More Than Forgetfulness

Which key is it again? What’s that woman’s name? Is that appointment today or tomorrow?

Lapses in memory, such as misplacing items or forgetting a word or name, are a normal part of aging. However, when changes in memory begin to interfere with daily living (i.e., you can’t remember how to start your car), it may be time to consider other reasons than just getting old. One possibility is Alzheimer’s disease.

Alzheimer’s is the most common cause of dementia and affects more than 6 million Americans with most being 65 and older. Changes typically begin in the part of the brain that affects learning, making it difficult for people to remember new information. Because the disease is irreversible, as it progresses the symptoms become increasingly severe. Symptoms include disorientation, confusion, and even loss of ability to carry on a conversation.

While there is currently no cure for Alzheimer's, there are treatments that can slow the worsening of dementia symptoms and improve the quality of life for those with the disease as well as their caregivers. As with any form of dementia, early diagnosis of Alzheimer’s is key.

Here’s a look at 10 common warning signs:

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. Displaying 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.

If you’re uncertain what you’re dealing with, the Alzheimer’s Association offers a free worksheet to help you recognize and assess changes in a friend, family member or loved one.

Herbert Gregg, MD, is a neurologist at Southwestern Vermont Medical Center.