Judd Matsunaga
How long has it been since you lost your mind? As we get older, subtle changes in you can be considered “normal aging,” such as occasionally forgetting where you put your car keys, forgetting the name of an acquaintance or struggling to find a word but remembering it later. But dementia — which blocks a person’s ability to remember, think clearly or make daily decisions — is NOT a normal part of aging.
According to the CDC website (www.cdc.gov/alzheimers, Aug. 14, 2024), an estimated 6.9 million Americans aged 65 and older are living with dementia. That’s about 1 in 9 people (10.9 percent) of the U.S. population. People with dementia have problems with one or more of these things: (1) Memory; (2) Attention; (3) Communication; (4) Reasoning, judgment and problem solving, and (5) Vision problems such as depth perception, processing visual cues or recognizing objects.
According to the CDC website, early detection seems to be the key to getting possible treatment. So, here are 10 warning signs of Alzheimer’s from Dr. Leslie Kernisan, board certified geriatrician and founder of the website “betterhealthwhileaging.net.” If you spot any of these warning signs with yourself or your older loved one, it might be time to get a medical evaluation.
1) POOR SHORT-TERM MEMORY
People often think this is normal with aging, but it’s not. It’s especially worrisome if they keep forgetting what happened recently or if they keep asking repeated questions because they can’t remember what they were recently told. Now, you should know that it’s extremely common for short-term memory to be affected but for long-term memory to be preserved for much longer.
2) REPEATING THE SAME STORIES
Now, why might a person be repeating the same story when they have early Alzheimer’s? One is that they may not remember that they just told you the same story recently. Another is that even though they’re having trouble with memory or thinking, some people still feel a drive to be socially respectable. So, they want to make the listener happy by making conversation. Or, I think in other cases, people are trying to cover up their memory problems because they realize at some level that if they keep saying something, they might be asked fewer questions.
3) DIFFICULTY WITH IADLs
Instrumental Activities of Daily Living are the life skills that we often learn as teenagers. They include things like managing finances, grocery shopping, cooking, home maintenance. In early Alzheimer’s, we often see people struggle to do things they used to do pretty easily, especially those activities that require a few steps. And the person often has trouble explaining why they couldn’t do it, or they’ll just deny that they had any trouble with it at all. This phenomenon is generally related to people developing difficulty with executive function and problem solving. And it’s common to have trouble with these skills in early Alzheimer’s.
4) DENYING DIFFICULTIES OR MISTAKES
Not only do many people with early Alzheimer’s have difficulty doing things they used to do, but it’s really common for them to either deny they had trouble or otherwise seem unaware of it. Now, it can sometimes be hard to tell if a person is truly unaware of their problems versus denying them because they’re embarrassed or worried that their independence is going to be taken away. But in general, we know that Alzheimer’s often affects insight, and people often have trouble remembering or perceiving difficulties they are experiencing. So, if this is happening to your parent or someone you care about, it’s very frustrating if they keep denying things, but you need to remember that they aren’t necessarily being stubborn or purposefully trying to deceive you. It’s probably lack of insight due to their brain changes.
5) ACCUSING OTHERS
Number five on my list is accusing others of taking things, stealing things, hiding things or misplacing things. For instance, the older person might start accusing others of having taken their wallet or purse or their glasses. And it sometimes comes up before the person is otherwise showing signs of memory loss that are obvious to the family. Why might this be happening? In many cases, it’s the older person who has misplaced their belongings due to memory problems or confusion. But they either can’t remember that or can’t really accept that so they conclude that someone else has taken the item.
6) DEVELOPING DELUSIONS
Occasionally, one of the earliest symptoms of Alzheimer’s is delusions, also known as false beliefs. Delusions often have a paranoid flavor, meaning they involve suspicion and fear of harm from others. The elder can become quite convinced that this is true.
7) DEVELOPING HALLUCINATIONS
A hallucination is when a person perceives something that others don’t. So, a visual hallucination means seeing something that others don’t, and an auditory hallucination means hearing something that others don’t. Hallucinations are sometimes an early warning sign of Alzheimer’s or another dementia. Visual hallucinations are actually associated with Lewy body disease, which is another common cause of dementia in older adults. In Lewy body disease, it’s fairly common for the person to report seeing children or animals.
8) GETTING LOST
Getting lost while driving or walking is another warning sign. Getting lost in familiar surroundings is another concerning symptom that sometimes pops up early. It can be related to memory problems, but it can also be related to difficulties with spatial memory or with recognizing familiar landmarks.
9) TROUBLE WITH SPEECH
Alzheimer’s often affects the part of the brain that manages language early on. So, one early warning sign is having trouble naming things or finding the right word. If people can’t name an object that’s shown to them, or if they use a descriptor instead of the name of the object, such as the thing you sit on, instead of saying chair, that would be concerning. It would also be concerning if they start to use words that aren’t quite right, such as saying book to refer to a newspaper.
10) UNCHARACTERISTIC BEHAVIORS
This is when things happen that leave others who know the person saying, “That’s so weird. This is so unlike them.” Sometimes, it’s uncharacteristic spending or risk-taking, or it’s actions that reflect impaired judgment. Other times, it’s a change in social appropriateness or in how the person engages socially. So, it might be someone starting to blurt out inappropriate things, or it could be that someone who used to be very social becoming withdrawn and much quieter.
In conclusion, if you’ve noticed one or more of these signs in your aging parent (or in someone you care about), Dr. Kernisan says to help them get an adequate medical evaluation so that you can find out what is causing the memory loss or other symptoms. But that, of course, can be tricky. “I don’t want you to panic, but I do want you to pay attention and keep thinking about how you can support your aging parent,” said Dr. Kernisan.
Judd Matsunaga is the founding attorney of Elder Law Services of California, a law firm that specializes in Medi-Cal Planning, Estate Planning and Probate. He can be contacted at (310) 348-2995 or. The opinions expressed in this article are the author’s own and do not necessarily reflect the view of the Pacific Citizen or constitute legal or tax advice and should not be treated as such.
