Alzheimer's Disease

Memory loss is usually the first sign of Alzheimer's disease. Many older people may worry about Alzheimer's disease if they start to have memory problems. Having some short-term memory loss in your 60s and 70s is common, and some people with mild memory problems will go on to develop Alzheimer's disease. If you start having memory problems, share your concerns with your family and your doctor.

Examples of normal forgetfulness include forgetting:

• Parts of an experience.
• Where the car is parked.
• Events from the distant past.
• A person's name, remembering it later.
• Where you left an object, such as your car keys.

Examples of memory loss caused by Alzheimer's disease include forgetting:

• An entire experience.
• How to drive a car or read a clock.
• Recent events, such as forgetting you left the stove on.
• Ever having known a particular person.

Alzheimer's disease also causes changes in thinking, behavior, and personality. Early in the disease, the person may still behave appropriately in social situations, leading others to believe that the person is not ill. Close family members and friends may first notice the symptoms of Alzheimer's disease, although the person may also realize that something is wrong. Learn the warning signs of dementia—such as having difficulty thinking or remembering, or having trouble balancing a checkbook—and talk to a doctor if a friend or family member has developed any of the signs. Symptoms vary as the disease progresses.

The Alzheimer's Association has identified 10 warning signs for Alzheimer's disease. These signs are:²

• Memory loss, such as forgetting recently learned information like names and phone numbers.
• Difficulty performing familiar tasks, such as cooking a meal.
• Problems with language, such as forgetting simple words or substituting unusual words.
• Disorientation as to time and place, such as forgetting where you live on your street.
• Poor or decreased judgment, such as dressing improperly for the weather or giving away large sums of money to strangers.
• Problems with abstract thinking, such as not being able to balance a checkbook or understand what numbers represent.
• Misplacing things, like putting an iron in the freezer or a wristwatch in the sugar bowl.
• Changes in mood or behavior, such as rapid mood swings—from calm to tears to anger—for no apparent reason.
• Changes in personality, such as becoming extremely confused, suspicious, fearful, or dependent on a family member.
• Loss of initiative, such as sleeping all the time, watching television all day, or not wanting to do any usual activities.

Symptoms that may be but are not always present include:

• Firmly held false beliefs (delusions), such as that someone is stealing from the person.
• Seeing or hearing things that aren't really there (hallucinations).
• Lack of interest in surroundings or activities, or withdrawal from family and friends.
• Purposeless activity, such as opening and closing a purse, packing and unpacking clothing, pacing, or repeating demands or questions.
• Verbal and physical aggression.
• Inability to control impulses, which may lead to unusual or inappropriate actions. Men are somewhat more likely than women to exhibit behavior problems such as wandering, abusiveness, and social impropriety.

Early in the disease, Alzheimer's usually does not affect a person's fine motor skills (such as the ability to button or unbutton clothes or use utensils) or sense of touch. A person who develops motor symptoms (such as weakness or shaking hands) or sensory symptoms (such as numbness) probably has a condition other than Alzheimer's disease. Conditions such as Parkinson's disease, for instance, may cause motor symptoms along with dementia.

Other conditions with symptoms similar to those of Alzheimer's disease may include:

• Other types of dementia, such as multi-infarct dementia, which is dementia resulting from a series of small strokes.
• Dementia plus not getting proper nutrition, such as being malnourished.
• Thyroid problems, such as hyperthyroidism or hypothyroidism.
• Depression.
• Other problems such as kidney and liver disease and some infections such as HIV (human immunodeficiency virus).