Alzheimer’s disease is the most common type of dementia, with an estimated 65 per cent prevalence in patients diagnosed with some form of the condition. An estimated 20,000 people in Saskatchewan live with some form of dementia, and the likelihood of onset increases with age.
To explore ten common warning signs of Alzheimer’s disease, geriatrician Leslie Kernisan, MD, shared some advice on spotting this and other forms of dementia early based on experience with her patients.
As with all medical evaluations, it’s important to consider changes from the individual’s pre-diagnosis baseline behaviour. As well, an individual can display symptoms such as poor short-term memory during high periods of stress, so several symptoms must be observed together on a regular basis.
Poor short-term memory: A diminishing short-term memory is a common symptom of Alzheimer’s disease. Here, individuals will forget what recently happened and they may ask repeated questions because they can’t remember what they were recently told.
Repeating stories or questions: “In particular, when I hear someone is repeating the same stories over and over again, that is a total warning sign for me,” she said. These individuals will repeat their stories due to forgetting that they’ve already told it, or they may feel driven to be conversational.
She said in some cases, repeating stories can be a way to cover for memory problems. “I think some people, at some level, are trying to cover up their memory problems… in a certain way, they realize that if they keep saying something, they may be asked fewer questions.” As a result, these individuals will feel much safer.
Difficulty with IADLs: Instrumental Activities of Daily Living (IADLs) are the life skills we often learn as teenagers. Examples include management of finances, grocery shopping and cooking, and home maintenance. With Alzheimer’s disease, it’s common to see people struggle with these basics.
Unaware of or denying difficulties and mistakes: People with early Alzheimer’s disease often have trouble doing the things they used to do, but many of them will either deny these troubles or seem unaware of their difficulties.
Accusing others: These accusations can be made against family members or close friends and include blaming them for stealing, hiding, or misplacing things.
“In many cases, it’s the older person (suffering some form of dementia) who has misplaced their belongings due to memory problems or confusion.”
Delusions: Delusions are beliefs held contrary to evidence or reality. Dr. Kernisan said she’s encountered several that range from a belief that people are entering the house at night, that people are out to get them, or that their medications are replaced by poison.
Hallucinations: Hallucinations occur when an individual perceives something that others do not. Hallucinations are categorized into visual hallucinations – where you see something that isn’t there, and auditory hallucinations – where you hear something that others cannot.
“Hallucinations are sometimes an early warning sign of Alzheimer’s or another (form of) dementia,” warned Dr. Kernisan.
Getting lost: Getting lost can be related to memory problems, but the tendency can also be caused by difficulties in spatial memory or with recognizing familiar landmarks.
Trouble with speech and language: Examples of this tendency include troubles in naming things – including familiar objects – and in finding the right words.
“That’s because Alzheimer’s does often affect the part of the brain that manages language.” This region of the brain is the temporal lobe, which also affects memory and the regulation of emotions.
Uncharacteristic behaviour: This is the type of behaviour that has a primary caregiver or loved one saying, “this is so unlike them.” Examples include uncharacteristic spending or a sudden tendency toward risk-taking. This change can also result in social consequences, which tend to be either increased isolation or suddenly blurting out inappropriate comments for the situation.
Dr. Kernisan completed clinical training at the University of California in San Francisco (UCSF), is a clinical instructor in the UCSF Division of Geriatrics, and has been practising geriatrics since 2006. She’s a proud graduate of Princeton University, Case Western Reserve University School of Medicine, and the UC Berkeley School of Public Health.
For more information, Dr. Kernisan runs an educational website at BetterHealthWhileAging.net.
