Doctors Answer Your 5 Most Pressing Questions About Alzheimer’s Disease
So many women have this superpower: the ability to pretend absolutely nothing is wrong and focus on everyone else. But trying to gloss over symptoms while also praying they’re nothing serious can be dangerous to your health—particularly when it comes to mental changes that could point to Alzheimer’s disease or other forms of dementia.
What you should do instead: See a doctor as soon as you notice questionable cognitive signs, because memory impairment may not be Alzheimer’s at all—it could be another issue entirely. And even if something serious like Alzheimer’s is the culprit, there’s more you can do than you think, and it’s important to get a jump on it. Here, experts answer your questions about the what-to-dos when you suspect that your brain—or the brain of someone you love—isn’t performing the way it should.
Many memory issues are everyday snags (don’t fret!),but others might be a reason for you or a loved one to see a doctor. The experts at the Alzheimer’s Association pinned down key differences between what you should get looked at and what’s just part of being human. Here are several things to watch for:
•Memory loss that’s more than occasional.
Just a normal day: Making a simple error in something you’re cooking, like forgetting to add the salt or sugar.
Worth checking out: You can’t remember the pancake recipe you’ve made every Saturday for the past 15 years.
•You have challenges in completing familiar tasks.
Just a normal day: Not remembering which of the remotes goes with the DVD player you rarely use.
Worth checking out: You aren’t sure how to work your washing machine and need to ask for help.
•You have trouble with time and pace.
Just a normal day: Not knowing which day of the week it is but still being able to figure it out.
Worth checking out: Losing track of the season or forgetting where you are or how you got there.
•You misplace things without being able to find them.
Just a normal day: Losing your car keys, but eventually determining where they landed.
Worth checking out: You can’t find your jacket when you’re leaving a gathering and can’t remember whether you even wore one.
•You have a tough time conducting or following a conversation
Just a normal day: Grasping for the right word to use.
Worth checking out: Stopping in the middle of an exchange and not being able to continue, or repeating yourself.
If you have a heart problem, you see a cardiologist. Suspicious mole? Go to a dermatologist. But when it comes to Alzheimer’s, which physician to see isn’t as obvious.
Start with your family doctor or nurse practitioner, but know that many don’t specialize in the diagnosis and care of people with Alzheimer’s. In fact, a survey conducted by Women Against Alzheimer’s and Nurse Practitioners in Women’s Health found that a majority of nurse practitioners felt little confidence in their ability to address memory and brain health. So if you’re worried about forgetfulness, ask your healthcare provider if he or she thinks you should consult a specialist such as a neurologist.
What you’re looking for is someone who spends a significant portion of his or her time diagnosing and caring for people with memory impairment. No matter whom you plan to see, ask the following when you call for an appointment: “Is the doctor someone who regularly does evaluations of adults who have memory problems or Alzheimer’s?” Not every one does—some specialize in stroke or other brain concerns. It’s worth making a few extra calls to ensure that you get the right care.
Hiding symptoms and living in fear of what they could mean is understandable, but exactly the opposite of what experts wish people did. There are advantages in preparing to manage Alzheimer’s, says John Schall, CEO of Caregiver Action Network. Here are three benefits to consider:
•You may be able to take medication. The current options may help mitigate symptoms for a few months or a couple of years. The catch: The longer you wait to find out what’s going on, the less useful they may be. One class of drugs (cholinesterase inhibitors) prevents the breakdown of a chemical that helps nerve cells communicate with one another. The other drug (memantine) may be prescribed in later stages and regulates a chemical process involved in learning and memory.
•You find relief. People who’ve been diagnosed early say that discovering what was up finally explained symptoms that had frustrated them. Plus, it helped to know that certain blips were the disease’s fault, not necessarily theirs.
•You ease the burden. One of the most caring things you can do for the people you love is to be diagnosed before symptoms interfere with your ability to have input in planning, and prior to some kind of crisis. Finding out can be tough, but it’s an act of love.
That used to be the case. Now there are some tests, but they’re either invasive or expensive. Currently, doctors use a spectrum of initial cognitive tests to check your memory. If a problem is confirmed, your doctor will then want to rule out anything else that could be causing symptoms. “You shouldn’t assume all memory issues are Alzheimer’s; there are treatable causes of memory impairment,” says Ronald Petersen, M.D., Ph.D., director of the Mayo Clinic Alzheimer’s Disease Research Center. For example, sleep apnea symptoms, depression, and medication side effects can masquerade as Alzheimer’s. As a next step in the process, you might have to do more cognitive checks—sometimes two hours of various oral, written, or computerized tests.
And when it comes to a brain scan, surprisingly, most available technology doesn’t always tell the whole story. MRI scans are mostly used to rule out other issues, and glucose PET scans can potentially identify patterns of activity consistent with Alzheimer’s but are not conclusive, says Dr. Petersen. Specialized PET scans found in research settings can reveal if you have elevated amyloid (one of the proteins that builds up in Alzheimer’s and prevents your mind from working well) in your brain, but those tests can be expensive. Your best course of action is to work with your physician and/or a specialist to figure out what the root cause of any memory issue might be.
If you’re caring for someone with dementia or Alzheimer’s, a support network can be critical to your well-being. Resources are different in every community, so contact your local Alzheimer’s Association chapter for support groups in your area. If you’re caring for your partner, check out the Well Spouse Association, which offers in-person and phone support group services for spousal caregivers. Finally, visit the Family Caregiver Alliance to find state-specific information on support networks, legal resources, and government programs.