When To See A Doctor
Forgetfulness may be a normal part of aging and is not always caused by a neurodegenerative brain disease such as Alzheimers. If you happen to suspect someone you know is suffering from early onset dementia symptoms and doesnt show any signs of improving, it may be a good idea to have them speak to a doctor to get neurological testing.
Often, a neurologist is required to assess dementia through a physical exam and ordering various tests to determine mental health. There are many things a neurologist can do in the office that can be a good indicator to whether the patient truly is suffering from dementia or not.
Typically, dementia affects persons of advanced age, usually over the age of 65, but it is possible for individuals to be affected as early as their 30s, 40s, or 50s. Earlier age of onset may have additional factors playing a role in the accelerated and early presentation of those individuals, such as genetics. While dementia, in general, may be difficult to treat, early recognition and diagnosis may aid in slowing the progression of the disease, allowing the ability to take the steps to prevent further mental deterioration.
Similar Symptoms Different Timing
Study volunteers took a series of standardized tests that measured any decline in thinking, memory, behavior, and functional skills. Researcher noticed changes in both groups those who did and did not end up with dementia.
We were somewhat surprised that the order of symptom occurrence was the same for people who did and did not develop Alzheimers disease, Roe said.
Symptoms occurred in three phases. Irritability, depression, and nighttime behavior changes developed first. This was followed by anxiety, appetite changes, agitation, and apathy. Finally, elation, mobility disorders, hallucinations , delusions, and impulsive, inappropriate behavior were reported.
People who were diagnosed with dementia developed these symptoms sooner. The results suggest that a series of non-cognitive changes begins before memory symptoms appear in Alzheimers disease.
While Roe is encouraged by the study results, she said its still unclear whether depression and other non-cognitive symptoms are a response to whats going on in the brain as Alzheimers develops, or if theyre caused by the same underlying changes.
Paranoia Delusion And Hallucinations
Distortions of reality, such as paranoia, delusions, and hallucinations, can be another result of the disease process in dementia. Not everyone with dementia develops these symptoms, but they can make dementia much more difficult to handle.
Lewy body dementia, in particular, increases the likelihood of delusions and hallucinations, although they can occur in all types of dementia.
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Early Signs Of Dementia In Men
Dementia is a collection of symptoms, and there are many overlapping features between the different types. Other diseases and disorders can contribute to dementia, which may affect thought processes, communication ability, focus, and memory capacity of those affected. It is important to not assume your loved one has dementia just because they are facing memory problems. The diagnosis can be complicated and requires the assessment of a doctor or medical professional. The following are some of the more common signs of early dementia in men:
Recent memory loss: Forgetting recent conversations or events is often the first sign. Memories are often not affected and may throw off family members, making them think that memory is okay. Often those affected by dementia will not be able to remember what they eat for breakfast.
Difficulty performing familiar tasks: A very reliable warning sign, according to many medical experts. Dementia patients often lose the ability to cook food they once did flawlessly or get lost on their way home in a neighborhood theyve lived in their whole lives.
Language problems: Struggling to communicate thoughts is often an early sign of dementia. They have difficulty explaining things or have trouble finding the right words to express themselves. They may also substitute the wrong word either knowingly or not.
People With Depression May Get Alzheimer’s Disease Early Says Study
While it is already known that depression is a risk factor for developing Alzheimer’s disease, the latest research claims that if people do develop Alzheimer’s disease, those with depression may start experiencing dementia symptoms about two years earlier than those who do not have depression. Additionally, those suffering from anxiety who go on to develop the condition, may start experiencing dementia symptoms about three years earlier than those who do not have anxiety.
The study involved 1,500 Alzheimer’s patients at their center, 43 percent with a history of depression and one-third with a history of anxiety disorders. This group of patients with depression and anxiety were generally diagnosed with dementia at a younger agetwo to three yearsthan those with no history of the mental health conditions.
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Common Early Symptoms Of Dementia
Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.
However, there are some common early symptoms that may appear some time before a diagnosis of dementia. These include:
- memory loss
- difficulty concentrating
- finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
- struggling to follow a conversation or find the right word
- being confused about time and place
- mood changes
These symptoms are often mild and may get worse only very gradually. It’s often termed “mild cognitive impairment” as the symptoms are not severe enough to be diagnosed as dementia.
You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.
Dementia is not a natural part of ageing. This is why it’s important to talk to a GP sooner rather than later if you’re worried about memory problems or other symptoms.
Falling More Frequently Than You Used To
Constantly tripping over your own two feet? Everyone falls now and again but frequent falling could be an early signal of Alzheimers disease, according to research. A study published in July 2013 in the journal Neurology found that presumptive preclinical Alzheimers disease is a risk factor for falls in older adults. People will come into our office concerned because they forgot what was on their grocery list last week, but when their spouse says theyve fallen four times in the past year, thats a sign of a problem, says Rankin. Frequent falls may also be a symptom of other brain disorders, including progressive supranuclear palsy.
Understanding The Causes And Finding Ways To Cope
When someone with dementia lashes out at you for seemingly no reason, it’s normal to feel surprised, discouraged, hurt, irritated, and even angry at them. Learning what causes anger in dementia, and how best to respond, can help you cope.
Behavioral And Mood Symptoms Of Lewy Body Dementia
Changes in behavior and mood are possible in LBD and may worsen as the persons thinking abilities decline. These changes may include:
- Apathy, or a lack of interest in normal daily activities or events and less social interaction
- Anxiety and related behaviors, such as asking the same questions over and over or being angry or fearful when a loved one is not present
- Agitation, or restlessness, and related behaviors, such as pacing, hand wringing, an inability to get settled, constant repeating of words or phrases, or irritability
- Delusions, or strongly held false beliefs or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are still living.
- Paranoia, or an extreme, irrational distrust of others, such as suspicion that people are taking or hiding things
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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.
Losing Rational Thinking Skills Means Losing The Ability To Manage Moods
Once we understand the skills lost and kept in dementia, we need to think about how those changes affect our feelings and moods. You may not have considered this before, but if you have both memory skills and rational thinking skills, you are fully equipped to escape any emotion that circumstance might bring your way.
Imagine, for example, that you and a friend have been playing phone tag for quite some time and you are finally on the phone talking, yet she seems preoccupied and uninterested in what youre saying. If youre like me, you might feel a blend of irritation and hurt. I would feel irritation because we finally have a chance to catch up yet she doesnt seem interested in talking, and hurt because shes someone I expect to care about my feelings and to want to listen to me. Now what do I do?
Now, because I dont have dementia, I have the skills needed to change my feelings before they settle into a negative mood. I have both rational thinking skills and memory skills at my disposal. I can use memory skills to remind myself that we havent talked in quite a while so I dont know whats been going on in her life. I can use rational thinking skills to consider whether she might be dealing with something far more concerning than I am. I can use both memory and rational thinking skills to put my story on hold and ask her about herself. I dont have to feel irritated or hurt because I can think about why she might be acting the way she is.
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Rapid And Unexplained Mood Swings And/or Depression
This is different to: more typical age-related behaviours such as becoming irritable when a routine is disrupted.
Mood and personality changes can be associated with early signs of dementia. This could include becoming confused, suspicious, depressed, fearful or anxious, and your parent may find themselves getting easily upset in places they feel unsure about. Some of the dementia symptoms NHS lists include:
- Increased anxiety
- Violent mood swings
For example, your parent may appear calm, then visibly upset, and then very angry in a matter of minutes. This is a significant sign of dementia anger and frustration specifically if its unprovoked.
Other physical signs include pacing, obsessing over minor details, agitation, fear, confusion, rage and feeling overwhelmed because theyre trying to make sense of a world thats now confusing to them.
Symptoms In The Later Stages Of Dementia
As dementia progresses, memory loss and difficulties with communication often become severe. In the later stages, the person is likely to neglect their own health, and require constant care and attention.
The most common symptoms of advanced dementia include:
- memory problems people may not recognise close family and friends, or remember where they live or where they are
- communication problems some people may eventually lose the ability to speak altogether. Using non-verbal means of communication, such as facial expressions, touch and gestures, can help
- mobility problems many people become less able to move about unaided. Some may eventually become unable to walk and require a wheelchair or be confined to bed
- behavioural problems a significant number of people will develop what are known as “behavioural and psychological symptoms of dementia”. These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations
- bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence
- appetite and weight loss problems are both common in advanced dementia. Many people have trouble eating or swallowing, and this can lead to choking, chest infections and other problems. Alzheimer’s Society has a useful factsheet on eating and drinking
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Common Changes In Behaviour
In the middle to later stages of most types of dementia, a person may start to behave differently. This can be distressing for both the person with dementia and those who care for them.
Some common changes in behaviour include:
- repeating the same question or activity over and over again
- restlessness, like pacing up and down, wandering and fidgeting
- night-time waking and sleep disturbance
- following a partner or spouse around everywhere
- loss of self-confidence, which may show as apathy or disinterest in their usual activities
If youâre caring for someone whoâs showing these behaviours, itâs important to try to understand why theyâre behaving like this, which is not always easy.
You may find it reassuring to remember that these behaviours may be how someone is communicating their feelings. It may help to look at different ways of communicating with someone with dementia.
Sometimes these behaviours are not a dementia symptom. They can be a result of frustration with not being understood or with their environment, which they no longer find familiar but confusing.
How To Handle Alzheimers Aggression
One of the biggest challenges for people taking care of elderly parents with Alzheimers disease or other types of dementia is dealing with outbursts of agitation and aggression.
Techniques for managing AD aggression, such as redirecting their attention or medication, can certainly help. However, Cindy Steele, RN, nurse scholar for Copper Ridge, a residential care community located in Utah, says the key to handling anger and aggression is finding out what is causing the outburst.
Dismissing aggression as a normal behavior associated with Alzheimers doesnt enable the caregiver to fix whatever is causing the outburst, explains Steele. Why do they seem to get upset? What causes it?
Steele focuses on behavior management for Alzheimers and dementia patients and says agitation and aggression are typically caused by one or more of the following five factors.
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Preventing And Handling Anger In Alzheimers Care
The more you are able to understand your loved ones aggressive triggers, the easier it will become to avoid those triggers and prevent anger outbursts. That said, it isnt always possible to avoid certain triggers. Because of this, it is important that you know how best to handle outbursts of anger, including both verbal and physical aggression.
Here are some guidelines for managing anger outbursts in Alzheimers care recipients:
- If you can determine the cause of their distress, see if it is possible to alleviate or solve the issue. This can stop an issue from becoming worse, and often helps dispel their anger.
- Avoid physical contact and NEVER react to violence with force, unless your personal safety or the safety of someone else is threatened. Trying to take physical control of a dementia sufferer often increases their anger and aggression.
- Use a calm tone of voice and avoid outward displays of distress, upset, anger, or fear. These signs are often detected by the angry person and will likely make their own distress and agitation worse.
- If possible, remove yourself from the room or situation. Give yourself and the person time to calm down. This will make it easier for you to react and may defuse or dispel their anger.
- Be kind and reassuring at all times. Do not attempt to argue or reason with the person. Instead, be sympathetic and accepting of their anger and frustration.
Tips For Coping With Agitation Or Aggression
Here are some ways you can cope with agitation or aggression:
- Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
- Allow the person to keep as much control in his or her life as possible.
- Try to keep a routine, such as bathing, dressing, and eating at the same time each day.
- Build quiet times into the day, along with activities.
- Keep well-loved objects and photographs around the house to help the person feel more secure.
- Try gentle touching, soothing music, reading, or walks.
- Reduce noise, clutter, or the number of people in the room.
- Try to distract the person with a favorite snack, object, or activity.
- Limit the amount of caffeine, sugar, and junk food the person drinks and eats.
Here are some things you can do:
- Slow down and try to relax if you think your own worries may be affecting the person with Alzheimers.
- Try to find a way to take a break from caregiving.
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How To Prevent Dementia And Angerits All About Body Language
And finally, because of all this, we need to become very aware of our nonverbal communications. In my article on mean dementia I explained that reading nonverbal communication is one of our intuitive thinking skills, and so it is something not lost to dementia. We begin learning to read our companions expressions, body language, and intonation at an incredibly young agewithin hours of birth. And we keep those skills in dementia.
Dementia will take away our ability to understand language and eventually the meaning of even the first words we learned as toddlers, but people who are experiencing dementia remain very aware of their companions expressions, body language, and intonation. And without memory skills to distract them with memories of the past, or rational thinking skills to distract them with plans or anticipation of the future, people who are experiencing dementia are entirely presentfully alive in the moment and to whats happening around them.
Coping With Agitation And Aggression In Alzheimer’s Disease
People with Alzheimers disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesnt seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.
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