Looking beyond memory loss
Your dad just asked the same question he asked — and you answered — a few minutes ago. You realize that it’s not the first time he's repeated himself or forgotten something you just said. What does this mean? Does he have Alzheimer's disease?
Memory changes can be scary, both as an older adult experiencing them and as a family member or caregiver noticing them. But it's important to note that forgetfulness doesn't necessarily equal Alzheimer's disease.
"The red flag is if it's happening on a consistent basis and is paired with a change in the person's ability to function," says Magdalena Bednarczyk, MD, a geriatrician at Rush University Medical Center. "When a patient comes to me for an evaluation, it's usually because family and friends have noticed uncharacteristic or concerning behaviors, not just memory issues."
According to Bednarczyk and the Alzheimer's Association, if you notice any of these 10 signs — especially more than one — talk to your loved one about seeing their primary care doctor or geriatrician as soon as possible:
1. Memory loss that disrupts daily life.
Lots of things can make you occasionally forgetful, including stress, taking certain medications or just having a lot on your plate.
But it should raise a red flag if you or your loved one is frequently doing the following:
Forgetting recently learned information or important dates or events
Mixing up family members or friends, or not recognizing them at all
Repeating the same question or story in a short amount of time
Relying increasingly or exclusively on reminders (e.g., notes) or family members to handle tasks that previously were easy to remember to do
"When we talk about memory changes, we're referring to short-term memory, not long-term memory," Bednarczyk explains. "Your mom may be able to recall going on a family vacation when she was 12, but she doesn't remember eating lunch that day, or that she took her medication an hour ago."
2. Challenges in planning or solving problems.
This could mean difficulty concentrating on solving your daily crossword puzzle, keeping track of finances (e.g., losing track of bills and forgetting to pay them). It may also be more difficult to stay organized or multitask, especially when there are a lot of moving parts.
"For instance, your mom loves cooking and always has the entire family over for holiday meals," Bednarczyk says. "But now it seems to be too much for her to handle, she's getting overwhelmed or frustrated, and she says she doesn't want to host the holidays anymore."
3. Difficulty completing familiar tasks.
"It's concerning when a person starts needing help with the day-to-day things they take for granted," Bednarczyk says, "when it becomes challenging to complete simple tasks that they've done many times before, whether at home, at work or during social engagements."
This may mean struggling to make a dinner reservation, fill out a report at work or pack lunch for work.
4. Confusion with time or place.
Some people are just bad with directions. But it should be of concern when a loved one suddenly forgets where they are or becomes disoriented in familiar places (e.g., they can't remember how to get home from the office). Or if they frequently lose track of dates or don’t know what time of day it is.
5. Trouble understanding visual images and spatial relationships.
Vision problems can be a sign of Alzheimer's, including difficulty reading, judging distances, and determining color or contrast.
For instance, your loved one falls down the stairs or off of a curb because they misjudge the height of the step-down. Some people with Alzheimer's also don't recognize their own reflections.
When a patient comes to me for an evaluation, it's usually because family and friends have noticed uncharacteristic or concerning behaviors, not just memory issues.
6. New problems with speaking, writing or understanding words.
We all have times where we're searching for the right word. Hence the phrase, "It's on the tip of my tongue."
But a person with Alzheimer's will likely have trouble following or joining a conversation, and struggle with vocabulary, such as finding words or calling things or people by the wrong name. They also tend to repeat themselves without being aware of it.
It may also be increasingly difficult to follow along with books, movies or TV shows, especially when they are long or complex.
7. Misplacing things and losing the ability to retrace steps.
People with Alzheimer's may put things in unusual places — like sticking a phone in the microwave, or car keys in the bathroom cabinet. They may accuse others of stealing because they can't remember that they were the one who misplaced the item.
If things start disappearing or things start popping up in odd places and your loved one doesn't have a toddler or dog in the house, there may be cause for concern.
8. Showing decreased or poor judgment.
This may mean giving large amounts of money to telemarketers or falling prey to con artists. It may also mean neglecting personal hygiene or cleaning house.
Of course, some people are naturally messier than others, so look for other accompanying symptoms.
9. Withdrawal from work or social activities.
A person experiencing memory loss may start to remove themselves from hobbies, social activities, work projects or sports.
They may simply have trouble keeping up with what's going on. But they also may feel self-conscious about the changes they're experiencing and not want others to notice.
10. Changes in mood and personality.
Watch for behaviors that are out of character. Is the person acting confused, suspicious, depressed, fearful or anxious more than usual? Are they getting easily upset in situations that didn't used to cause agitation, or at times when they're out of their comfort zone?
These signs may indicate Alzheimer's, or they may signal that something else is wrong, like depression or a bad reaction to medication. "That's why it's important to see a doctor for an evaluation as soon as possible," Bednarczyk says. "The doctor can help figure out exactly what's going on — and how to help."
It may, however, be difficult to talk to your loved one about these changes and convince them to see a doctor. If you need suggestions on how to approach your loved one or what to say, Bednarczyk offers expert advice in 6 Tips for Talking About Memory Loss.