Recognizing the Early Signs of Alzheimer's

Published by Contra Costa Times

Posted on Thu, Oct. 20, 2005

By Dr. Aneela Ahmed

Recently a 70-year-old woman was brought to me by her daughter because the mother got lost while driving and seemed confused. She had become messy in her personal grooming and at home. For no apparent reason, the patient had begun to worry about a man intruding into her house.

I talked with the patient and her daughter, examined the mother, and did a psychological evaluation. She had Alzheimer's disease, the most common form of dementia, which affects an estimated four million older Americans.

Dementia is any gradual impairment of brain function, including memory, reasoning, and judgment so severe that it affects a person's ability to function.

Alzheimer's is one type of dementia, in which brain cells associated with memory, intelligence, judgment, language, and behavior are destroyed. The cause is not known, though there are many theories, and much ongoing research.

The onset of Alzheimer's is gradual and often subtle. One fairly reliable rule is that people with dementia seldom complain of memory loss. Instead, it's almost always the patient's family that speaks to the doctor about declining mental abilities.

Some changes in memory are normal as we grow older, but the symptoms of Alzheimer's are more severe than periodic lapses in memory.

Other early signs of Alzheimer's include:

Disorientation to time and place - getting lost in familiar places and confusion about what time and day it is
Problems with language - word-finding difficulties, losing train of thought, inventing new words
Impaired judgment - giving away large sums of money, dressing without regard to weather
Problems handling everyday tasks such as cooking a meal or paying bills
Misplacing objects and then later claming someone stole them
Change in personality and behavior - being fearful, suspicious, irritated, and declining hygiene and grooming
Change in mood - depressed, withdrawn, lack of initiative.

Many Alzheimer's sufferers deny they have a problem. If you suspect your loved one has Alzheimer's, call his or her doctor as soon as possible. Early diagnosis helps with decisions about living arrangements, driving and other safety issues.

There are no blood tests or x-rays to diagnose Alzheimer's. Your doctor relies on family members or caregivers to provide details about the patient's declining mental function, as well as on a physical examination and a variety of psychological tests that may suggest the diagnosis.

It is important to rule out other causes of dementia such as medication side effects, thyroid disease, depression and vitamin deficiencies. Unfortunately, there is no cure for Alzheimer's. However, medication can slow the progress of the disease and enhance the quality of life for patients and their families, so it may be helpful to catch the disease early on.

These medications - called cholinesterase inhibitors (Aricept, Reminyl, Exelon), as well as a new drug called Namenda - may slow disease progression in some Alzheimer's patients. Unfortunately, the medicines do not cure or stop the disabilities associated with the disease. Virtually all patients will eventually need full-time care, including hygiene and feeding. This imposes a tremendous burden on families and caregivers.

Alzheimer's may seem insurmountable but there are steps you can take to make the best of living with this difficult disease. Contact the Alzheimer's Association at 1-800-272-3900, Alzheimer's support at 925-685-5260, 925-682-6330, 925-938-7800 or online at www.alz.org for more information.

Dr. Aneela Ahmed is a geriatric psychiatrist at Contra Costa Regional Medical Center.