You’re about to leave the house but can’t find your keys. You’re mystified, because you have a spot where you always put them. But finding them only thickens the plot: They are sitting next to the phone, where you never leave them.
That kind of scenario by itself is not a sign of Alzheimer’s disease, experts say. But it might be, depending on the what lay behind the key loss and what you do about it. Suppose, said Ruth Drew, director of family and information services at the Alzheimer’s Association, you forget about the phone call that caused you to set your keys down to begin with. If you think, “Someone moved my keys, it couldn’t have been me because I never put my keys by the phone,” she said, that is a typical sign of the brain deterioration associated with Alzheimer’s.
The disease itself was discovered in 1906 by Dr. Alois Alzheimer. In examining the brain of a woman whose fatal symptoms had included memory loss, language problems and unpredictable behavior, he found clumps and tangled bundles of fibers. Today these amyloid plaques and neurofibrillary tangles, as they are called, are known to characterize Alzheimer’s. Healthy neurons slow down, lose their ability to communicate and die in a process involving the hippocampus, the memory-forming part of the brain.
The onset of Alzheimer’s can predate actual symptoms by 10, 15 and even 20 years. Thus, getting diagnosed early can be vital, even for an affliction that cannot be halted, cured or slowed. For treatment can alleviate the symptoms and prolong one’s quality of life. The earlier the intervention, the more effective it is.
“There is a lot of gain from possible interventions that makes your life better, makes you better handle the disease, or if you’re a caregiver, better handle the disease of the person you care for,” said Marc Wortmann, executive director of Alzheimer’s Disease International (ADI), the London-based umbrella organization for Alzheimer’s groups worldwide. ADI’s new study, “World Alzheimer Report 2011: The Benefits of Early Diagnosis and Intervention,” reflects such benefits.
Getting diagnosed early also affords the sufferer a chance to make plans. “I’ve worked with a lot of families in late-stage Alzheimer’s,” Drew said. “[They] want to do the right thing, but they don’t always know what the right thing is.”
Early diagnosis enables the person to elect specific kinds of care, nursing-home placement and the like. Just as important, a screening may determine that what ails the subject is not Alzheimer’s at all. Many treatable issues—depression, conflicting medications, hormonal imbalance, vitamin deficiency—can cause symptoms.
Ten early signs distinguish Alzheimer’s:
• Disruptive Memory Loss. Forgetting recently learned information, important dates or events; asking repeatedly for the same information; or needing numerous reminder notes are bad signs. A typical age-related lapse could be temporarily forgetting a name or appointment.
• Challenges in Planning or Problem-Solving. Following recipes or keeping track of bills could become tricky, as opposed to making an occasional checkbook-balancing error.
• Difficulty With Familiar Tasks. Daily tasks such as driving somewhere familiar may become bewildering. An age-related change: needing an assist to set up a DVR.
• Confusion With Time or Place. Losing track of dates or seasons and the sense of time passing contrast with someone aging normally, who might get briefly confused about what day it is.
• Trouble With Visual Images and Spatial Relationships. A sufferer might have trouble reading, judging distance and determining color or contrast, or may walk past a mirror and think someone else is in the room. Problems extend to balance and things like negotiating curbs.
• New Word Problems. Someone who has been proficient with words his entire life may find it difficult to follow or join a conversation, stop talking mid-conversation, or repeat himself. We all have occasional trouble, said Drew. “But this is more profound. People can’t remember simple words like pen or watch or chair. They’ll say, ‘the thing you write with, the thing you sit on.’?”
• Misplacing Things. “People put their watch in the freezer and their ice cream in the cupboard,” said Drew. The person may also be unable to retrace his or her steps to find a lost item.
• Impaired Judgment. Good judgment and decision-making may head south, as could grooming and cleanliness.
• Withdrawal From Work or Social Life. A person may quit hobbies, social activities, work projects or sports.
• Changes in Mood and Personality. Sufferers can become confused, suspicious, depressed, fearful or anxious. They may have a short fuse. Becoming set in one’s ways is more natural.
None of these behaviors are definitive proof of Alzheimer’s. But they are warning signs that argue for being checked. As Drew put it, “The diagnosis of Alzheimer’s disease is a diagnosis of exclusion.”