Distinguishing Normal Aging from Early Alzheimer's
Observing changes in a loved one can be unsettling, and it's important to understand the difference between minor, age-related forgetfulness and the more severe, persistent symptoms of early Alzheimer's. While normal aging might involve occasionally misplacing keys, Alzheimer's typically includes a pattern of memory loss that significantly disrupts daily routines.
The 10 Warning Signs of Alzheimer's
Experts have identified a set of warning signs that indicate a need for a medical evaluation. These symptoms often worsen over time and represent a noticeable decline from a person's previous abilities.
- Memory Loss That Disrupts Daily Life: Forgetting recently learned information, important dates or events, or relying heavily on memory aids. This goes beyond occasionally forgetting a name and recalling it later.
- Challenges in Planning or Problem-Solving: A person may struggle to follow a familiar recipe, keep track of monthly bills, or concentrate on tasks.
- Difficulty Completing Familiar Tasks: Routine activities, such as driving to a known location, organizing a grocery list, or playing a favorite game, become difficult.
- Confusion with Time or Place: Losing track of dates, seasons, or the passage of time. A person may forget where they are or how they got there.
- Trouble Understanding Visual Images and Spatial Relationships: Vision problems, difficulty with balance, or trouble judging distance can occur. This can affect reading or driving.
- New Problems with Words in Speaking or Writing: Struggling to follow a conversation, repeating themselves, or having trouble finding the right word for a familiar object.
- Misplacing Things and Losing the Ability to Retrace Steps: Putting items in unusual places and being unable to retrace steps to find them. As the disease progresses, they may accuse others of stealing.
- Decreased or Poor Judgment: Exhibiting changes in decision-making, like using poor judgment with money or neglecting personal grooming.
- Withdrawal from Work or Social Activities: Losing interest in hobbies and social engagements due to changes in conversation or abilities.
- Changes in Mood and Personality: A person may become confused, suspicious, depressed, fearful, or anxious, and be easily upset.
Normal Aging vs. Alzheimer's: A Comparison
| Symptom | Normal Age-Related Change | Early Alzheimer's Symptom |
|---|---|---|
| Memory | Forgetting names or appointments occasionally, but recalling them later. | Forgetting recently learned information and forgetting it later, requiring frequent reliance on memory aids. |
| Problem-Solving | Making an occasional error when balancing a checkbook. | Significant challenges in following a plan, working with numbers, or paying bills. |
| Familiar Tasks | Occasionally needing help with technology or a new task. | Having trouble completing daily tasks, like cooking a familiar meal or driving. |
| Language | Sometimes struggling to find the right word. | Frequently having trouble finding words, repeating stories, or stopping mid-sentence. |
| Judgment | Making a bad decision from time to time. | Consistently poor judgment with money or personal hygiene. |
| Mood | Feeling weary of work or social obligations at times. | Experiencing frequent mood swings, anxiety, suspicion, or depression that is out of character. |
What to Do If You Suspect Alzheimer's
Noticing these signs can be distressing, but taking proactive steps can lead to a diagnosis and better management of the condition.
How to approach the conversation
Talking to a loved one about memory concerns requires sensitivity and care.
- Choose the right time and place. Select a private, calm setting to minimize anxiety.
- Express concerns gently. Frame the conversation around observations rather than accusations. Instead of saying, "You're forgetting everything," try, "I've noticed you've been having some trouble with your bills, and I'm a little concerned".
- Suggest a joint doctor's visit. Offer to go with them to their primary care physician for a general check-up. This can be less intimidating than immediately suggesting dementia tests.
- Be patient. Your loved one may be scared or defensive. If they dismiss your concerns, give them space and try again later. It may take multiple conversations.
Taking the next steps
Once you've had a conversation, a medical evaluation is essential to rule out other conditions and confirm a diagnosis.
- Schedule a Doctor's Appointment: The primary care physician can conduct initial assessments and rule out other reversible causes of memory loss, such as medication side effects, vitamin deficiencies, or thyroid issues.
- Organize Information for the Doctor: Document the specific instances and patterns of behavior that raised your concern. This detailed information is vital for an accurate diagnosis.
- See a Specialist: The doctor may refer your family member to a neurologist, geriatrician, or neuropsychologist for further evaluation and testing. This may include mental status tests, neurological exams, and brain imaging.
- Plan for the Future: An early diagnosis allows the family and individual to plan for legal and financial matters, explore treatment options to manage symptoms, and participate in important life decisions while the individual can still express their wishes. For legal planning resources, the Alzheimer's Association is a valuable source of information.
Conclusion
Understanding how to identify the subtle yet persistent signs of Alzheimer's is the first step toward effective care and support. By recognizing the difference between normal aging and concerning cognitive changes, families can act early to pursue a diagnosis. While the conversation may be difficult, approaching it with empathy and preparation can help ensure your loved one receives the best possible care, maintains their dignity, and is involved in planning for their future. An early diagnosis provides valuable time to establish routines, explore treatments, and prepare the entire family for the road ahead.
