A Stranger to Myself: Alzheimer's and Dementia

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I get these questions pretty often when patients contact me through HealthCareMagic. So I thought I would write a bit of basic information on Dementia in general and Alzheimer's specifically. The first thing one has to remember is that Alzheimer's & Dementia are not a normal part of aging. There is NO SUCH THING as SENILE DEMENTIA. If your doctor diagnosis you with this, get another opinion.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for majority of dementia cases.

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Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as "senility" or "senile dementia," which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

Early Detection of Alzheimer’s / The 10 signs

The Alzheimer’s Association has very helpfully put together a self-screening list that can help patients and their loved ones decide if they need to be tested for the disease. It consists of 10 early screening symptoms. If any of these are positive, then you need to consult your Primary Care Provider or a good Neurologist and see what needs to be done next.

The thing that you need to remember here is that there is no single TEST for Alzheimer’s, no blood test, no scan. It’s a clinical diagnosis that needs to be done by a qualified Neurologist. 

So use these questions as a screening test: If your answers concern you. Then the next step is to bring the screening test and the answers you wrote to the Doctor and let them outline the next steps with you.

1: Memory loss that disrupts daily life: One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What's typical? Sometimes forgetting names or appointments, but remembering them later.

2: Challenges in planning or solving problems: Some people 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.

What's typical? Making occasional errors when balancing a cheque -book.

3: Difficulty completing familiar tasks at home, at work or at leisure. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

What’s typical? Occasionally needing help to use the settings on a microwave or to use a computer.

4: Confusion with time or place. People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What's typical? Getting confused about the day of the week but figuring it out later.

5: Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection.

What's typical? Vision changes related to cataracts.

6: New problems with words in speaking or writing: People 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 problems finding the right word or call things by the wrong name (e.g., calling a watch a "hand clock").

What's typical? Sometimes having trouble finding the right word.

7: Misplacing things and losing the ability to retrace steps. A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

What's typical? Misplacing things from time to time, such as a pair of glasses or the remote control.

8: Decreased or poor judgment: People with Alzheimer's may experience changes in judgment or decision making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

What's typical? Making a bad decision once in a while.

9: Withdrawal from work or social activities. A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

What's typical? Sometimes feeling weary of work, family and social obligations.

10: Changes in mood and personality. The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

What's typical? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

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