Alzheimer's Disease (cont.)
Ten warning signs of Alzheimer's disease
The Alzheimer's Association has developed the following list of warning signs
that include common symptoms of Alzheimer's disease. Individuals who exhibit several of these
symptoms should see a physician for a complete evaluation.
- Memory loss
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
It is normal for certain kinds of memory, such as the ability to remember
lists of words, to decline with normal aging. In fact, normal individuals 50 years
of age will
recall only about 60% as many items on some kinds of memory tests as individuals 20 years
of age. Furthermore, everyone forgets, and every 20 year old is well aware of
multiple times he or she couldn't think of an answer on a test that he or she
once knew. Almost no 20 year old worries when he/she forgets something, that
he/she
has the 'early stages of Alzheimer's disease,' whereas an individual 50 or 60
years of age with a few memory lapses may worry that they have the 'early stages
of Alzheimer's disease.'
Mild cognitive impairment
The criteria for dementia are conservative meaning that a patient must have
had considerable decline in the ability to think before a diagnosis of dementia
is appropriate. The progression of Alzheimer's disease is so insidious and slow that patients go
through a period of decline where their memory is clearly worse than its
baseline, yet they still do not meet criteria for dementia. This transitional
syndrome is called Mild Cognitive Impairment (MCI). Individuals affected with
MCI have cognitive impairment that is demonstrated on formal neuropsychological
testing but are still able to function well. Formal neuropsychological testing
usually means that the patient is administered a battery of standardized tests
of memory and thinking. Some of these tests are something like the IQ tests we
may have taken in school. When these tests were developed they were administered
to hundreds or thousands of people so that statistics are available to say how a
person's score compares to a sample of healthy persons of the same age. If a
person scores in the top 50%, it means that he or she did better than at least
50% of other normal people who took the test. Persons with lower scores - often
in the bottom 7% - are considered to have MCI.
There are several forms of MCI. Perhaps the most common is associated with
impairment in memory but not in the ability to plan and reason. Persons with
this type called "amnestic MCI" (amnestic comes from "amnesia" and means no
memory) have a high risk of developing Alzheimer's disease over the next few years. Persons with
preserved memory but impaired reasoning or impaired judgment (call non-amnestic
MCI) have a lower risk of developing Alzheimer's disease.
As treatments are developed that decrease the risk of developing Alzheimer's
disease or slow
its rate of progression (as of June 2007, no such medication has been approved by
the FDA), recognition of amnestic MCI will be increasingly important. It is
hoped that medications will be developed that will slow the rate of progression
of MCI to Alzheimer's disease or completely prevent the development of
Alzheimer's disease.
Next: What are the causes Alzheimer's disease? »
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