Things One Shouldn’t Forget – Maintain a Watch for Early Signs of Alzheimer’s Disease

Q: My mother lives with us now, and I have noticed lately that she is forgetful. There is so much talk today about Alzheimer’s disease that I worry not only for her, but for myself as well. What is normal forgetfulness for someone (my mother is 78), and when should you worry and see a doctor?
A: As people age, it is not uncommon to see signs of forgetfulness as part of normal aging. However, when cognitive difficulties begin to interfere with daily functioning (driving, working, forgetting appointments, managing your own finances, taking care of everyday needs and errands, problems with language/word finding, etc.), those may be warning signs to seek out further evaluation. Start with your primary-care provider.

Q: What are other causes of forgetfulness?
A: Impaired memory can be due to a wide variety of medical conditions, including overmedication and medication side effects, substance abuse or misuse, depression and other psychiatric issues, and medical conditions such as an underactive thyroid or nutritional or vitamin deficiencies such as low vitamin B12. Again, your primary-care provider is a good place to start for an evaluation.

Q: My grandmother had Alzheimer’s disease. Is it hereditary? Does that mean our chances of developing Alzheimer’s are much greater?
A: We do know that some types of Alzheimer’s dementia have a hereditary basis, especially for people who develop memory problems younger than age 65. For most people with Alzheimer’s, it doesn’t necessarily run in families, except that we know the older you are, then the more likely you are to eventually develop Alzheimer’s. So, if your family has a lot of people who are living into their 80s and 90s, it is more likely to see them develop Alzheimer’s.

Q: Could you explain for me the difference between dementia and Alzheimer’s? I’ve had people tell me before that a loved one doesn’t have Alzheimer’s, but has dementia.
A: Alzheimer’s is a kind of dementia. In fact, it’s the most common cause — probably accounting for 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} — of all dementia diagnoses. Other kinds of dementia not related to Alzheimer’s include vascular dementia, dementia due to Parkinson’s disease, Lewy body dementia, frontotemporal dementia, and various other conditions.

Q: How quickly does the illness progress, and what medications are available to help?
A: Progression depends on the type of dementia, the age of onset, and the time course of the condition. With good care, it is not unusual for people to live seven to 15-plus years after initial diagnosis of Alzheimer’s. For Alzheimer’s dementia, there are medications such as Aricpet and Namenda that can slow the progression of the condition, but we currently have no medications that stop or cure Alzheimer’s disease.

Q: What got me thinking about this whole subject is the fact that I recently saw on the news that a new blood test may potentially help detect Alzheimer’s disease at an early stage, giving people up to 15 years warning before the symptoms appear. What can you tell me about that?
A: While there are blood tests and brain scans which show some potential for early detection, these are still considered in the research stage and are not a reliable recommended test right now. Currently, the best evaluation would be to start with a primary-care provider, who, if necessary can refer someone for further testing. This may include a neurological evaluation, brain imaging, blood tests, neuropsychological testing, and psychiatric evaluation. Baystate Medical Center offers comprehensive evaluation through our Memory Disorders Program. For more information about the program, call (413) 794-5555.

Q: Is research any closer to a cure or helping to treat or delay Alzheimer’s?
A: A tremendous amount of research is ongoing to help us better understand Alzheimer’s — and hopefully one day treat and prevent the condition. We make progress every year, but right now care is primarily supportive, with efforts to slow progression of the severity of cognitive decline. The Alzheimer’s Assoc. is an excellent resource for information and guidance for both patients and caregivers.