Dear Dr. Garner,
My mother is 65, and I noticed she is becoming forgetful lately.
No matter how many times we give her an answer to a question, she keeps asking the same question over and over again. She also seems to forget appointments that we’ve made with her. Just yesterday, we were supposed to take her out for dinner. When we got to the house, she was in her pajamas and had no recollection of our meeting.
I am concerned that she is developing Alzheimer’s disease. Could you tell me if there is any way to know for sure if this is Alzheimer’s?
Afraid of Alzheimer’s
This is one of the most frequently asked questions I receive, but before I address your question, I would like to recognize a loyal Tablet reader and Ask the Doctor viewer, Josephine Orrichio. It was a pleasure meeting you and your family at The Francesco Loccisano Memorial Foundation Dinner. You truly have an amazing family.
Now, back to your question. Within the past couple of weeks, there was new research that demonstrated that the earliest signs of Alzheimer’s disease in the brain occur up to 20 years before symptoms appear. This is important because if identified early, there is medication which can lessen memory loss and improve the thought process.
It’s only after about 20 percent of brain cells have died that dementia appears. This may be the reason that medications for alleviating Alzheimer’s are not as effective as we would have hoped, as it is started too late. What is important about the new research is that it demonstrates that Alzheimer’s disease does not occur suddenly but has at least a 20-year development period in which a person may show no symptoms. The key is to develop simple tests to identify those at risk and to improve upon the medication available to prevent its onset.
The Alzheimer’s Association has a list of symptoms that occur during aging that help identify Alzheimer’s disease. Let’s review them:
• Memory loss that disrupts daily life. This is forgetfulness that interferes with daily routines.
• Difficulty in planning or solving problems. This includes being able to follow recipes, and keeping track of bills or appointments.
• Difficulty completing familiar tasks. This includes difficulty driving to a familiar location or forgetting where you parked the car.
• Confusion with time or place. This is forgetting where you are or how you got there.
• Trouble understanding visual images and spatial relationships. This is best represented with difficulty driving by veering into other lanes and frequently being “honked” by other cars.
• Difficulty finding the right word. An example that the Alzheimer’s Association points to is calling a watch a hand clock.
• Misplaced things. The afflicted person repeatedly loses items. She may forget where she put her glasses. Frequently, the patient may accuse others of stealing.
• Poor judgment. People with Alzheimer’s experience lapses in judgment. They’re vulnerable to con artists. They pay less attention to keeping themselves clean.
• Withdrawal from social activities. Someone who was a big fan of a sports team or an event may suddenly lose interest and withdraw from the activity.
• Change in mood and personality. The person can become confused, suspicious, depressed and anxious. They are easily upset with friends and coworkers.
While the above are signs of Alzheimer’s disease, relatives know the patient as well as, if not better than, the doctor. Any change that bothers a family member or friend regarding a person’s memory or thought process should be related to the patient’s doctor to initiate an evaluation.
Another interesting early change of Alzheimer’s may be the difficulty to smell certain scents such as vanilla or orange.
As new tests to detect Alzheimer’s become available, they will enhance the planning and treatment of the disease.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.