Is it Alzheimer's or just old age?

Not long ago, I started working with a client who was becoming increasingly forgetful. Her children, who lived in another state, hired me after a recent trip home to celebrate Mom’s 80th birthday. As often happens when there are long separations, certain changes (or declines) can seem more pronounced. One daughter noticed that Mom was no longer balancing her checkbook. The other noticed that there was no food in the fridge and that mom had lost weight. They both worried that Mom was not taking her meds correctly, if at all. They had been paying a neighbor to check in on mom several times a week, but they realized that this was no longer enough. They also worried that these signs might indicate Alzheimer’s. Mom, after all, had two of the three risk factors: she was older and her mother had had Alzheimer’s. (Mom did not, however, have the APOE-e4 Risk Gene.)

Alzheimer’s is the most common type of dementia. One in 10 people over 65 have it; one in three over 85 do. It is a disease of the brain which causes problems with memory, thinking and behavior. It is also sometimes easy for families to confuse its symptoms with the signs of normal aging.

One of the most common signs is forgetting recently learned information. In the case of normal aging, a person might forget an appointment, but remember it later. With Alzheimer’s, they might, instead, simply ask you to repeat the appointment details over and over and over.

In the case of my client, the best first step was to set up an appointment with her internist, letting him know ahead of time some of her daughters’ concerns. The internist’s first priority was to eliminate any medical conditions that might mimic Alzheimer’s symptoms, such as a urinary tract infection, side effects and/or drug interactions of Mom’s medications, vitamin deficiency, thyroid issues, even depression or other issues.

Some internists are excellent at conducting an initial screening for Alzheimer’s while others are less so or simply do not have the time. In the case of my client, the physician found enough signs to warrant further testing.

When we called to make an appointment for a new patient, there was a two to three month wait to be seen at UNC. There was a wait period of two to five months at the Bryan Center. Because the family wanted answers quickly, they decided to go for an evaluation to another excellent neurology practice nearby. Raleigh Neurology could see a new patient in four to six weeks.

Alice Watkins, former executive director of Alzheimer’s NC (now called Dementia Alliance), said, “The number one priority is to quickly determine if it is Alzheimer’s or not. If it is, the earlier the diagnosis, the sooner the person receiving the diagnosis can begin to put things in order such as wills, Durable Power of Attorney and Health Care Power of Attorney. They can also begin medications, a healthier diet, exercise and other actions that may slow the progression of the disease. The family also needs to know because they are the ones who will be providing the care.”