Nearly six million seniors are living with Alzheimer’s disease in the United States, and that number is about to go up drastically. The size of the population aged 65 and older is projected to grow from 56 million in 2020 to 88 million by 2050, leading experts to warn of a dramatic increase in Alzheimer’s diagnoses, as well. Researchers are still working to find a cure, but until then, early diagnosis is the most promising route for Alzheimer’s patients.
Early detection of Alzheimer’s is key both for those affected and their families, says Dr. Fatima Naqvi, vice chair of Geriatrics at MedStar Montgomery Medical Center in Olney, Maryland. “An early diagnosis provides more possibilities for care and treatment and allows people to plan ahead while they are still able to make important decisions and advocate for themselves,” she says. “These advantages result in a higher quality of life for the patient.”
Here’s what you need to know about spotting the early signs of Alzheimer’s, what to expect from a diagnosis and how caregivers can help patients navigate the process.
How to spot the early signs of Alzheimer’s
Many experts believe that Alzheimer’s disease may begin 20 or more years before symptoms arise and that changes to the brain may go undetected for decades. Over time, however, this degenerative disease damages nerve cells in the brain to the point that it impacts a person’s daily functions.
According to the Alzheimer’s Association, some of the most common early signs of Alzheimer’s disease include:
Challenges with problem-solving or planning
This may include difficulty working with numbers or following directions, such as keeping track of bills or following a recipe. Occasional errors are to be expected, but a pattern of mistakes and concentration issues may suggest a deeper issue.
Difficulty completing familiar tasks
Driving to a familiar location, playing a favorite game or accomplishing simple tasks like organizing a grocery list may suddenly seem extremely challenging for someone with Alzheimer’s.
Feeling confused about the day and time
They may forget the day of the week or even season and may experience confusion about where they are and how they got there.
Unprecedented communication challenges
Alzheimer’s patients may have trouble keeping up with a conversation, struggle with vocabulary, stop speaking mid-sentence or repeat themselves frequently.
Misplacing things and having difficulty retracing steps
It’s common to misplace things as we age, but Alzheimer’s patients may put items in strange places and then struggle to have any recollection of where they placed them. As the disease progresses, they may even accuse other people of stealing.
Changes in mood or personality
People with Alzheimer’s may act confused, depressed, anxious or even fearful. They may be easily upset at home as well as in unfamiliar situations.
Withdrawal from social activities
Previously favored activities like spending time with friends, keeping up with a favorite sports team or engaging in a hobby may no longer be enjoyable for someone with Alzheimer’s.
Memory loss that disrupts daily life
Naqvi lists red flags like forgetting recently learned information, forgetting important dates or events, asking the same questions and an increased reliance on family members for things they used to handle on their own. “These are separate from the expected memory loss that may come with the normal aging process,” she notes. To distinguish normal signs of aging with Alzheimer’s disease, an official diagnosis is required.
How is Alzheimer’s disease diagnosed?
So how is Alzheimer’s diagnosed? Unfortunately, there is no one test to diagnose Alzheimer’s disease. It’s a multi-step process that may require a team of various physicians. Here’s what that might look like.
Begin with a trusted primary care physician
This should be the first point of contact in the Alzheimer’s diagnostic process, says Jennifer Tucker, COO of Homewatch CareGivers. “The PCP will be able to first address concerns against the backdrop of knowing the patient’s health history,” she adds.
Seek out an Alzheimer’s specialist
The patient’s primary care physician will likely refer them to another type of specialty provider that specializes in Alzheimer’s disease. A specialist — such as a cognitive neurologist, psychologist, psychiatrist or geriatrician — will then take the next steps toward making an official diagnosis.
Check out your local Alzheimer’s Association for a list of Alzheimer’s disease and dementia specialists in your area.
Get tested
“We use a combination of medical history, physical and neurological exams, mental evaluations, diagnostic tests and brain imaging to fully diagnose a patient,” Naqvi says. MRIs and CT scans can help rule out conditions that cause similar symptoms to Alzheimer’s, such as hydrocephalus or brain tumors.
The future of testing
Researchers continue to work toward developing an accurate way to detect Alzheimer’s disease before symptoms start. Biological markers (biomarkers) are one of the most promising paths being investigated, according to the Alzheimer’s Association. A biomarker is something that can be measured to indicate the presence of a disease — as in how a particular blood sugar level can indicate the presence of diabetes.
Researchers are currently studying biomarkers such as beta-amyloid and tau levels in cerebrospinal fluid, both of which are hallmark abnormal proteins that have been linked to Alzheimer’s dementia. Experts are also exploring brain changes detected by imaging.
Supporting patients with an Alzheimer’s diagnosis
Because the prospect of an Alzheimer’s diagnosis can be overwhelming, it’s important for family members and caregivers to handle the process with care. Here are several tips for discussing the subject with a loved one, according to experts.
Get ahead of the issue
Iris Waichler, a patient advocate and author of “Role Reversal, How to Take Care of Yourself and Your Aging Parents,” suggests starting the conversation before your loved one is in crisis. “[Say] you want to understand what their wishes are as they age and what you can do to help them get the best possible care and remain as independent and healthy as possible,” says Waichler, who cared for her own parents in their final years.
Get to the root cause of any pushback
Some patients may be resistant to admitting their symptoms or seeking treatment. Tucker encourages caregivers to dig deeper into the root cause of any resistance. “Your loved one may see accepting help as being vulnerable, or that they will be a burden to their family,” Tucker says.
Address the type and cost of care
“When having the initial conversation about care, ask your loved one what kind of care they would prefer and enlist the help of other family members,” says Tucker. “Describe to them the positives of care and explain to them your needs for wanting this. You can even suggest a trial run for them to see how they like it.” Be sure to discuss any long-term care insurance or savings your loved one may have that can put used toward covering their care.
Treatment for Alzheimer’s disease
Though there’s no cure for Alzheimer’s disease, there are a number of prescription medications that have been shown to slow the progression of the disease, helping to maintain mental function and manage behavioral symptoms. Exercise, lifestyle changes and dietary modifications may also be beneficial, particularly to patients in the early to middle stages of Alzheimer’s.
And there’s hope for even more treatment options in the future, Naqvi says, explaining, “The good news is there is a worldwide initiative underway to better understand and treat the disease, delay its onset, and hopefully, one day, even prevent it from developing.”
As intimidating as it may be, an Alzheimer’s diagnosis can help patients and their loved ones create a clear path forward — especially when the diagnosis happens early. A strong care team will answer questions, set expectations and explain treatment options every step of the way to ensure that your loved one can maintain a good quality of life for as long as they can.
