The early signs of Alzheimer’s can be subtle and often difficult to differentiate from symptoms of the natural aging process. There are certain behaviors however that may be early indicators of Alzheimer’s, especially if they persist and begin to disrupt daily life. With early detection and diagnosis, more can be done to mitigate the onset and progression of Alzheimer’s disease.
According to medical professionals, the following are common signs to watch for and monitor.
- Memory loss. One of the most common, early signs of Alzheimer’s is when someone forgets something they just said. Not something that was said two days ago, but what was said five minutes ago. For example: “Mom, let’s take the dog for a walk.” Mom agrees, gets her coat and says: “Where are we going, the grocery store?” Forgetting names, important dates, or events may also be a sign. When someone asks the same question or relays the same information over and over again, it may also indicate memory loss related to Alzheimer’s.
- Familiar tasks become challenging. The brain doesn’t track as well when it’s beset by Alzheimer’s. An early indicator of the disease is when tasks that were once simple and routine become difficult and confusing. Forgetting how to make coffee in the morning, figuring out what to wear, or tying shoelaces could all be indicators that these familiar tasks are becoming more challenging. When numbers get confusing (numbers on a restaurant check for example), it may also be an early sign of Alzheimer’s.
- Confusion with time and place. If someone is continually confused about where they are or what time it is, it may be an early sign of Alzheimer’s. For instance, if they think that it’s time to eat breakfast at midnight, wonder why they ended up in the garage or when they were going to the kitchen. Likewise, if they think they’re at the library or the next-door neighbor’s and they’re actually still at home, it might be time to seek professional advice.
- Problems with speaking and writing. Another early sign of Alzheimer’s is when someone struggles to complete a sentence. Your loved one may forget what they’re saying or get stymied trying to find a word. My mother was an avid reader who prided herself on her vocabulary and grasp of the English language. An early sign of her dementia was her inability to find the words she wanted. Truly at a loss for words, she would give up. She would also use the wrong word sometimes and not know it: “the woof is making too much noise” (as in dog). Since Alzheimer’s changes the way in which someone expresses themselves through language, it may be helpful to understand some basic practices for communication in all stages of Alzheimer's. Writing may also become problematic. Normal hand to eye to brain coordination may be compromised.
- Misplacing things. We all do this as we grow older. But an early sign of Alzheimer’s is when someone is constantly losing things. When they can’t retrace their steps, recall what they did or where they were. Not only do they misplace things, but they also put them in unusual places. My mother put her shoes in the microwave once. She also put my shoes in her closet. (I thought I was the one losing it. I couldn’t find them for days!) She liked to take things from my room, thinking they were hers, and “put them away.”
- Compromised decision making and judgment. An unusual, rash action or an odd judgment call may also be an early sign of Alzheimer’s. For example, a parent selling their home without telling anyone else in the family, or a loved one giving all the family china and silver to the gardener. Other unusual behavior -- such as walking into town in their bathrobe (my mother’s specialty!) -- may also be a sign.
- Social withdrawal. If someone who was always social, active, and engaged suddenly withdraws and becomes reclusive, it may be another early sign of Alzheimer’s. Playing bridge and spending time with grandchildren were once favorite activities for my friend. When she constantly resisted these, it was another warning sign. Sometimes an individual recognizes they aren’t as competent or comfortable in social situations. They may be pulling back to avoid embarrassment, inevitably missing out on the health benefits of socialization and sense of purpose within their community.
- Anxiety and depression. Memory failure and an inability to handle new situations and unfamiliar environments can be very stressful. This can lead to high anxiety levels and depression which may also indicate the onset of Alzheimer’s. The anxiety may manifest itself as worry; your loved one may begin fretting about things more than ever before. The depression may manifest itself as an apathy – a disinterest in doing anything. While researchers can’t say whether depression is caused by Alzheimer’s or is a reaction to it, clearly there is a link.
- Apathy and malaise. Even if a person doesn’t seem depressed, they may start to demonstrate a disinterest in activities that were once enjoyed. They may be unable to motivate themselves to do anything. This apathy or malaise may be other early signs of dementia. When someone doesn’t want to get out of bed, get dressed, or even eat, something’s not right. This new indifference may be a result of suppressed depression or an inability to process information and/or communicate well.
- Changes in mood and personality. Aging is not easy and can make anyone cantankerous. But when someone who is usually polite, charming and lovely gets mean and angry easily, it could be another early warning of Alzheimer’s. Another sign to be aware of is if a loved one suddenly becomes more distrustful or suspicious.
- Changes in personal appearance. When a well-groomed person who has always taken pride in their appearance no longer does, it could be an early sign of Alzheimer’s. Disregard for personal hygiene may also be a sign, such as forgetting to shower regularly or failing to comb their hair. Dressing in a haphazard, sloppy fashion, or an inability to match shoes and socks may also be part of the cognitive decline brought on by Alzheimer’s.
- Impaired vision. While someone’s actual vision may not have changed, with Alzheimer’s their brain may be changing. The part of the brain that processes vision deteriorates faster than others, so changes in eyesight may be another early sign of Alzheimer’s.
What to do When a Loved One is Exhibiting Symptoms of Alzheimer’s
If these symptoms persist and are interfering with a loved one’s ability to lead a normal life, it’s time to intervene or at least start carefully monitoring their well-being. Don't let yourself or a family member remain in denial about what may be Alzheimer’s. With early diagnosis, treatment and proper support, the progression of Alzheimer’s can sometimes be mitigated. It’s never too soon to learn what can be done to ensure a loved one’s health, happiness, and safety.
- See a medical professional. There are many tests today that can help determine whether someone is suffering from Alzheimer’s. There are also many treatments and medications that may help. If a loved one is suspect about a trip to the doctor, it could be done under the guise of a routine medical exam.
- Enlist the support of family and friends. Don’t try to manage this alone. A network of support is needed.
- Locate local support groups. These can be an invaluable resource offering practical advice as well as emotional support for caregivers. You will find that you are not alone.
- Educate yourself. Go online and you’ll find lots of information about Alzheimer’s. A lot of research and advice is readily available. This is not a “new” disease. There is significant clinical research today which provides a better understanding of Alzheimer’s and what we can do about it.
- Make their home safe. Implementing home safety measures for those with Alzheimer’s is essential for mitigating risk and supporting your loved one in their home. Adapt living quarters so they are easier to navigate. Remove or relocate low tables or décor that could be a risk. Make life simpler – have all their daily toiletry items within easy reach by the bathroom sink. You may have to lock the front door from the outside so your loved one can’t wander out to the street. It’s all about taking the necessary precautions to ensure their safety at home if they are confused or disoriented, especially if they are living alone.
- Suggest driving alternatives. It may not be safe for them to continue driving. Taking the car keys away from an aging loved one is never easy. Start conditioning your loved ones with the idea of letting others do the driving. Whether it’s Uber, Lyft, or a local senior car ride program, there are many car services today. We got my mom to accept this with the idea of having her own “chauffeur”. How special is that?! Besides, why drive if you don’t have to? Why hassle with traffic and parking if you don’t have to?
- Ensure out and about safety. When your loved one is out and about whether it’s a walk in the park or a trip to the corner market (all of which I would encourage), make sure that you or someone reliable is there to help them get out and about safely. If someone is exhibiting Alzheimer’s symptoms, it’s best that they aren’t alone when they go out to do errands. Wandering in seniors with Alzheimer’s can be dangerous, and proper precautions can prevent your loved one from getting lost or even hurt. I can’t tell you how many times I lost my mom in a department store or the grocery market even when I was with her! It’s great that they get out and about, but make sure they have an “escort”.
- Make their cell phone accessible. Cell phones have GPS! Make sure their cell phone is with them at all times and accessible. Program your cell phone number into their “favorites” if it isn’t there already. There are attractive neck lanyards with pocket pouches where cell phones can nest, readily available. You’ll be able to find them, and they can find you.
- Schedule regular visits from family and friends. If your loved one lives alone, put together a schedule so that someone is visiting in person or at least calling on a regular basis. Not only will this provide you with peace of mind, it provides much-needed social interaction for someone with Alzheimer’s who may begin to withdraw.
- Promote exercise, healthy diet, brain games & social interaction. All of these have been clinically proven to mitigate the onset of Alzheimer’s and slow its progression. Encourage regular exercise even if it’s just walking every day for 20-30 minutes. We now know that a nutritious diet is good for brain health – use these nutrition tips for seniors with Alzheimer’s for a diet that’s low in sugar and high in fresh foods, fruits, vegetables and low-fat protein. Brain games for seniors such as crossword & jigsaw puzzles, reading, and card games all stimulate the brain, and so does social interaction.
There isn’t a cure for Alzheimer’s but in many instances, there is much that can be done to slow its progression. If you are aware of the early warning signs and can respond accordingly, it can make a big difference. Be patient, be compassionate, and don’t forget to take care of yourself as well.