THIS week Dr Zak answers two questions from readers who had concerns about conditions that may be related to the nervous system.

His advice is provided in good faith and in line with current guidance and treatment. It cannot be a substitute for consulting your own doctor.

QUESTION: I have had a tremor for a long time. It has recently got worse. I am worried this may be Parkinson’s Disease, asks Arthur, 75.

ANSWER: It is important to recognise that some minor ‘shakes’ as they are often referred to, are normal. These do become more noticeable over the age of 50. Indeed, there is a term ‘senile tremor’ to describe this. Tremors may be caused by medical conditions such as serious infection or over activity of the thyroid gland. They may happen in acute mental illness or withdrawal from alcohol or other substances.

Tremors can also be split into those that are more noticeable at rest, known as essential tremor, versus those that become more pronounced when trying to complete a task. These are called action tremors.

Although both are termed ‘benign’ ie, non-harmful, they can interfere with daily life to varying degrees.

Sometimes benign tremors are made worse by emotional upset and reduced by alcohol.

The tremor of Parkinson’s usually starts as one-sided, affecting one arm, before moving to other parts of the body. In addition, either the sufferer, or those around them notice other features. These include slower movements, the most obvious being a shuffling gait. Facial expressions may be reduced or absent. As a result, Parkinson’s may be confused for a mood disorder in the early stages.

Unlike benign tremors, Parkinson’s Disease affects several bodily functions, although these can be mild at first, and take time to develop.

A benign tremor will not turn into Parkinson’s Disease, though it is important to recognise if you have any new symptoms that may be suggestive of the condition.

QUESTION: I am worried that my 70-year-old mum is may be getting dementia. Her memory for events when we were children is pin sharp. But she seems to forget things that happened only days ago. What is normal and when should I worry? She is adamant there is no problem, asks Barbara.

ANSWER: As we age, mild lapses in memory do occur. These are often jokingly referred to as “senior moments.” Problems with memory and the ability to perform simple tasks can also occur if you are in pain, under emotional stress, or if another sense is affected, typically sight or hearing.

There is a stage between normal and dementia, known as mild cognitive impairment. It is often during this phase that concerns are initially raised, either by the individual, or family members.

Dementia is a complex illness with different causes. You can have two types of dementia in the same person, for example Alzheimer’s and Vascular. This is referred to as mixed dementia.

However, one of the easiest ways to think about dementia is to imagine a bookcase. Those books at the bottom are memories and experiences from early life, those nearer the top being from later, to the present day.

When the bookcase shakes, it is those books at the top that are most easily displaced and fall out, yet those at the bottom are more secure, and hence remain.

Many people have significant fears about a diagnosis of dementia, including concerns that their freedoms may be taken from them. This is not true for the majority. There has been a strong drive to keeping persons in their own environment for as long as possible.

When considering what is best to do, it may help to consider whether the person is a risk to themselves or others, and what insight they display into this potential risk. An individual still driving who has significant memory lapses, yet refuses to acknowledge these, is an example.

Providing your mum is willing, your GP will be happy to assess her thoroughly looking at her memory, as well as any other issues of concern. If appropriate, at this point, a referral to the local memory clinic can be made for a full assessment.