December 22, 2015

An expert explains normal age-related changes, and those that could signal Alzheimer’s.

 

Sometimes we joke that forgetfulness is part of growing old, but how do you tell if symptoms are normal aging or signs of Alzheimer’s? Alzheimer’s disease causes a slow decline in memory, thinking and reasoning skills. In Tennessee, an estimated 120,000 people age 65 and older have Alzheimer’s disease.

Below, we share the Alzheimer’s Association’s 10 warning signs and symptoms of the brain disease. Angela Jefferson, Ph.D., director of the Vanderbilt Memory & Alzheimer’s Center, explains what’s normal and what’s more worrisome.

1. Memory loss that disrupts daily life

We can become more forgetful as we age. For example, we might forget a person’s name just after meeting them, or we might take longer to think of a word or a familiar actor’s name from a movie. These changes, when they happen infrequently, may reflect normal aging. However, if these lapses happen often or worsen to the point where someone’s forgetting recent events or can’t remember the names of his grandchildren, he could be developing dementia. When declining memory or thinking skills start affecting someone’s ability to perform activities of daily living (such as paying bills, preparing meals and taking medications), we become even more concerned that there is underlying dementia.

2. Challenges in planning or solving problems

People with Alzheimer’s disease often have difficulty solving problems, or planning things out. Examples include problems following an unfamiliar recipe, planning a new trip or dealing with a household emergency, such as a hot water heater breaking.  Making a math error when balancing the checkbook or leaving a tip — infrequently — is more a sign of normal age-related problems.

3. Difficulty completing familiar tasks at home, at work or at leisure.

If a loved one is having trouble completing familiar tasks, such as preparing a simple meal, washing clothes or putting dishes in usual storage places, that is a possible sign of dementia.

4. Confusion with time or place

One symptom of Alzheimer’s is disorientation in time or to place. This may manifest as a person mixing up the sequence of events (e.g., we had dinner, then we went to the movies) or having trouble remembering the day of the week or current year. A person can also experience confusion or a sense of getting turned around when traveling in familiar areas. A typical age-related experience is having mild confusion in an unfamiliar place where someone has never traveled. But after he or she gets familiar with the area, a person aging normally would no longer be confused.

5. Trouble understanding visual images and spatial relationships

People with Alzheimer’s can have difficulty judging distance or appreciating spatial relationships with other objects. This difficulty can manifest while driving, so they have trouble parking or may drive too close to the car in front of them. Having a harder time seeing objects at night while driving is a more normal complaint about vision and aging.

6. New problems with words in speaking or writing

Everyone has “senior moments” when we cannot think of the word we want to use. People with Alzheimer’s have more frequent difficulty putting into words what they want to say. Some Alzheimer’s patients have trouble remembering simple everyday words, or use vague phrases like “you know” and “that thing” instead of providing more specific responses. They also tend to get off-track in conversations, losing train of thought. Over time, a person’s ability to form sentences or even write his signature can be affected. Occasionally forgetting a word but replacing it with another word of similar meaning is just typical aging.

7. Misplacing things and losing the ability to retrace steps

We all get busy or distracted, and we may set things down in a spot we usually wouldn’t, making them difficult to find later. If a person consistently has trouble retracing steps to find items or puts them in unusual places (for example, placing milk in the cupboard instead of the refrigerator), that could reflect a problem. A person aging normally may forget where she left her cellphone, but she can retrace her steps to find it.

8. Decreased or poor judgment

Dementia can cause poor judgment, such as bad or surprising financial decisions — for example, someone who is usually conservative with money making a high-risk investment. A person with Alzheimer’s may also refuse to make decisions that used to be easy, like ordering from a menu. Or the person may require a lot more support from loved ones to make such decisions. Occasional poor decisions are probably just normal aging.

9. Withdrawal from work or social activities

People with Alzheimer’s often start to withdraw from work or social activities, because they have trouble remembering how to do routine tasks at work or difficulty following conversations. A typical age-related experience: Doing less strenuous activity because of tiring easily.

10. Changes in mood and personality

It is very common for people with dementia to have changes in mood, including anxiety, depression, irritability, anger, paranoia or even elation. Some people with dementia also experience personality changes – someone who has been mild-mannered in the past may start saying inappropriate things, or vice versa. Feeling sad after losing a loved one is a more normal change in mood.

With all the family togetherness, the holidays are a prime time to spot emerging health concerns for aging parents. As you gather this week, keep this advice in mind.

Did you know your memory can be trained? Practice these five strategies with your loved ones to help keep their brains in tip-top shape.