What to do if you suspect Alzheimer’s
The list of potential symptoms is long, and it’s not necessarily specific, Kennedy says. “Maybe you notice something wrong with a person’s conversation, even if you can’t put your finger on it,” he says. “Something’s just not quite right.”
In judging what matters and what doesn’t, “‘change’ is the operative word,” says Linda Ercoli, director of geriatric psychology at UCLA. But Alzheimer’s typically comes on gradually - all too appropriately, the disease is said to have an “insidious onset” - so changes in a parent’s behavior may not even register “until it reaches a certain threshold.”
Changes may be most significant if they make it difficult for a parent to do the things he or she has always done well before, adds Dr. Jeffrey Burns, associate director of the University of Kansas Alzheimer’s Disease Center in Kansas City. “That should be a red flag,” he says.
Memory symptoms
The ability to retain immediate memories will increasingly affect your loved one’s short-term thinking. Click on any of the symptoms, below, to learn more about what to expect and what to do:
Repeats questions, stories, ideas within minutes (or less)
Forgets appointments and important tasks
Gets lost, even on familiar routes
Leaves many reminder notes to self but forgets writing them
Forgets to refill prescriptions or take medication properly
Other thinking skills
Brain changes will increasingly affect many cognitive (thinking) skills beyond memory. Click on any of the symptoms, below, to learn more about what to expect and what to do:
Has difficulty concentrating
Loses track when giving directions
Begins to say less in phone conversations
Reads books with fewer words
Cooks simpler recipes
Misuses words (such as calling a toothbrush a stick)
The change shouldn’t just be a one-time thing either. It’s important to see a pattern of behavior, Kennedy says. “It’s the second forgotten bill, the second time a pot is left on the stove to burn. Anyone can do those things once.”
In some cases, the disease may affect someone’s mood or personality. A parent in the early stages of Alzheimer’s might seem uncharacteristically suspicious, depressed or apathetic, Ercoli says. Perhaps that parent will become upset or frustrated more easily than in the past.
Sometimes the clue can be that a parent’s long-standing concern about good hygiene has waned. “That’s a big one,” says Patti Davis, whose father, President Ronald Reagan, was perhaps the most famous victim of Alzheimer’s.
Alzheimer’s symptom #2: Confusion over words
Does the person have difficulty finding the “right” word when he’s speaking?
Does she forget or substitute words for everyday things (such as “the cooking thingamajig” for pot or “hair fixer” for comb)?
Of course it’s normal for anyone to occasionally “blank” on a word, especially words not often used. But it’s considered a red flag for Alzheimer’s if this happens with growing frequency and if the needed words are simple or commonplace ones.
This can be a very frustrating experience for the speaker. He may stall during a conversation, fixating on finding a particular word. She may replace the right word with another word. This substitute could be similar enough that you could guess at the meaning (“hair dryer” instead of “hairdresser”), especially early on in the disease process. Or it could be completely different (“bank” instead of “hairdresser”) or nonsensical (“hairydoo”).
But it should take more than a hunch to prompt a visit to a doctor. Before taking that step, Davis recommends discussing your suspicions with someone else who’s involved in your parent’s life - a sibling, your other parent or a friend.
“I wouldn’t go solely on your own opinion,” says Davis, who now facilitates a support group for relatives of Alzheimer’s patients at UCLA. “You may not be the most objective observer. You could be in denial, or you could be too quick to think something is wrong.”
But if your consultation does nothing to allay your fears, you have no choice. Geriatricians are adamant that your parent should see a doctor.
For one thing, you could find out that the diagnosis is something less dire, such as hydrocephalus, an under-active thyroid, low vitamin B12 or even vascular dementia (which, unlike dementia caused by Alzheimer’s, can sometimes be reversed or at least stalled).
If Alzheimer’s is indeed the diagnosis, there are medications to try. Though they help only about 60% of patients and don’t really change the disease process, they may manage to stave off the decline by a precious six months to a year, Kennedy says. The earlier they’re started, the greater the effect, Cherry adds.
Another advantage of an early diagnosis is that it can help to keep your parent safe and out of trouble, says Dr. David Reuben, chief of the geriatrics division in the Department of Medicine at UCLA: “Perhaps she shouldn’t be driving. Perhaps she shouldn’t be cooking.”