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Aging In Place

Early Diagnosis

By Jennifer Bradley, Staff Writer/ Resource:

Forgetfulness is normal. Everyone has bouts of it; and even more with age. Whether a name, address or appointment, these facts slip through a person’s mind easily. For someone with Alzheimer’s disease, they don’t return; that’s the difference. The most common early symptom is a short-term memory loss.

The Alzheimer’s Association agrees that early detection is crucial to long-term management and symptom maintenance. According to the National Institute on Aging, “Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks.” Researchers today have hope, however, that catching it early can prevent most of the worst damage to a loved one.

When an early diagnosis is made, a caregiver becomes more of a task manager. A loved one will need help remembering appointments, names, medications, managing money and other simple planning efforts. A caregiver is the best encourager a loved one has. You must be a friend and a shoulder to lean on, as well as an observer. You are the person to go to events with, and help your loved one communicate when they can’t find the words. At some point, family and friends will need to be told. Life’s average days that included what used to be menial tasks will no longer be taken for granted. Recognizing the symptoms earlier rather than later can make the difference in the number of good days and number of bad days in the first stage of the disease.

The Diagnosis Process

If you suspect your loved one may be dealing with more than simple memory loss, the most important thing is not to ignore it. Hoping it may get better, or thinking it’s just a phase, could only lead to late diagnosis if in fact the situation proves to be more serious.  Remember, too, that there can be many treatable causes for memory loss not related to Alzheimer’s and the sooner your loved one sees the doctor, the better the outcome for everyone.

With a physical examination, doctors may test a loved one for reflexes, muscle tone and strength, rising and walking, sight and hearing, coordination and balance. Lab tests rule out any other possibilities for the memory loss and confusion, such as thyroid disorders or vitamin deficiencies. While basic mental status testing can take just 10 minutes, a doctor may want more extensive neuropsychological tests done. These can take several hours to complete, but are helpful if the medical professional does suspect early onset Alzheimer’s as a diagnosis. These tests show the functionality of a loved one compared to that of the average person their age.

Brain imaging also is a popular diagnosis option in use today. From CT scans to MRIs and PET scans, brain imaging allows medical professionals to pinpoint abnormalities and also specific changes known to relate to Alzheimer’s disease. These are very important if the diagnosis is in fact Alzheimer’s. Brain imaging gives insight to the stage of the disease, the rate of progression and shape, position and volume of brain tissue. The brain of a person with Alzheimer’s is different than that of someone without the disease.

New Tests on the Horizon

As scientific understanding about the nature of Alzheimer’s disease has progressed, so has the urgency to find definitive tests to diagnose and manage the disease. Certain genes have been identified as being associated with Alzheimer’s disease; but while genetic tests give insight to the possibility of Alzheimer’s, they don’t confirm it. Also the only genes isolated so far have been linked to so called early-onset Alzheimer’s, which is only associated with about five percent of the cases occuring in people under age 65. The other 95 percent are diagnosed with the more common late-onset form. The risk of developing the late-onset form is still not yet understood, but believed to be caused by a variety of factors including environment, genetics and lifestyle factors.

Researchers are also pursuing the development of a blood test to screen for an individual with Alzheimer’s by looking for certain proteins in the blood called biomarkers. The goal of a successful biomarker test would enable doctors to detect Alzheimer’s before the symptoms appear.   Another example of an Alzheimer’s screener is an eye test that would act as a diagnostic tool.

Early Treatment Counts

For someone with Alzheimer’s, changes have occurred in their brain possibly even 20 years prior to diagnosis.  With an early diagnosis, or even pre-diagnosis, as researchers are hoping to have in the next decade, treatment options can be tailored to a more preventive focus.

In the early stages of Alzheimer’s, a loved one may experience increased irritability, depression or anxiety. These typically are the result of increased confusion and memory loss, but yet the ability to know they can’t focus as well.  For behavioral-type symptoms, there are medications available to assist. They can be targeted to a specific symptom of the disease. However, looking for reasons behind the behavior and addressing those may be just as successful for a caregiver.

Many times, the person is overwhelmed, by a setting or even a conversation they just can’t participate in at the level they used to. A loved one will benefit greatly by managing these “trigger” situations. Find out what makes a loved one “tick” so to speak, and avoid those at all costs. Between fear, and then mental and physical fatigue, the wrong setting can set a person into another door of frustration. A calm, friendly environment is usually the best medicine for someone with Alzheimer’s, even in the early days.

For the physical symptoms of memory loss, confusion and problems with thinking/reasoning, medication is the current mainstay. Two types are approved by the U.S. Food and Drug Administration: cholinesterase inhibitors (Aricept, Exelon, etc.) and memantine (Namenda). Current medications can’t stop the progression of the disease, but can lessen or stabilize the symptoms for a period of time in some people.  Many caregivers report frustration with the current medications, feeling that they are doing little or nothing to help their loved ones, especially over a period of time when the disease continues to progress despite the medication.

The other treatment measure for early Alzheimer’s comes in the form of sleep management. A loved one with this condition will most likely have a change in sleep patterns and difficulty with sleep. While scientists still do not understand why, they do know the “what.” People tend to wake up more and stay awake longer during the night. Brain wave studies show a decrease in dreaming and non-dreaming sleep stages.

The Role of Clinical Trials

There is a great need for people to participate in clinical trials, notes the Alzheimer’s Association. The group says this is the only way to further advance the prevention, diagnosis and treatment of the disease. There are a few types of clinical research, including: treatment trials, diagnostic studies, prevention trials, screening studies and quality of life studies.

The biggest challenge for all trials and studies today is finding people willing to participate. The funding is available, and a cure will not be without more research and treatment development.

While researchers continue to piece together how and when brain damage begins, the five million people in this country diagnosed with Alzheimer’s will continue to hope for the cure. Their caregivers wish for the same. Noticing symptoms early on is still the first line of defense in Alzheimer’s management. When it seems like normal forgetfulness has escalated, it’s time to take that next step, for your loved one and yourself, and seek a diagnosis as soon as possible.


  • Memory loss that disrupts daily life

  • Challenges in planning or solving problems

  • Difficulty completing familiar tasks

  • Confusion with time or place

  • Trouble understanding visual images and spatial relationships

  • New problems with words in speaking or writing

  • Misplacing things and losing the ability to retrace steps

  • Decreased or poor judgment

  • Withdrawal from work or social activities

  • Changes in mood or personality

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