Alzheimer’s Disease: When should you see a doctor?

One in 10 people over 65 are currently living with Alzheimer’s disease — a number that is expected to rise exponentially over the next few decades, especially here in Nevada. Recent statistics show that the “gray tsunami” is making waves in the Silver State, with an estimated 64,000 residents living with the disease by 2025 – a 48.8 percent increase from the 45,000 residents affected today.

Given these alarming statistics, it’s likely that at some point someone you know will be affected, which is why it’s important to be observant of the early warning signs. While the brain changes that cause AD start years and even decades before symptoms emerge, it can be difficult to differentiate between normal aging and signs of the early stages of the disease.

However, the earlier AD is detected, the better, as an early diagnosis can help those living with the disease, and their families, plan for the future, initiate treatment (both lifestyle and medications), and consider participation in a clinical trial. Clinical trials in AD —where new and promising treatments are being tested—are increasingly looking to test new medications at the earliest stages of the disease when symptoms first emerge.

To help recognize some of these early warning signs, below are five symptoms to look out for – most importantly being a noticeable change from prior level of functioning, which affects one’s ability to perform daily tasks.

Memory Loss and Cognitive Changes

AD is a brain disease that causes a slow decline in memory, thinking and reasoning skills. Most notably during the early stages, you may find that your loved one has started to forget information they recently learned, repeats themselves, loses things without being able to find them later, and becomes unable to complete tasks that used to be easy for them (e.g. paying bills, scheduling and attending appointments, and taking their medications). While mild memory loss is a normal part of aging, it shouldn’t be persistent or get worse over time. People with normal aging will eventually find their lost item or remember the appointment they scheduled. When memory loss becomes the “norm,” it’s time to get checked out.

Behavioral Changes

Aside from cognitive changes (thinking or memory), AD and other dementias can cause behavior changes. In some people, poor judgment, faulty logic when solving problems or difficulty concentrating may be the initial symptoms. Apathy (lack of interest in activities) and social withdrawal may also be signs of brain disease.

Language

Struggling to find the right word is a common symptom of normal aging—sometimes we are distracted with other things on our mind, had a bad night of sleep, or “are having a bad day.” Language changes in dementia are more than just finding the right word and affect a person’s ability to communicate. When a person has problems being understood or has difficulty communicating their thoughts, it’s important they be evaluated as this could be a sign of dementia.

Visuospatial Difficulties

The visual system has two components: the capture, focus, and transfer of light (completed by the lens, retina, and optic nerve) and the interpretation of this light into meaningful information (completed by the back part of the brain or occipital cortex). In some dementias, the first symptom may be due to faulty ways that the brain is interpreting visual information. Symptoms of these dementias may include difficulty judging distances (driving a car) or manipulating items (such as hanging a picture, using utensils or other household objects). If your loved one is experiencing visuospatial problems or vision problems that the optometrist cannot understand, it may be time for a neurological evaluation.

Personality Changes

As we age, people typically become set in their routines and may be upset if this is disrupted. However, people with dementia may experience more drastic personality changes including becoming anxious, fearful, suspicious, confused or depressed. It is important to be cognizant of dramatic changes like this and take action to have these changes evaluated.

•••

If you’re still on the fence about whether to bring in your loved one for a checkup, ask yourself these questions:

• Are you more worried about leaving your family member at home alone for a week than you used to be?

• Do you think he or she would be able to get by with food, take medications and handle any problems that could arise by themselves?

The course of AD varies from person to person and for some, it can be difficult to identify the early stages. But if you answered yes to either of these questions or are noticing some of the symptoms outlined above, it’s likely time to schedule an appointment with a doctor.

Dr. Aaron Ritter is the director of Clinical Trials program at the Cleveland Clinic Lou Ruvo Center for Brain Health. To learn more about the early symptoms of AD or to schedule an appointment with a neurologist specialized in the early detection and treatment of brain disease, call 855-LOU-RUVO or

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