Gathering A Complete Medical History
As with the treatment of any medical condition, physicians will ask for a rundown of a patients past and present health issues and all medications they are currently taking. The doctor will also take a brief family medical history to assess the patients risk of developing certain conditions due to genetic, lifestyle and environmental factors. For example, if a patients parent had early-onset Alzheimers disease, it increases the likelihood that the patient will also develop this disease.
A Failing Sense Of Direction
A persons sense of direction and spatial orientation commonly starts to get worse with the onset of dementia. They may have difficulty recognizing once-familiar landmarks and forget how to get to familiar places they used to have no trouble finding.
It may also become more difficult to follow a series of directions and step-by-step instructions.
Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
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Symptoms Of Mild Cognitive Impairment
Some people have a condition called mild cognitive impairment, or MCI. It can be an early sign of Alzheimers. But, not everyone with MCI will develop Alzheimers disease. People with MCI can still take care of themselves and do their normal activities. MCI memory problems may include:
- Losing things often
- Forgetting to go to events or appointments
- Having more trouble coming up with words than other people the same age
Learn more about Alzheimer’s disease from MedlinePlus.
The Role Of Plaques And Tangles
Scientists arent completely sure about why neurons die and tissue shrinks in the brains of people with Alzheimers disease, but they strongly suspect that amyloid plaques and tau tangles are the cause.
The thinking is that plaques form when pieces of a protein called beta-amyloid clump together. Researchers are beginning to think that groups of a few pieces of beta-amyloid, rather than plaques, may cause the worst damage by blocking the chemical signals neurons use to communicate.
In healthy brain tissue, tau protects the transport systems that supply cells with nutrients and other important substances. But when tau forms tangles, cells cant get the essentials they need and begin to die, according to the Alzheimers Association.
However, there is new controversy surrounding the role of beta-amyloid in Alzheimers, so more research is needed on the subject.
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Research And Statistics: How Many People Have Alzheimers
More than six million people in the United States are living with Alzheimers, and 1 in 3 seniors dies with Alzheimers or another dementia, according to the Alzheimers Association
As the number of older Americans rises, reflecting advances in medicine and the aging of the baby boomers, the number of people with Alzheimers is expected to more than double to as many as 13 million by 2050, barring any significant medical breakthroughs.
Signs Of Mild Alzheimers Disease
In mild Alzheimers disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family. Problems can include:
- Memory loss
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Increased sleeping
- Loss of bowel and bladder control
A common cause of death for people with Alzheimers disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.
There is currently no cure for Alzheimers, though there are medicines that can treat the symptoms of the disease.
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Why Am I Here
Getting confused about where you are or why you are there is another common sign.
People can get lost, especially in unfamiliar places, and they can become disorientated at home too.
They might go upstairs or into another room and not recognise it, for example.
Confusion can mean not knowing what day or month it is.
Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
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What Happens If A Doctor Thinks It’s Alzheimer’s Disease
If a primary care doctor suspects Alzheimers, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:
- Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem.
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
- Neuropsychologists, who can conduct tests of memory and thinking.
Memory clinics and centers, including Alzheimers Disease Research Centers, offer teams of specialists who work together to diagnose the problem. In addition, these specialty clinics or centers often have access to the equipment needed for brain scans and other advanced diagnostic tests.
Who Is This Dementia Quiz For
Below is a list of 9 questions composed for people who are concerned about memory loss. The questions relate to life experiences common among people who have symptoms of dementia, currently known as Neurocognitive Disorder , and are based on criteria in the DSM-5.
The following questions encompass the six domains of cognition that are evaluated when assessing symptoms NCD: executive functioning, complex attention, perceptual-motor ability, social interactions, learning/memory-related difficulties, and challenges involving daily activities.
Please read each question carefully, and indicate how often you have experienced the same or similar challenges in the past few months.
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What Are The Benefits Of Early Diagnosis
Early, accurate diagnosis is beneficial for several reasons. Beginning treatment early in the disease process may help preserve daily functioning for some time, even though the underlying Alzheimers process cannot be stopped or reversed.
Having an early diagnosis helps people with Alzheimer’s and their families:
- plan for the future
- take care of financial and legal matters
- address potential safety issues
- learn about living arrangements
- develop support networks
In addition, an early diagnosis gives people greater opportunities to participate in clinical trials that are testing possible new treatments for Alzheimers disease or other research studies.
To learn more about Alzheimer’s disease clinical trials, see www.nia.nih.gov/alzheimers/volunteer.
Review The Warning Signs Of Alzheimers
Alzheimer’s disease has a few distinct warning signs. Watch out for these changes in behavior and thinking that may indicate your loved one is in the early stages of the disease.
- Memory loss: This can include a failure to recall recent events or asking the same question over and over. The person may also lose things often and become frustrated while looking for them.
- Confusion about time or place: The person may forget where they are or what year it is.
- Difficulty interpreting visual information: Your loved one might not recognize familiar faces and could have trouble judging distances.
- Trouble with written and verbal communication: Your loved one may frequently have a hard time coming up with the right word or communicating their thoughts.
- Lack of interest: The person may lose interest in activities they used to enjoy.
- Trouble with familiar tasks: The person may have a hard time completing familiar tasks like following a recipe or balancing a checkbook. They may get lost while driving to familiar places.
- Trouble planning or thinking ahead:The person may have a hard time paying bills on time or planning activities.
- Mood or personality changes: Your loved one may be abnormally irritable or have mood swings that seem out of character.
- Poor judgment: Your previously savvy loved one may be easily persuaded by salespeople or may be less cautious when driving.
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Encourage Them To See Their Doctor
If youve noticed that someone close to you is showing symptoms of dementia, its important to encourage them to see their doctor to talk through whats been going on.
Talking to someone about changes youve noticed in them can be difficult. It can help to have the conversation in a space where both of you are comfortable, are able to hear each other clearly and speak freely. Health Direct recommends starting the conversation by talking about what youve noticed and the other common reasons this might be happening. For example, you might say youve noticed the person has had trouble with their memory recently, and ask if theyve been stressed or not sleeping well. Then you can suggest that its time to see a doctor to find out whats happening.
If you dont have a close relationship with the person, you might talk to someone who knows them well about what youve noticed, see if theyve noticed the same things and ask them to bring it up with the person.
If a person remains resistant to following up about changes in their memory or behaviour, Dementia Australia recommends finding a different, physical reason to encourage the person to see the doctor, like an overall physical check-up, a blood pressure test or diabetes check. You can see more suggestions on what to do if the person you are concerned about does not want to see their doctor on the Dementia Australia website.
Know The Signs Of Dementia
Early diagnosis can help people with dementia plan for the future, and might mean they can access interventions that help slow down the disease. Being familiar with the signs of dementia can help people receive a diagnosis as early as possible.
Early signs that a person might have dementia can include:
- being vague in everyday conversations
- memory loss that affects day-to-day function
- short term memory loss
- difficulty performing everyday tasks and taking longer to do routine tasks
- losing enthusiasm or interest in regular activities
- difficulties in thinking or saying the right words
- changes in personality or behaviour
- finding it difficult to follow instructions
- finding it difficult to follow stories
- increased emotional unpredictability.
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Causes And Risk Factors Of Alzheimers Disease
What causes Alzheimers? That is the billion-dollar question of dementia research. Scientists have made progress in understanding what happens in the brain as the disease progresses, but they still dont know just what kicks off these changes.
Researchers believe that the vast majority of Alzheimers cases are due to some combination of genetics, lifestyle, and environment. Risk factors include:
- Age Alzheimers disease is not a normal part of aging, with many people entering their nineties with their cognitive abilities intact. But age increases risk: Most people with the disease are 65 and older. After 65, risk doubles every five years. Nearly one-third of people who are 85 and older have Alzheimers.
- Family History Having a first-degree relative such as a parent or sibling with the disease is a strong risk factor. This may reflect shared genetics, environmental factors, or both.
- Genetics Scientists have identified over 20 genes involved with Alzheimers, although only one gene variant, called APOE-e4, appears to significantly raise risk. Still, some people with the APOE-e4 gene never develop Alzheimers, while others who develop Alzheimers dont have the gene.
Risk factors for Alzheimers that may be somewhat under a persons control include:
Knowing The Stages Of Dementia Helps You Plan
Even if the stages arent exact and symptoms can still be unpredictable, being able to plan ahead is essential.
The truth is that Alzheimers and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.
On an emotional level, having an idea of what symptoms to expect helps you find ways to cope with challenging behaviors.
It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.
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Talk To Your Loved One
Some people with early dementia are aware of their memory problems. They may have noticed lapses and might be relieved to talk about it. Others may become angry and defensive, and deny all concerns. What you know about your loved one will help you decide if you should take a direct or gentle approach.
When you do decide to talk to your loved one, be thoughtful. Choose a time of day when you think they might be most willing to listen.
Use “I” statements. For example, “I’m a little worried about you. I’m wondering how you’re doing. I thought I noticed you have a harder time lately with your memory. I was wondering if you’ve noticed the same thing.”
This approach can decrease your loved one’s defensiveness. It tends to be more effective than a statement like, “You seem to be having trouble with your memory.”
You also might want to avoid using the word “Alzheimer’s.” It’s an emotional word, and you don’t know for sure if this is what your loved one has. Instead, consider using words like “memory problems.”
If You Are Diagnosed With Dementia
Obtaining an early and accurate diagnosis can improve the quality of life for people with dementia.
Talk to your doctor about treatment and ongoing assessment.
Support and information is available through the National Dementia Helpline on 1800 100 500.
Thanks to Associate Professor David Ames for reviewing this material.
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Information For Your Doctor
Itâs a good idea to put together the following for your first appointment:
- A list of symptoms — include everything youâre feeling, even if you donât think it could be related to dementia
- Any sources of major stress or recent life changes
- A list of all medications you take, including vitamins and supplements, and the dosage
- A list of any questions you have
Medical Tests Used To Diagnose Alzheimers Disease
There is no single Alzheimers test that can determine whether a person has the disease. Currently, Alzheimers disease can only be confirmed after death through examination of brain tissue in an autopsy. Diagnosing Alzheimers and other types of dementia while patients are still alive is not yet an exact science, but doctors do have an arsenal of tests that can narrow down the underlying reason for a patients symptoms, such as memory problems and changes in behavior. However, it is important to keep in mind that these mental and physical tests are conducted to rule out all other possible causes, not to verify the presence of AD.
Clinicians are about 80 percent accurate in determining whether someone has AD, but a lot of cases arent black and white, explains David Morgan, Ph.D., CEO and director of the Byrd Alzheimers Center and Research Institute at the University of South Florida.
While this figure may not seem reassuring, it is still crucial for patients to undergo testing as soon as they begin exhibiting symptoms. The results will help physicians provide a diagnosis and appropriate treatment suggestions, which will enable patients and their families to make plans and prepare for the future.
So, when should one seek medical attention for suspected Alzheimers?
Identifying The Stages Of Alzheimers
Alzheimer’s Or Normal Aging
Just about everyone has minor memory glitches as they get older. If someone forgets a name or why they walked into the kitchen, that doesn’t mean they have Alzheimer’s.
The main problem that defines the disease is trouble planning and handling day-to-day tasks, like paying bills, managing a checkbook, or using familiar appliances around the house.
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Referral To A Specialist
If a GP is unsure about whether you have Alzheimer’s disease, they may refer you to a specialist, such as:
- a psychiatrist
- an elderly care physician
- a neurologist
The specialist may be based in a memory clinic alongside other professionals who are experts in diagnosing, caring for and advising people with dementia and their families.
There’s no simple and reliable test for diagnosing Alzheimer’s disease, but the staff at the memory clinic will listen to the concerns of both you and your family about your memory or thinking.
They’ll assess your memory and other areas of mental ability and, if necessary, arrange more tests to rule out other conditions.