Forgetfulness or Something More? Signs of Alzheimer's and Dementia

Where did I leave my keys? What’s that woman’s name again? Why did I come into this room?

Lapses in memory, such as misplacing items or forgetting a word or name, are a normal a part of aging. But when changes in memory begin to interfere with daily living (for example, you can’t find your way home when driving), it could mean that there’s more at work than the passage of time.

Understanding Dementia and Alzheimer’s

According to Dr. Stuart Anfang, chief, Division of Adult Psychiatry, Baystate Behavioral Health, “Dementia is a general term for a decline in cognitive skills including memory, thinking and reasoning. Alzheimer’s disease is the most common cause of dementia. In fact, 60%-80% of people with dementia have Alzheimer's. But there are as many as 50 other causes of dementia.”

While dementia and Alzheimer’s are not a normal part of aging, an estimated 5.8 million Americans are afflicted by the conditions.

“All dementia,” he explains, “is caused by damage to brain cells. Causes range from a history of head injuries, mini-strokes or other events that cause vascular changes in the brain, Parkinson’s Disease, long-time alcohol use, traumatic brain injury, infections of the central nervous system, HIV, tumors, thyroid conditions, and, of course, Alzheimer’s disease.”

Dr. Anfang notes that “The greatest risk factor for developing Alzheimer’s is increasing age. Most people with Alzheimer's are 65 and older. Changes typically begin in the part of the brain that affects learning, making it difficult for people to remember new information. As it progresses, symptoms get increasingly severe and include disorientation, confusion—especially about time and place—mood and behavior changes, and, in late-stages, individuals lose the ability to carry on a conversation and respond to their environment.”

Unlike many other forms of dementia in which the causes are understood and, in some cases, reversible, the cause of Alzheimer’s is not clear, and the damage done to the brain as the disease progresses are irreversible.

10 Early Signs and Symptoms of Alzheimer’s

Because the symptoms of Alzheimer’s come on slowly, it’s easy to miss the warning signs. The Alzheimer’s Association offers a free worksheet to help you recognize and assess changes in a friend, family member or loved one.

The 10 most common warning signs include:

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, repeatedly asking the same question, or increasingly relying on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

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.

3. Difficulty completing familiar tasks

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

4. Confusion with time or place

Losing track of dates, seasons and the passage of time is common for some people with Alzheimer’s. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

5. Trouble understanding visual images and spatial relationships

Vision problems may be a sign of Alzheimer’s for some people. They may also have problems judging distance and determining color or contrast, which can cause issues with driving.

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.

7. Misplacing things and losing the ability to retrace steps

A person living with Alzheimer’s may put things in unusual places, such as car keys in the refrigerator. They may lose things and be unable to go back over their steps to find them again. As the disease progresses, they may accuse others of stealing.

8. Decreased poor judgment

Individuals may experience changes in judgment or decision-making. They may fall victim to a scam, not manage money well, pay less attention to personal grooming or may have trouble caring for a pet.

9. Withdrawal from work or social activities

A person living with Alzheimer’s 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 such as church or book clubs. They may have trouble keeping up while watching sports or television.

10. Changes in mood and personality

Individuals living with Alzheimer’s may experience mood and personality changes. They may be easily upset in both common and new situations and may appear fearful or suspicious.

People with one or more of these 10 warning signs should see a doctor to find the cause. Early diagnosis gives them a chance to seek treatment and plan for the future.

Diagnosing Dementia and Alzheimer’s

If you’re concerned about a loved one’s cognitive skills or behavior, contact their primary care  doctor. As it turns out, lots of things can cause memory issues including vitamin deficiencies, infections, depression, sleep apnea, issues with the thyroid, and even some prescription and over-the-counter medicines can cause dementia-like symptoms. It’s important to share with the provider what you or others have noticed and whether the change has been sudden or gradual. Be sure to bring a complete list of current medications and be honest about any alcohol or drug use.

The doctor may conduct a brief mental status exam and may order blood work to rule other causes like those noted above. In some cases, imaging may be recommended to look for any signs of a stroke or other structural problems.

Depending upon the findings, patients may be referred to a Memory Disorder Program, like the one found at Baystate, or may be prescribed medications to address the specific type of dementia diagnosed.

“Getting a diagnosis is the most important part of addressing dementia,” says Dr. Anfang. “Early diagnosis increases the chances of successfully treating reversible conditions that cause of dementia. There are practical advantages as well. The sooner the patient and family know the diagnosis, the more time there is to make future arrangements, handle financial and legal matters and establish a support network.”