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10 Warning Signs of Alzheimer's Disease



 

Reproduced with the permission of the Alzheimer's Association.
Copyright 2004 Alzheimer's Association,
www.alz.org, 800.272.3900

Some change in memory is normal as we grow older, but the symptoms of Alzheimer's disease are more than simple lapses in memory. People with Alzheimer's experience difficulties communicating, learning, thinking and reasoning problems severe enough to have an impact on an individual's work, social activities and family life.

The Alzheimer's Association believes that it is critical for people with dementia and their families to receive informa-tion, care and support as early as possible. To help family members and health care professionals recognize the warning signs of Alzheimer's disease, the Association has developed a checklist of common symptoms.

1. Memory loss. One of the most common early signs of dementia is forgetting recently learned information. While it’s normal to forget appointments, names or telephone numbers, those with dementia will forget such things more often and not remember them later.

2. Difficulty performing familiar tasks. People with dementia often find it hard to complete eve-ryday tasks that are so familiar we usually do not think about how to do them. A person with Alzheimer's may not know the steps for preparing a meal, using a household appliance or participating in a lifelong hobby.

3. Problems with language. Everyone has trouble finding the right word sometimes, but a person with Alzheimer's often forgets simple words or substitutes unusual words, making his or her speech or writing hard to understand. If a person with Alzheimer's is unable to find his or her toothbrush, for example, the individual may ask for “that thing for my mouth.”

4. Disorientation to time and place. It’s normal to forget the day of the week or where you’re going. But people with Alzheimer's disease can become lost on their own street. They may forget where they are and how they got there, and may not know how to get back home.

5. Poor or decreased judgment. No one has perfect judgment all of the time. Those with Alzheimer's may dress without regard to the weather, wearing several shirts on a warm day or very little clothing in cold weather. Those with dementia often show poor judgment about money, giving away large sums to telemarketers or paying for home repairs or products they don’t need.

6. Problems with abstract thinking. Balancing a checkbook is a task that can be challenging for some. But a person with Alzheimer's may forget what the numbers represent and what needs to be done with them.

7. Misplacing things. Anyone can temporarily misplace a wallet or key. A person with Alzheimer's disease may put things in unusual places, like an iron in the freezer or a wristwatch in the sugar bowl.

8. Changes in mood or behavior. Everyone can become sad or moody from time to time. Someone with Alzheimer's disease can show rapid mood swings — from calm to tears to anger — for no apparent reason.

9. Changes in personality. Personalities ordinarily change somewhat with age. But a person with Alzheimer's can change dramatically, becoming extremely confused, suspicious, fearful or dependent on a family member.

10. Loss of initiative. It's normal to tire of housework, business activities or social obligations at times. The person with Alzheimer's disease may become very passive, sitting in front of the television for hours, sleeping more than usual or not wanting to do usual activities.

If you recognize any warning signs in yourself or a loved one, the Alzheimer's Association recommends consulting a physician. Early diagnosis of Alzheimer's disease or other disorders causing dementia is an important step to getting appropriate treatment, care and support services.



Stages

Understanding Stages and Symptoms of Alzheimer's Disease*

Alzheimer's disease develops slowly and causes changes in the brain long before there are obvious changes in a person's memory, thinking, use of words or behavior. Stages and changes the person will go through are outlined below.

Common Changes in Mild AD

  • Loses spark or zest for life - does not start anything.
  • Loses recent memory without a change in appearance or casual conversation.
  • Loses judgment about money.
  • Has difficulty with new learning and making new memories.
  • Has trouble finding words - may substitute or make up words that sound like or mean something like the forgotten word.
  • May stop talking to avoid making mistakes.
  • Has shorter attention span and less motivation to stay with an activity.
  • Easily loses way going to familiar places.
  • Resists change or new things.
  • Has trouble organizing and thinking logically.
  • Asks repetitive questions.
  • Withdraws, loses interest, is irritable, not as sensitive to others' feelings, uncharacteristically angry when frustrated or tired.
  • Won't make decisions. For example, when asked what she wants to eat, says "I'll have what she is having."
  • Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.
  • Forgets to pay, pays too much, or forgets how to pay - may hand the checkout person a wallet instead of the correct amount of money.
  • Forgets to eat, eats only one kind of food, or eats constantly.
  • Loses or misplaces things by hiding them in odd places or forgets where things go, such as putting clothes in the dishwasher.
  • Constantly checks, searches or hoards things of no value.

 

Common Changes in Moderate AD

  • Changes in behavior, concern for appearance, hygiene, and sleep become more noticeable.
  • Mixes up identity of people, such as thinking a son is a brother or that a wife is a stranger.
  • Poor judgment creates safety issues when left alone - may wander and risk exposure, poisoning, falls, self-neglect or exploitation.
  • Has trouble recognizing familiar people and own objects; may take things that belong to others.
  • Continuously repeats stories, favorite words, statements, or motions like tearing tissues.
  • Has restless, repetitive movements in late afternoon or evening, such as pacing, trying doorknobs, fingering draperies.
  • Cannot organize thoughts or follow logical explanations.
  • Has trouble following written notes or completing tasks.
  • Makes up stories to fill in gaps in memory. For example might say, "Mama will come for me when she gets off work."
  • May be able to read but cannot formulate the correct response to a written request.
  • May accuse, threaten, curse, fidget or behave inappropriately, such as kicking, hitting, biting, screaming or grabbing.
  • May become sloppy or forget manners.
  • May see, hear, smell, or taste things that are not there.
  • May accuse spouse of an affair or family members of stealing.
  • Naps frequently or awakens at night believing it is time to go to work.
  • Has more difficulty positioning the body to use the toilet or sit in a chair.
  • May think mirror image is following him or television story is happening to her.
  • Needs help finding the toilet, using the shower, remembering to drink, and dressing for the weather or occasion.
  • Exhibits inappropriate sexual behavior, such as mistaking another individual for a spouse. Forgets what is private behavior, and may disrobe or masturbate in public.

 

Common Changes in Severe AD

  • Doesn't recognize self or close family.
  • Speaks in gibberish, is mute, or is difficult to understand.
  • May refuse to eat, chokes, or forgets to swallow.
  • May repetitively cry out, pat or touch everything.
  • Loses control of bowel and bladder.
  • Loses weight and skin becomes thin and tears easily.
  • May look uncomfortable or cry out when transferred or touched.
  • Forgets how to walk or is too unsteady or weak to stand alone.
  • May have seizures, frequent infections, falls.
  • May groan, scream or mumble loudly.
  • Sleeps more.
  • Needs total assistance for all activities of daily living.

 

*Adapted from Caring for People with Alzheimer's Disease: A Manual for Facility Staff (2nd edition), by Lisa P. Gwyther, 2001. Published by the American Health Care Association (1201 L Street, NW, Washington, DC 20005) and the Alzheimer's Association (919 N. Michigan Ave., Suite 1100, Chicago, IL 60611).

adear@alzheimers.org









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