Warning Signs of Alzheimer’s Disease

10 Warning Signs of Alzheimer's Disease by Bobbi Jo Curty, B.A. in Social Work, Director of Social Services.

We have all used the phrase, “I must be getting old” when we say or do something that has slipped our mind. It is a common misunderstanding in society to assume that when you get older, you also begin to lose your mind. However, this does not necessarily go hand in hand. There are moments of forgetfulness that are typical, such as misplacing the car keys, forgetting why we stepped into the next room or being unable to recall minor details from a recent event. This type of occurrence can happen to someone in their twenties as well as someone in their nineties. How can we distinguish the difference between what is normal aging and what is a potential warning sign of Alzheimer’s disease?

Just as we cannot always acknowledge, or admit to, the deficits in our own lives, it is difficult to determine if some of these warning signs are evident in ourselves or our loved ones. We can walk around with blinders over our eyes and justify why particular things have happened or why they keep occurring. We may experience thoughts such as, “Mom used to always enjoy cooking healthy, well-balanced meals, I don’t know why she is losing weight and not eating like she used to” or “Dad is purposely calling me at all hours of the night” or “I don’t know why Mom doesn’t seem to care anymore about setting her hair or putting on make-up, she used to look so nice when we would go out.” As caregivers, it is easy to fill our minds with excuses for how our loved one seems to be behaving. We may think it is intentional and that they are just “being stubborn.”

Alzheimer’s disease is a brain disease that affects all aspects of daily living. It impairs one’s memory, one’s ability to engage in appropriate reasoning skills, and inhibits one’s thought process. Being able to recognize the warning signs of Alzheimer’s allows for early detection and the opportunity to receive appropriate treatment. Although not one single person diagnosed with the disease will display the exact same traits or behaviors as another person, there still remain apparent similarities which provide indicators of Alzheimer’s disease. Here are the signs and symptoms one must be aware of when trying to understand if these behaviors are normal parts of aging or warning signs of Alzheimer’s disease:

• Disruptions in daily life. We all can forget things at times. It becomes a concern when ongoing memory loss is affecting day to day tasks. Some Alzheimer’s signs may include forgetting dates of appointments or important events or frequently asking the same questions over and over again. These daily, mundane tasks that were once handled independently are now becoming a regular issue. Loved ones may start to see a slow mental decline; the person struggling may often require the assistance of a loved one for daily reminders.
• Difficulty with problem-solving. We take for granted the basic steps of getting ready for our day. Activities of daily living such as brushing our teeth, showering, and getting dressed have become second-nature for many people. We don’t realize that our brain is planning step-by-step of what to do next. Our brains function on auto-pilot; however, an older adult with cognitive decline that is affected by Alzheimer’s disease may perform one step, and once it is completed, they are unsure what the next step is. They can present with difficulty focusing on a task and may have trouble concentrating on achieving this task. This Alzheimer’s warning sign can become more evident in the finances of a person’s life. A person that was once an expert at bookkeeping may now have difficulty balancing a checkbook or maintaining accuracy with their monthly bills. The ability to follow even simple instructions, such as with a basic cooking or baking recipe, can become difficult to process for people affected by Alzheimer’s.
• Completing familiar tasks become more difficult. What once was an easy and often mindless task has now become difficult to maintain or even to initiate for someone who has Alzheimer's disease. Routine tasks that have been completed repeatedly from day to day become more challenging to achieve for adults who have Alzheimer’s disease. Such examples may include driving a car to a familiar location and no longer being able to find the correct route or a housewife who always kept a neat and tidy home is no longer keeping up with the household chores such as vacuuming or using the washer and dryer correctly.
• Displaying confusion with temporal orientation. A person with Alzheimer’s may show the warning signs that they are not able to provide the correct date and time on a consistent basis. A person with Alzheimer’s cannot process the passing of time. The brain tends to live moment by moment and cannot carry over details such as dates, from day to day. A person may even forget where they are and how they got there. Often, a person with Alzheimer’s may require frequent reminders about the date and time. There are devices for purchase that may aid in providing ongoing orientation such as, a large analog clock which includes time and date. This clock may also provide vocal reminders on a daily basis. A caregiver may even cross off dates on a calendar and place it in a position that will be seen frequently throughout the day.
• Difficulty processing visual and spatial relationships. Deficits in a person’s vision can be a warning sign of Alzheimer’s. Although vision problems may occur due to aging, having the ability to accurately judge visual and spatial distances can be caused by deterioration of the brain. A person may present a problem when visualizing colors and their contrast. Visual judgment times can be affected due to the brain decline. This is particularly concerning if the person with Alzheimer’s is still driving due to the importance of immediate and appropriate reaction time.
• Displaying issues with the use of words in writing and reading. A person with Alzheimer’s has difficulty initiating a conversation. Conversations tend to flow effortlessly for healthy brains, but a brain with Alzheimer’s often cannot follow the conversation. They may show difficulty with communication in speaking and writing with words that used to be familiar to them. Often, they have trouble finding the right word for something or may stop in the middle of a conversation and not know what they were talking about. A warning sign of Alzheimer's can be observed as “having the word on the tip of your tongue.” The person may hesitate before speaking in an attempt to find the right word. They may even be thinking of a word, but instead verbalize a word with similar pronunciation, such as intending to say “blouse” but say “blow” or intending to say “sock” but say “soap.” When the person is unable to recall the word, they may attempt to describe it instead, such as “You know, the thing on the wall with the numbers.” In the early stages of Alzheimer’s, a person may be aware that they are having difficulty with vocabulary and this may become incredibly frustrating for them.
• Items are misplaced more frequently and the ability to retrace steps becomes more difficult. Another warning sign of Alzheimer’s is demonstrated when a person is frequently misplacing items and are unable to recall where certain items belong, such as dishes in the cupboard, milk in the refrigerator, or money in their pocketbook. Things are often misplaced and instead placed in unusual locations. Because they are unable to recall where they put an item, it can result in accusatory statements of “someone was in my house and stole my (insert missing item).” Often, this behavior becomes more frequent, and the Alzheimer’s disease sufferer may display anger and paranoia if and when a caregiver is attempting to redirect the conversation.
• Impaired judgment and poor decision-making. A person with Alzheimer’s may tend to display occurrences of poor decision-making. In their younger years, this person may have always been clever and “on their game” when marked with making a judgment call. Unfortunately, when affected by the Alzheimer’s disease, their brain no longer has this ability to perform at the optimal level that it once had. They present with an ongoing pattern of clearly inappropriate decisions or actions. They no longer have optimal safety awareness. An example may be walking across a busy highway. A person with Alzheimer’s may continue to drive their car, even when they are unable to adhere to traffic laws. They may no longer understand the importance of proper personal hygiene, so they may keep the same clothing on day after day. Because they are often not aware of the date and time, they may not understand the changing of seasons and changes in the weather. They may dress in a t-shirt and shorts when there is 6 inches of snow outside. Their impaired judgment can also leave them victim to letters or phone scams preying on the elderly for financial exploitation.
• Isolation and withdrawal. A person with Alzheimer’s disease may still be aware that they are experiencing changes in their health. They may not be able to recognize that there is a cognitive decline occurring, but they may be in-tune with the fact that they are having trouble with word-finding or misplacing personal belongings. This will often come out as frustration and may present in forms of verbal and physical aggression, due to the frustration. It can result in an increase of withdrawal from social functions or disengaging in a favorite hobby. A person with Alzheimer’s disease may isolate themselves at home, where the environment is still familiar enough to them that they are not putting themselves into an unfamiliar setting that may overwhelm or overstimulate them.
• Changes in mood and personalities. The changes in an Alzheimer’s brain can affect a person’s mood and personality. A person who was once a soft-spoken, timid housewife may become a loud, obnoxious, cursing-like-a-sailor woman. At this stage of Alzheimer’s, it is typically more difficult for family members to be a witness to how the disease is changing their loved one. Their personality changes, and it becomes difficult to still see the person they once were. Often, another warning sign of Alzheimer’s is seeing a person withdrawing from their typical routine because of their change in mood. A person may have never had a mental illness, but their Alzheimer’s brain is now displaying signs and symptoms of anxiety, depression, or paranoia. Changes in mood can lead to lack of appetite, loss of interest in things once enjoyed, isolation, feelings of sadness and loneliness, and can also result in thoughts of self-harm or suicidal ideations.

What is the next step if any of these warning signs of Alzheimer’s disease are recognized in you or your loved one? It is crucial to set up an appointment to be seen by your Primary Care Physician to determine the cause of the symptoms. Recognizing the warning signs of Alzheimer’s Disease may be the first step that leads to early detection. Any changes in the brain should be taken seriously and should not immediately be discounted as typical signs of aging. Truly understanding a person’s daily routine and seeing the forms of disruption that may be occurring is an important starting point in determining the presence of Alzheimer’s disease. Early detection of Alzheimer’s disease allows a person to receive proper treatment. Although there is no cure, there are various forms of medication and treatment that can lessen the symptoms of memory loss and possibly extend the particular early stages of the disease’s progression. Understanding that your symptoms are occurring for a reason may give you peace of mind and lessen your anxiety knowing that there is a reason why your memory has not been functioning as it used to. This can enable you to plan appropriately for the future and maximize the right resources for you and your family. Being able to understand the ten warning signs of Alzheimer’s disease will give you the necessary steps to taking control of your cognitive health.

About the Author:

Bobbi Jo Curty earned her Bachelor's Degree in Social Work from Eastern University in 2008. Bobbi has 10 years of experience working as a social worker in a continuing care retirement community and has helped many patients with dementia and Alzheimer's disease. She currently works as a Director of Social Services for a retirement community in Manheim, PA and oversees social workers for more than 100 community residents.