20 Signs and Symptoms of Alzheimer's
Key Warning Sign: Change
Change is the key warning sign. Ask yourself, "Has the person's ability to remember ordinary daily activities changed from before?"
Are You Worried?
Do you have a history of family members with Alzheimer's? Perhaps you are worried that you or someone you love seems to be forgetting more than usual. I was a caregiver for my husband's mother and father, who both had Alzheimer's, so I understand your emotions, concerns, and fears. It took almost two years for my husband and I to realize that his parents had Alzheimer's and get appropriate help. During those two years, we struggled to understand all of the changes in his parents and to deal with many difficult situations. Since then, I have carefully researched all of the signs and symptoms of this disease in order to help other people to make sure they get an appropriate diagnosis as early as possible.
In this article, I hope to provide you with enough information to decide if you need to seek additional medical help. I include:
- Early warning signs.
- Simple, easy memory tests you can give to someone without them necessarily knowing what you are doing.
- Explanation of the importance of early detection and what to do about it.
- Simple ways to improve cognitive ability (which my husband and I are already doing to help delay any memory impairment we might face).
20 Warning Signs
The key warning sign is change. The earliest symptom of dementia is a weakening in the ability to process information, especially new information. This is a sign we missed in my in-laws, who were completely unable to function after moving from their home in Arizona to a new home near us. The fact that they were not able to remember how to get to the store just down the street, and were not able to unpack any of their things should have been a warning sign for us. Here are some other typical warning signs:
- Losing sense of smell or taste, or changes in those senses.
- Having trouble remembering names more than before.
- Losing things like car keys or glasses more often than before.
- Forgetting where the car is parked more frequently.
- Not being able to remember how to get to a store or friend's house.
- Not being able to remember the title of a movie that was just watched.
- Substituting a word because the person can't remember the one they wanted.
- Forgetting appointments or phone calls more frequently.
- Needing to re-read something because they forgot it, or writing lots of reminders (my husband's father had notebooks full of reminders for himself, which made us realize after his diagnosis that he had been dealing with memory loss for several years).
- Repeating questions because they forgot the answer.
- Having people tell them that they already said that.
- Feeling depressed without a particular cause.
- Not remembering whether they took medications.
- Buying too much of something, or buying things they forgot they already have.
- Having more difficulty in organizing events, or paperwork.
- Finding it more difficult to finish complicated tasks.
- Not feeling motivated to finish a project they started.
- Being more irritable and less in control of emotions.
- Having more trouble learning a new task, like how to use a new phone.
- More difficulty in handling finances than before.
Warning Signs of Alzheimer's Poll
Does the person you are concerned about show some of these warning signs of Alzheimer's?
Mild Cognitive Impairment
People who answer "yes" to some of the above early warning signs may not have dementia that interferes with daily living, but they may have mild cognitive impairment (MCI) which means they:
- Do have at least one area of impaired memory function.
- Often can continue normal daily living, although close family members may notice a difference in their memory.
- Have trouble remembering anything new.
- Won't necessarily progress to having Alzheimer's, but have a 10 to 15 times higher chance of developing the disease each year.
Looking at my in-law's financial records and other papers after I became their caretaker, I realized that while Michael and Nicole had managed to live independently in Arizona, they had been having memory troubles for several years. Because of MCI, they had made some erratic financial decisions and also had some medical problems that we did not know about at the time. We wished that we had known about MCI and could have gotten them help earlier and kept them healthier longer.
Dementia vs. Alzheimer's
Dementia is defined as significant memory loss which interferes with daily life. About 70% of people with dementia will eventually be diagnosed with Alzheimer's (which is one of the main causes of memory loss).
What is Mild Cognitive Impairment?
Mild cognitive impairment (MCI) was a term coined by Dr. Ron Peterson of the Mayo Clinic to refer to memory impairment which is less than dementia, but not quite normal.
- Dementia is defined as having two areas of impairment which affects daily living.
- People with mild cognitive impairment may be able to function quite well in normal daily living but they have enough damage to their brain that they do not function the same as before.
For example, people with MCI might be able to balance a checkbook but would have trouble keeping track of all their finances and bills. They may not be able to keep good records for their taxes or may spend more money than they have in income.
We experienced this problem with my in-laws, who almost gave all of their money away to the Salvation Army several years before we realized they had Alzheimer's. Fortunately, the gentleman they contacted guessed there was a problem with their mental capacity and denied their donation. This gracious man actually spent a great deal of time looking for our contact information in order to let us know about the situation. We were so grateful to him, even though we still didn't realize at that time that they had Alzheimer's.
Since not every agency would have the integrity of the Salvation Army about donations, it is vital to be alert to any changes in mental functioning that indicate a person is not as capable as they have been previously.
Early diagnosis of memory impairment can allow for drug and behavioral treatments to delay the onset of more serious symptoms.
MCI Memory Test
One easy test is the MIC 10 item objective recall test. This test asks a person to remember 10 new words after waiting for ten minutes. Most people with normal functioning can remember more than 5. Someone with dementia might not remember any of them, but a person with MCI might remember only 3 or 4. The idea for the test is taken for Gary Small's and Gigi Vorgan's excellent book, The . Here is how to take the test: Alzheimer's Prevention Program
- Set a timer for 1 minute.
- Memorize the list of ten words for that minute.
- Set the timer for 10 minutes and do something else. Surf the web, fold your laundry or do a few sit-ups.
- When the timer goes off, get a paper and pencil and write down as many of the words as you can recall without looking back at the list.
- 5 or more, memory is probably in the normal range.
- 0-4: You may want to get a further assessment from a medical professional.
Memory Assessment Test
Why MCI is Important to Measure
MCI might be seen as the brain's equivalent to the high blood pressure and high cholesterol. We know that changes in our blood can be invisible symptoms of a potential heart attack and stroke. Similarly, MCI is an invisible symptom of potential memory disease. Like those cardiovascular symptoms we have all been taught to watch out for, MCI is not always noticeable.
Luckily, also like those more familiar symptoms, early discovery of MCI allows for early treatment through lifestyle changes, diet, and medication which can delay the onset of more serious memory problems. Moreover, even if you don't show signs of MCI, making some healthy changes now can help keep your brain healthy.
Moreover, sometimes MCI is actually caused by a medical problem or medication which can be treated to reverse the problem. That was the case with my mother. After having taken care of my in-law's, I was very alert to changes in my mother's mental state and became concerned when she would answer questions in a strange way. Because she had previously had hearing problems and surgery to replace her ear bones, I encouraged her to have her hearing tested. Sure enough, her artificial ear bones had hardened and she again had a profound hearing loss. When she got hearing aids (and remembered to wear them!), her ability to answer and remember was restored.
Why Early Diagnosis Helps
With some memory training, a person with MCI might be able to improve their ability to retain information even though they may not be able to completely recover their previous abilities.
The bad news: Most people are not correctly diagnosed with Alzheimer's or other memory loss problems until they have a crisis. Often, this is four years after the symptoms have first appeared. By that time:
- Daily life has been disrupted for them and their families.
- They need considerable help to continue to function.
- It may be too late to use drugs or other therapies to delay the disease.
The good news: If you pay attention to warning signs which come before a person actually has the disease you can:
- Get medical attention to see if the memory loss is caused by something reversible like medications, hearing loss, high blood sugar or other problem.
- Practice the steps of delaying further memory loss which can keep a person independent for longer.
- Get medical treatment early so that drug therapies which delay dementia work better.
- Have time to prepare and plan as a family.
Lifestyle Changes to Help Memory
Diagnosing early warning signs means you can make lifestyle changes to prevent or delay the onset of severe symptoms. After having been a caretaker of Alzheimer's loved ones, I researched extensively to find out what the best studies said about how lifestyle could affect memory. Two books that I especially liked were: , by Dean and Ayesha Sherzai, who offer practical ideas that can help anyone improve their cognitive health; and The Alzheimer's Solutionby Jean Carper, whose description of her own journey to combat a family history of early-onset Alzheimer's is inspiring and helpful, especially to anyone who also has relatives with this disease. 100 Simple Things You Can Do to Prevent Alzheimer's and Age-Related Memory Loss
My husband, who is a biology professor, helped me to evaluate the studies I found, and together we devised a plan for our own lives (I've included some good resources below). Knowing that his parents both had Alzheimer's, my husband is acutely aware of the fact that he may be at risk. Luckily, research suggests that there are things that people can do to delay memory loss. Here are the suggestions we are following, which seemed to us the most overall beneficial for our physical and mental health:
1. Regular Exercise: include aerobic, strength and balance exercises. Do at least 30 minutes of exercise every day and supplement this with changing your daily habits to:
- take the stairs rather than the elevator
- parking further out so you walk more
- include gardening, housework and other chores in your daily activities to make sure you move rather than sit all day.
- walk the dog
2. Eat Healthy Foods and Keep at the Correct Weight
- eat lean meats
- eat plenty of vegetables and fruits of different colors
- eat whole grains
3. Strengthen your Mind:
- learn memory strategies
- take a class to learn a new skill
- play games which involve thinking
- surf the web to learn something new
- learn a new language (my husband is working on French and Mandarin)
- do word puzzles
4. Reduce Your Stress
- make sure you get enough sleep
- take time away from work and media and relax
- take breaks away from the computer to interact with someone in person
- take a time management class to learn to manage your goals and set priorities
- talk out your concerns with friends, family or a therapist if you need one
- write out your thoughts and concerns in a journal
5. Socialize: People who have an active social network are less likely to have Alzheimer's than those who spend most of their time alone. We are lucky that we have a close network of work and church friends and 5 children to keep us busy. If you don't have a strong network of social connections, you may want to actively seek out opportunities to spend time with people you already know and to make new friends:
- join a club
- talk to people in line at the store
- help a neighbor
Our Journey to Prevent Memory Loss
In my own efforts to keep my mind healthy, I've worked hard to lose weight and keep it off by exercising regularly and eating healthy meals. I've also worked to learn Mandarin Chinese since my daughters were adopted from China and we've traveled there. Furthermore, I keep socially active by helping to run Acteens, a church-based missions organization for young women.
I'd love to hear your own story of caregiving or your tips on keeping your brain active and healthy. Please add your wisdom in the comments below!