University Times

Alzheimer's disease: When forgetfulness becomes a cause for real concern

John is a 68-year-old retiree. He lives indepen- dently with his wife, still drives a car, handles the family finances, enjoys walks and lively discussions with friends, golfs at least once a week and generally performs all of the functions of a responsible adult. But he has become a little forgetful.

While everybody at one time or another forgets where they've placed their keys or the garage floor on which they've parked their car, John's forgetfulness is a bit worse. Two, three, four times, he has agreed to met his friends for lunch and forgotten. A couple of times, he also has scheduled appointments with his doctor and not shown up.

The situation, in fact, has reached the point where family members have begun to comment on John's forgetfulness. It has even been suggested that something serious is happening. And sure enough, when John is tested, his memory is found to be functioning below the norm for his age group.

What John is suffering from is Mild Cognitive Impairment, according to Ronald Peterson, professor of neurology at the Mayo Clinic. He cannot be classified as having Alzheimer's disease, but he could be at risk. Peterson described a person such as John when he spoke on "Mild Cognitive Impairment: Normal Aging or Early Alzheimer's Disease?" on Nov. 12.

November is National Alzheimer's Disease Month. Peterson's appearance was co-sponsored by UPMC Health System's Alzheimer's Disease Research Center and the Greater Pittsburgh Chapter of the Alzheimer's Association.

"General cognitive function is down a little bit, memory down a lot," said Peterson of individuals such as John. "It is a category of people who are clearly at risk." Although Peterson's lecture was heavily geared toward health care professionals working with Alzheimer's disease patients, plenty of general information on the disease, including possible warning signs, was available at the symposium.

Alzheimer's disease is the most common cause of dementia, a major form of mental impairment, in older people. The disease affects the parts of the brain that control thought, memory and language. Symptoms include confusion and an inability to carry out routine, everyday tasks.

Initially, according to the National Institute on Aging, the only symptom of the disease may be a mild forgetfulness. In later stages, behavioral and personality changes such as aggressive acts or aimless wandering may accompany a marked cognitive decline. According to Peterson, patients with Alzheimer's disease usually decline by 10 percent to 15 percent each year.

The National Institute on Aging estimates that four million people in the United States suffer from Alzheimer's disease. It usually occurs after age 65, but younger people also may develop the disease. The risk of Alzheimer's increases steadily with age. According to recent estimates, about 3 percent of people ages 65 to 74 have Alzheimer's and nearly half those over age 85 could have the disorder.

Although the risk of getting the disease increases with age, it is not a normal part of aging, according to the National Institute on Aging.

Alzheimer's disease is named after Alois Alzheimer, a German psychiatrist who in 1906 described changes in the brain of a woman who had died of an unusual mental illness. Alzheimer found abnormal plaque deposits and tangled bundles of nerves in the woman's brain that have since come to be recognized as characteristic of the disease that bears his name.

To help alert people to the possible onset of Alzheimer's disease, the Alzheimer's Association has developed the following 10 warning signs of Alzheimer's disease. According to the association, persons who exhibit several of the symptoms should see a physician for a complete examination.

* Recent memory loss that affects job skills. It is normal to occasionally forget assignments, colleagues' names or a business associate's telephone number, and then remember it later. Persons with Alzheimer's may forget things more often and not remember them later.

* Difficulty performing familiar tasks. Busy people can be so distracted at times that they forget to serve the carrots for dinner. People with Alzheimer's not only may forget to serve an item for dinner, but that they even prepared dinner.

* Problems with language. Everybody has trouble finding the right word at times, but a person with Alzheimer's disease may forget simple words or substitute inappropriate words, making his or her sentences incomprehensible.

* Disorientation of time and place. It is normal to forget the day of the week or a destination for a moment. But people with Alzheimer's can become lost on their own street, not know where they are, how they got there or how to get home.

* Poor or decreased judgment. Normal people may become immersed in an activity and forget about the child they are supposed to be watching. People with Alzheimer's disease may entirely forget that a child has been left in their care. They also may dress inappropriately, wearing several shirts or blouses at the same time.

* Problems with abstract thinking. Balancing a checkbook can be disconcerting to anyone on occasion. Someone with Alzheimer's, however, may completely forget how to do it and have no concept of numbers.

* Misplacing things. Anybody can misplace their wallet or their keys. The Alzheimer's victim may put things in completely inappropriate places, such as an iron in the freezer or a wristwatch in the sugar bowl.

* Changes in mood or behavior. Everybody becomes moody from time to time. But individuals with Alzheimer's disease can exhibit rapid mood swings for no apparent reason.

* Changes in personality. The personalities of normal people change somewhat with age, but a person with Alzheimer's disease can change drastically, becoming extremely confused, suspicious or fearful.

* Loss of initiative. It is normal to tire of housework, business activities or social obligations, and then regain the initiative. Persons with Alzheimer's disease, though, may become very passive and require cues and prompting to become involved.

–Mike Sajna