S2E25. The 10 Warning Signs of Alzheimer’s

I’ve been blogging for a year and a half now and, surprisingly enough, have yet to delve into the early symptoms of dementia in their entirety. I’ll correct that oversight below, but before I do, I’d like to add a little perspective.

When you go through the list below, I think you’ll agree with me that there has already been a significant cognitive decline by the time you experience those kinds of problems. Given that we have no treatment that can reverse the effects of dementia, the primary value of diagnosis at that point would seem to be to initiate the transition to some form of assisted living, whether it be in a facility or via support provided by your family.

But there is another really good reason for getting checked out. It’s very possible that the cognitive mistakes you are making have a cause other than dementia. In particular, depression, sleep disturbance, stress and medication interactions can all generate symptoms that mimic dementia. There is great value, then, in ruling out these other causes before you start to fret over beginning your long goodbye.

Having said that, I hearken back to my original intent in writing this blog which was to try to identify indicators that you were slipping well before you get to the debilitated state described in the ‘warning signs’ below. My hope was that perhaps an extra year or two of awareness would give you time to make lifestyle changes that might slow the progression of the illness. What I’m searching for is cognitive errors (my ‘mistakes on the journey’) that are more worrisome than ‘normal aging’ yet not as debilitating as a ‘warning sign.’

As for now, it appears that dementia-related errors are (1) more frequent and (2) more disruptive than those found in normal aging. It’s a fine line, indeed.

With that in mind, I joined a webinar this past Tuesday presented by the Alzheimer’s Association (www.alz.org) titled ’10 Warning Signs of Alzheimer’s’ in hopes of hearing about more subtle indicators of an approaching dementia. 

Spoiler alert: I was disappointed. The material covered was no different than that already posted on their website and, in fact, utilized the same slides. So rather than provide a summary of what I learned, it makes more sense for me to just present the information directly from their website, as I really don’t have anything to add. These are the best guidelines we as laypeople have to differentiate normal aging from dementia. The take-home message is this: If someone you know is exhibiting one or more of these symptoms, it’s probably time for a full diagnostic evaluation.

Here are the 10 warning signs:

1. Memory loss that disrupts daily life.

One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What’s a typical age-related change?
Sometimes forgetting names or appointments, but remembering them later.

2. Challenges in planning or solving problems.

Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

What’s a typical age-related change?
Making occasional errors when managing finances or household bills.

3. Difficulty completing familiar tasks.

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.

What’s a typical age-related change?
Occasionally needing help to use microwave settings or to record a TV show.

4. Confusion with time or place.

People living with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What’s a typical age-related change?
Getting confused about the day of the week but figuring it out later.

5. Trouble understanding visual images and spatial relationships.

For some people, having vision problems is a sign of Alzheimer’s. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.

What’s a typical age-related change?
Vision changes related to cataracts.

6. New problems with words in speaking or writing.

People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have trouble naming a familiar object or use the wrong name (e.g., calling a “watch” a “hand-clock”).

What’s a typical age-related change?
Sometimes having trouble finding the right word.

7. Misplacing things and losing the ability to retrace steps.

A person living with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

What’s a typical age-related change?
Misplacing things from time to time and retracing steps to find them.

8. Decreased or poor judgment.

Individuals may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.

What’s a typical age-related change?
Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.

9. Withdrawal from work or social activities.

A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities or other engagements. They may have trouble keeping up with a favorite team or activity.

What’s a typical age-related change?
Sometimes feeling uninterested in family or social obligations.

10. Changes in mood and personality.

Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone. 

What’s a typical age-related change?
Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

If these are the 10 criteria by which we are to measure our cognitive health, then I passed my 71½-year check-up with flying colors!

The only item that is close to raising a warning flag is #9: Withdrawal from work or social activities. As Sally has pointed out, I’m not as talkative as I used to be and now have a tendency not to participate in conversations. But it’s not because I’m not following along or can’t find the words or put together a sentence. I would describe myself in those situations as being comfortable and attentive, albeit not actively engaged. To the extent that my silence might represent a precursor to the development of poverty of thought, though, it’s worth keeping on eye on.

So I’ll take my current mental status as a win…and continue to search for earlier warning signs of dementia.

__________

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