For people of a certain age, it’s not uncommon to seize on any forgetfulness as a symptom of Alzheimer’s disease. Lose the car keys, forget a name, read a Top 10 list of dementia’s warning signs, and the worry begins.
“Even more epidemic than Alzheimer’s itself is the fear of Alzheimer’s,” said Richard Lipton, who heads the Einstein Aging Study at the Albert Einstein College of Medicine in New York.
So in an attempt to offer some perspective, here’s another list.
We interviewed three experts: Lipton, who also heads the division of cognitive aging and dementia at Montefiore Medical Center; Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center; and Heather Snyder, director of medical and scientific operations at the nonprofit Alzheimer’s Association.
Their thoughts about what to watch for:
1. Memory lapses.
You shouldn’t automatically fret about dementia if your car keys go missing. It’s when you start forgetting truly important stuff that you should worry.
“It’s also not necessarily forgetting where your keys are – in fact, I don’t know where my keys are right now – it’s forgetting what keys are for. Or not knowing what a key is for until you put it in your freezer,” Snyder says. “It’s that type of change in memory.”
The Alzheimer’s Association’s list says you should be concerned about memory loss that disrupts daily life.
“When you meet somebody at a party, you can’t remember their name, and then you say to your partner, ‘Well, what was that person’s name?’ and they say, ‘Harry Schwartz,’ and you say, ‘Oh, yeah, that’s right,’”
That’s not a warning sign of Alzheimer’s, Lipton says. A warning sign is when you don’t remember Harry Schwartz at all.
2. Inability to do tasks one used to do well.
A retired accountant who always balanced his checkbook to the penny and no longer can do that might want to see a physician. Difficulty planning and executing familiar tasks can signal deeper cognitive problems.
“Sometimes you get signs that Mom or Grandma has always hosted Thanksgiving dinner, and she just can’t do it anymore – she just can’t conceptualize getting all the pieces together at the same time,” Petersen says. “As people age, they need some help – that’s part of normal aging. But when it becomes more than that, and they just can’t cope with it, that becomes more worrisome.”
3. Confusion about time or place, or trouble getting around.
It’s worrisome if a person becomes lost in a familiar place or goes into a grocery store and becomes confused about how to leave. People may also have trouble with visual images or spatial perception. Noticeable changes in physical mobility – how you walk, the length of your stride and how fast you walk – might also be a tip-off to cognitive decline.
4. Change in mood, personality.
Significant changes in mood might also indicate cognitive decline. Symptoms such as apathy, irritability and agitation, which are similar to those of depression and other psychiatric disorders, may signal dementia’s onset if they are pervasive and out of character, Petersen says. Another telltale sign is withdrawal from family or social life.
“If you’re sitting around at a dinner table, and everyone is talking about things, and you’re actually having a difficult time following the conversation and remembering the flow of the conversation, you’re maybe more likely to not participate,” Snyder says.
5. Other causes could be at work.
Of course, it’s possible that other health problems could be causing symptoms that are also associated with Alzheimer’s. Conditions such as hyperthyroidism, hormonal imbalances and interactions between medications can mimic cognitive decline. And many of those conditions are easily reversible.
“That’s why it’s so important to talk to a health care provider,” Snyder says.