Do you forget where you left your keys? Have trouble remembering the name of a co-worker? Get lost on the way to a meeting or an event at a location you have driven to before?
Everyone, young or not so young, experiences memory loss from time to time, but how can you tell if your periodic lapses are just a normal part of aging, or a sign of something more serious…like Alzheimer’s disease?
It is estimated that some 5.2 million Americans currently have Alzheimer’s disease. About 5 million of these are over 65 – the other 200,000 have younger-onset Alzheimer’s. As the Baby Boomer generation ages, the number of people with Alzheimer’s or other dementias will grow even larger. Because it is a progressive disease, for which at this time there is no cure, an early diagnosis and timely initiation of appropriate treatment, can help to slow the advancement of the disease and extend the period a person can maintain a better quality of life.
What is Alzheimer’s Disease?
Alzheimer’s is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. It was named for Dr. Alois Alzheimer, a German physician, who was the first person to actually understand what was happening inside the brains of affected people. Alzheimer’s disease accounts for 50 to 80 percent of dementia cases. It is a progressive brain disorder that damages and eventually destroys brain cells, leading to memory loss and changes in thinking and other brain functions. It usually develops slowly and gradually gets worse as more brain cells wither and die. Ultimately, it is fatal.
The Warning Signs of Alzheimer’s
• The most common sign of Alzheimer’s disease is memory loss that disrupts daily life… especially forgetting recently learned information. Other symptoms include: forgetting important dates or events; asking for the same information over and over; increasingly needing to rely on memory aids or family members to help with simple tasks.
• Another symptom is having increasing difficulty planning and solving problems. Some people have trouble working with numbers and may have trouble following a familiar recipe or keeping track of monthly bills. They may have trouble developing or following a plan or difficulty concentrating, so that it takes longer to do tasks.
• It may become harder to complete familiar tasks at home or at work. It may be more difficult to remember the rules of a game or even to use appliances such as a microwave or TV remote control, harder to drive to a familiar location, keep up with deadlines or manage a budget.
• A person with Alzheimer’s may experience confusion about time and place. They may lose track of dates, seasons and the passage of time, and may have difficulty adapting to changes in schedule. Sometimes they may forget where they are or how they got there.
• It is not uncommon for a person to have trouble understanding visual images and spatial relationships. Some people develop vision problems and may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.
• Problems with words when speaking or writing can also be a symptom of Alzheimer’s disease. A person may have trouble following or joining in a conversation. They may repeat themselves, or may lose their train of thought and stop in the middle of a conversation unable to continue. It may be difficult to find a word they are looking for or they may call an object by the wrong name.
• It is not uncommon for someone with Alzheimer’s to frequently lose or misplace things. They may put things in unusual places and not be able to remember where they put them without the ability to retrace their steps.
• Another symptom is the inability to reason and use good judgment. They may make questionable choices such as giving away large amounts of money to telemarketers or take unnecessary risks such as grabbing a hot pan from the stove without a potholder. They may also pay less attention to grooming or keeping themselves clean.
• The onset of Alzheimer’s may be signaled by a withdrawal at work or from social activities. A person may lose interest in hobbies, sports or projects at work. They may have trouble keeping up with a favorite sports team, or forget how to do tasks, such as sewing or playing a musical instrument that they once enjoyed.
• There may be a noticeable change in mood or personality. A person may become moody, depressed, fearful, anxious or suspicious. They may be easily upset, especially if their normal routine has been disrupted so that they feel out of their comfort zone.
Gwen Windham, M.D., MHS, Internal Medicine physician and Clinical Director of The MIND Center Clinic at University of Mississippi Medical Center specializes in Geriatrics and Gerontology. Dr. Windham spoke with Well-Being about some of the ways to distinguish between memory loss that is a normal part of aging and memory loss that may be associated with the onset of Alzheimer’s disease. Note: The MIND Center Clinic offers comprehensive evaluation and innovative treatment to patients with a range of conditions affecting memory and cognition including Alzheimer’s disease and other dementias.
“One way to compare normal memory loss with that of a person with Alzheimer’s disease is whether the memory comes back,” explains Dr. Windham. “If you forget where you left your umbrella, but later you remember, that is probably an example of normal forgetfulness. The memory was recorded in your brain, and you were later able to access it. In the case of Alzheimer’s, if you forget where you put something a few minutes or hours ago and cannot recall it after time, it could be that the experience was never recorded in your memory. When the part of the brain that is capable of stroring new information is not working properly, it causes a person to repeat the same stories or ask the same questions.
What to do if you (or a loved one) is exhibiting symptoms of Alzheimer’s disease
If you notice any of the warning signs of Alzheimer’s, don’t ignore them. It is important to make an appointment with your doctor so you can be properly diagnosed and begin treatment. Your primary care physician may refer you to a specialist for an assessment.
According to Dr. Windham, the assessment should include a thorough medical history, a review of symptoms, a detailed examination including a neurological examination, and a discussion of how the person is functioning in his or her daily life. A critical part of this history is to interview someone who knows the person well. Often, people with Alzheimer’s disease or other dimentia do not recognize or remember their impairments or how these are affecting them. The assessment may also involve referral to a neurologist or neuropsychologist, and may include blood work and imaging to rule out other physiological causes for symptoms. While we often hear about CT scanning and MRI tests associated with the diagnosis of Alzheimer’s disease and other forms of dementia, imaging alone is not adequate for an accurate diagnosis.
“In brain autopsies of people without clear symptoms of Alzheimer’s, researchers have found pathology that would indicate that the individuals were suffering from the disease, while some autopsies of individuals with moderate to severe Alzheimer’s have shown limited evidence of brain changes normally associated with the condition,” notes Windham. “In other words, imaging alone is not sufficient for a diagnosis, one way or the other.”
The importance of early detection
A diagnosis of Alzheimer’s disease is difficult to accept, but the sooner you know what you are dealing with, the better chance you have of slowing down the progress of the disease. You can explore treatments that may provide some relief of symptoms and help you maintain a level of independence longer. You can also have the opportunity to take part in decisions about your own care, living options, and financial and legal affairs.
Family members and other caregivers will benefit from the help of professionals who can provide support and important tips about coping with a loved one with Alzheimer’s disease.
“One of the hardest things for a family member or loved one to remember about living with and caring for someone with Alzheimer’s disease is that you can’t change it and you can’t change them,” adds Windham. “All of the reminding in the world won’t alter the fact that they simply can’t remember the way they once did. They are not doing it ‘on purpose’ and correcting them or trying to ‘make’ them remember only causes more stress for both of you. The most loving things you can do are…first, get them the medical help they need, and second, make sure they are in a safe environment. Then listen to their stories again and again, answer their questions no matter how many times they ask, and just love them…for who they were yesterday, who they are today and who they may be in days to come.”
For more information about coping with Alzheimer’s disease and other forms of dementia, visit the official website of the Alzheimer’s Association at www.alz.org.
For more about The MIND Center Clinic at UMMC or to schedule an appointment, call 601-984-4467 or email MINDCenter@umc.edu.
Beverly “Gwen” G. Windham, M.D. MHS, Internal Medicine, Geriatric Medicine, and Clinical Director of The MIND Center Clinic at University of Mississippi Medical Center, received her Doctor of Medicine degree at the University of Mississippi School of Medicine. Dr. Windham is Board Certified in Internal Medicine and received fellowhip training in Geriatric Medicine at Johns Hopkins Bayview Medical Center in Baltimore, MD. She specializes in geriatrics and gerontology.
Are you a caregiver? Check out The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer’s Disease, Related Dementias and Memory Loss by Nancy L. Mace and Peter V. Rabins.