This article was authored by Together We Thrive Wellness Partner, TriHealth
Everyone loses their car keys or is late on a payment once in a while. It happens. However, when should a loved one's forgetfulness make you wonder, could this be more serious?
“As we get older, all of us have some increasing problems with our memory,” Angela Morriss MD, a neurologist at Group Health explains. “It’s always a challenge to know what memory impairment is representative of normal aging and what kind of memory impairment is representative of early Alzheimer’s disease."
Alzheimer’s Disease: What’s the Cause?
Alzheimer's disease, the most common form of dementia, is significant loss of brain function, such as memory, judgment, attention and abstract thinking, that affects more than 5 million Americans.
Brain abnormalities are what doctors typically look for when diagnosing Alzheimer's. Common abnormalities include:
- The production of abnormal cells, or plaques that are made up of beta-amyloid protein. “[This protein] inserts itself between your neurons, or your brain cells, and that prevents your brain cells from talking to each other effectively,” Dr. Morriss explains.
- Neurofibrillary tangles, which are the damaged remains of microtubles that allow for the flow of nutrients through the neurons.
- Loss of nerve cell connections. This occurs when the tangles and plaques cause neurons to lose their connection to each other and die off. As the neurons die, brain tissue shrinks.
You are also more likely to develop Alzheimer’s if you:
- Are older
- Have a close blood relative, such as a brother, sister or parent with the disease
- Have certain genes linked to the disease
Symptoms of Early Alzheimer’s Disease
The most common symptom of early Alzheimer’s is recent memory impairment. This is not the same as short-term memory, which is the ability to hold something in your head long enough to store it for longer-term memory. “People who have a normal sort of memory impairment – or memory impairment you see with aging – will typically remember what they’ve forgotten within a couple of minutes,” Dr. Morris points out.
On the other hand, individuals with Alzheimer's typically do not have problems with long-term memory.
Other symptoms may include problems with:
- Executive Function (concentration, decision-making, staying on task)
- Orientation (getting lost while driving, especially in an familiar environment)
- Thinking and judgment
“If we see any one of those things, plus a memory impairment, we begin to get worried about Alzheimer’s disease,” she warns.
Is Mild Cognitive Impairment Alzheimer’s Disease?
Mild cognitive impairment is the stage between normal forgetfulness caused by aging and the development of Alzheimer’s disease. While mild cognitive impairment does not always transition into dementia, having this condition does put you at a higher risk.
When Should I See My Doctor?
If you are noticing memory loss or other cognitive changes that are beginning to affect your everyday life – like forgetting to take medications, missing appointments or neglecting to take out the trash – that’s an alert to schedule an appointment with your primary care doctor, who may then triage you to a neurologist.
Dr. Morriss also emphasizes that an Alzheimer's diagnosis is a process and should not be made too quickly. “You want to get to know the patient. You want to find out what their pattern of cognitive impairment is, and you want to do the testing – the MRI, the laboratory testing – and you want to reevaluate the patient to see if there is a progression.
In many cases – especially if there is any uncertainty in the potential diagnosis – your doctor will suggest that you get baseline neuropsychological testing to obtain a more extensive assessment of your thinking and memory. They will then reevaluate you three to six months later to see if there is a progression.
Is There Anything You Can Do to Prevent Alzheimer’s Disease?
The genetics of Alzheimer’s disease is complicated. Early-onset Alzheimer’s disease accounts for less than 5 percent of all cases. However, if you have a first degree relative with later onset Alzheimer’s disease, you are at higher risk for developing the disease later in life. Dr. Morriss does not recommend routine genetic testing, because there is not a neuroprotective medication available for preventing Alzheimer’s disease at this point, although there is active research in this area..
She does recommend staying active – on all accounts. “Physical exercise, cognitive exercise and remaining socially active are, really, the most important things to reduce your risk of memory impairment."