It happens to us all. You’re in the middle of a conversation about a book when you realize that you can’t remember the title or the author’s name. You start to introduce a friend to an acquaintance and suddenly can’t remember either name. You find yourself standing in front of the refrigerator wondering exactly why you opened the door.

We know what you’re thinking: Is it Alzheimer’s disease (AD)? Or another form of dementia?

If you’re concerned about memory loss and what you can do to preserve your memory well into your senior years, you need reliable, accurate information.

If you’re worried about AD, the first step is to talk to your primary care physician about any symptoms you’ve been experiencing. Because diagnosing AD is primarily a process of elimination, your medical history and any recent health changes you’ve noticed might point to an explanation other than dementia. Your physician should screen you for depression, which can impair memory and cause anxiety, irritability, and poor concentration.

Your physician should also inquire about any medications and dietary supplements you are taking: Are you taking the proper dosage? Are you on the right schedule? Has another physician recently prescribed a new drug or changed your dosage? Again, medications can have effects that mimic those of AD, and this possibility must be ruled out.

Why Diagnosis is so important?

When people notice mental slips and fear dementia, they may be reluctant to push for testing. There is, after all, no cure for AD. But a positive diagnosis, while frightening, offers some positive opportunities such as;

• Treatments can slow the progression of the AD, giving you more time to enjoy with friends and family.
• When AD is caught early enough, it allows people to participate in their own healthcare decisions.
• Early diagnosis provides time to prepare psychologically, spiritually, and financially for the inevitable consequences of the disease.
• Early diagnosis also gives a potential caregiver, typically a family member, more time to obtain the education and training needed to provide a dignified and healthy life for their loved one.

Causes of AD

Despite tremendous advances in the understanding of AD, scientists have yet to pinpoint a true cause for the disorder. Some patients may have a single underlying cause, but in others, a whole host of factors appear to interact in some way to bring on the disease. Old age is the strongest risk factor for AD; others are Down syndrome, a family history of dementia, and the presence of a specific form (e4) of the gene that makes a certain protein, called apolipoprotein E, or APOE.

Women may also be at higher risk for AD than men; and cardiovascular disorders such as high blood pressure and heart attack are also possible risk factors. Another possible risk factor is head injury. Other conditions that have been considered potential triggers of AD include immune system malfunctions, endocrine (hormonal) disorders, slow-acting viruses, and toxins.

Progression of AD

AD advances slowly in three general symptomatic stages, ranging from mild forgetfulness to severe dementia. Symptoms of the first stage—which include impaired memory of recent events, faulty judgment, and poor insight—appear most commonly after age 70. (However, in a small group of patients, symptoms may emerge as early as age 30 or 40.) In the first stage of the disease, people with AD may forget important appointments, recent family events, and highly publicized news items. Other symptoms include frequently losing or misplacing possessions, repetition of questions or statements, and minor or occasional disorientation.

As the disease progresses into the second stage, memory problems grow worse and basic self-care skills begin to decline. AD patients may have trouble expressing themselves verbally or in writing, and may be unable to perform everyday activities such as dressing, bathing, using a knife or fork, or brushing their teeth. They may also suffer from delusions or hallucinations.

In the third stage, people with AD lose almost all capacity for reasoning. They may end up completely dependent on others for their care. The disorder eventually becomes so debilitating that patients cannot walk or feed themselves and become susceptible to other diseases. Lung and urinary tract infections are common. Pneumonia is the most frequent cause of death.

Age-related memory loss or AD can be a challenge, but educating yourself will provide you with practical advice and peace of mind.

I encourage our readers to look for more information on the John Hopkins Hospital web site where you can find additional information. I also want to take this opportunity to thanks John Hopkins hospital for the great job they are doing in an effort to keep our patients educated and informed on AD.