There are several types of memory problems people can have. If you are referred because of memory concerns it is very important to bring along a family member or someone who knows you well. If you are being seen in memory clinic, a nurse will ask questions about your memory and how you are managing at home, as well as doing a memory test. Another nurse will ask the same questions of your family member. This appointment takes approximately 1 hour. You may need to have blood tests, and sometimes a CT scan of your brain at a later date. This is a computerised x-ray, which involves you lying down for about 15 minutes while a machine passes over you. Following these tests, you will see a geriatrician at a separate visit, to talk about the diagnosis and look at what supports are needed to help you remain independent at home.

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. Following this medical assessment, you may be referred to a falls prevention programme, or other allied therapists. You may also be referred for a bone density scan to assess your risk of having a fracture. For more information on falls prevention the ACC website has information on https://www.acc.co.nz/preventing-injury/trips-falls/

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. If the stroke has had significant physical effects you may be admitted to our rehabilitation unit aimed at increasing your independence, preventing complications from stroke and preventing further strokes. For more information on stroke a very useful website is the New Zealand Stroke Foundation site www.stroke.org.nz

Urinary incontinence or a loss of bladder control is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.

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. If you are diagnosed with osteoporosis you may be prescribed several medications to improve your bone strength. You will have follow-up either with your GP or specialist to make sure that the medication suits you. You will be given some more detailed reading about things you can do to help manage your osteoporosis and about the type of medication you are on.

Parkinson's disease is a progressive neurological condition affecting movements such as walking, talking and writing. Parkinson's has three main symptoms: tremor, stiffness and slowness of movement (bradykinesia). The cause of Parkinson's is not completely understood. A group of nerves in the brain called the substantia nigra slowly degenerate and cease to produce a chemical messenger called dopamine. When more than half of dopamine is lost, the symptoms of Parkinson's disease are produced. Parkinson’s disease cannot be cured. Treatment focuses on managing symptoms and generally involves medications which attempt to replace the dopamine that is lacking. There is a no single test to diagnose Parkinson’s disease. In its early stages a diagnosis of Parkinson’s disease can be very difficult even for an experienced doctor. Even then a period of observation and reassessment may be needed before the diagnosis is confirmed. The diagnosis is based on: • the person’s medical history and symptoms • the neurological and physical examination • imaging techniques such as computerised tomography (CT) or magnetic resonance imaging (MRI) may be used to rule out other conditions.