed by measuring bone mineral density (BMD). This test involves taking x-rays or a computer tomography (CT) scan of the bones in your spine, wrist, arm or leg. You may be asked to have a blood test to look for reasons why you might have osteoporosis. Treatment There is no cure for osteoporosis, but there are treatments that can improve bone strength and reduce your chances of breaking a bone.

This term is used to describe lung disease where the breathing tubes become blocked and the surrounding tissue and air sacs inside the lungs become damaged. COPD includes conditions such as emphysema, chronic bronchitis and chronic asthma. COPD is a long term and sometimes fatal disease that can be managed and slowed down. Smoking is the main cause of emphysema and chronic bronchitis. Chronic bronchitis is an inflammation of the main breathing tubes (bronchi) in the lungs, which results in the production of excess mucous (phlegm) and a reduction in the amount of airflow in and out of the lungs. In the early stages of chronic bronchitis, a cough usually occurs in the morning. As the disease progresses, coughing persists throughout the day. There is often associated shortness of breath and an increased rate of chest infections. Emphysema is the gradual destruction of the air sacs (alveoli) in the lungs. The alveoli are unable to completely relax. As they become larger they are not as good at transporting oxygen to the blood. Emphysema is cannot be cured, but can be managed through medication and lifestyle changes. You may have some of the following tests before or after your appointment: chest X-ray, spirometry, lung function tests, CT chest. The specialist will decide if you need any of these tests, depending on your symptoms and examination findings. There are ways to manage COPD. The first and most important is to stop smoking if this applies to you. There are exercises and dietary changes that can help maintain and improve fitness. Medications include inhalers, although they are not used for everyone. If you have COPD it is a good idea to have the flu vaccination every year. For more information on COPD see Asthma New Zealand | Take control of your breathing today

This is when a patient’s kidneys are unable to remove wastes and excess fluid from the blood. Kidney failure is divided into two general categories, acute and chronic. Acute kidney failure occurs suddenly and may be the result of injury, loss of large amounts of blood, drugs or poisons. Kidneys may return to normal function if they are not too badly damaged. Chronic renal failure means kidney function has slowly worsened over a number of years and often the kidneys do not get better. When chronic renal failure has progressed to end stage renal disease (ESRD), it is considered irreversible or unable to be cured. Renal replacement therapy Renal replacement therapy is a treatment that removes wastes and excess fluid from the blood when patients’ kidneys are not able to do it on their own. It comes in a number of forms, both continuous and intermittent, involving filtration and dialysis. In acute renal failure, the dialysis may only be needed for a few days or weeks while the kidneys recover. In some cases long-term dialysis and or a kidney transplant may be needed.