By Joseph Kandel, M.D.
Alzheimer’s is a disorder of the brain that leads to a decline in memory, comprehension, thinking, and judgment. Often this is a slow process; occasionally it occurs more rapidly.
Frquently, memory loss is the first sign of this disorder. However, not all individuals with memory loss have Alzheimer’s disease. It is quite common to misplace your car keys, your glasses, or forget the name of someone you know. However, most people will find their keys and glasses, and recall the name of their friend later in the day. Many individuals find that they need to make lists more frequently in order to keep up with daily tasks. Usually these changes are fairly easily managed, and do not interfere with most independent life activities.
Unfortunately, in some individuals the cognitive changes, memory loss, and social impairments become progressive, and can lead to a concern that the patient has dementia. “Dementia” is a general term that simply means a waxing and waning of cognitive ability. This often will involve impairment of thinking, judgment, memory, concentration, and behavior.
Here are some early warnings that a person may have Alzheimer’s:
1. Memory loss that can impair routine daily activi-
ties. Forgetting recently learned information (short term memory), repeating questions, constantly relying on others.
2. Difficulty following directions or solving pro-
blems. This can include difficulty with a checkbook, following cooking recipes, or simply taking longer to do things.
3. Confusion with time or location. Examples include forgetting when they last ate, arriving at the wrong time or date for an event, or even getting lost in familiar surroundings.
4. Problems with language. Getting lost in mid sentence, trouble finding the right word, or even using incorrect words can signal a problem.
5. Impaired judgement. This could involve issues with money management, personal hygiene, or social faux pas’s. They may simply pay less attention and therefore make errors.
6. Social and emotional changes: commonly, individuals developing Alzheimer’s will withdraw from social activities and will prefer isolation rather than engagement. They may have moodiness, irritability, may become confused and suspicious. They can be anxious and become easily upset.
So what should you do if you have some or all of the signs or symptoms?
SEEK MEDICAL ATTENTION WITH A SPECIALIST THAT DEALS WITH MEMORY ISSUES AND ALZHEIMER’S DISEASE, A BOARD CERTIFIED NEUROLOGIST. WHY? BECAUSE NOT ALL ISSUES WITH MEMORY, JUDGMENT, AND ATTENTION
ARE ALZHEIMER’S! There are many reversible causes of memory loss and cognitive decline, and these should all be explored. Possible causes of these problems could include the following:
1.Medications. Many senior adults are on single or multiple medicines; one or all of these could be interacting to cause a deficit in memory and attention and concentration.
2.Head injuries. While most people would recall a major head trauma, such simple things (in the elderly) as bumping their head on the car door, or a violent sneeze could produce a problem that leads to memory loss and problems with concentration.
3.Nutritional issues or vitamin deficiencies. Many elderly have an incomplete diet, lacking the necessary nutrients and vitamins. Frequently low B12 levels can produce the exact symptoms of Alzheimer’s disease. There has been a recent explosion of information regarding gluten and other factors that may have adverse effects on brain activity.
4. Significant medical conditions. Diseases such as low thyroid or abnormal sugar metabolism can produce difficulties with concentration, attention, focus, and memory. Improving your medical management can often improve your thinking ability.
5. Substance use. Chronic alcohol use, even mild or moderate amounts over a long period of time, can have an adverse effect on memory, attention, balance, and coordination. More recently, with the push to legalize marijuana, we know this may have an adverse impact on brain functioning.
6. Depression. Senior adults who are depressed can manifest this as a clinical dementia. They have all of the signs and symptoms of dementia, but it is the chemical change of the brain from depression causing this.
What will your doctor do? They will take a complete history, as well as family history, do a neurological examination, and then most likely order diagnostic testing. This may include MRI of the brain, EEG to check the rhythm of the brain, blood flow studies, and laboratories. In addition, a paper and pencil test (neuropsychological testing) may be helpful.
Based on these results, appropriate treatment can be initiated. This may include behavior modification, medications, cognitive retraining, and physical exercise just to name a few. Entering into a clinical trial may be an option. All of this can be discussed with your physician and your family.
For more information, please go to www.NeurologyOffice.com or call 239-231-1414. Or check out Dr. Kandel’s books on Amazon.com!