Symptoms and Complications

Mild forgetfulness is normal with advancing age, but healthy older people are usually good at remembering what's most important to them. There is reason for concern if they start forgetting what they were just doing, get lost in their own neighborhood, or start displaying uncharacteristic or inappropriate behavior. If your husband is always misplacing his keys, it may mean nothing. If he starts leaving them in the fridge or the sugar bowl, it may be cause for concern.

One of the most recognizable symptoms of Alzheimer's disease is a speech problem, such as a person choosing the wrong words, or not understanding simple sentences. Problems with numbers are also common. These are the most reliable signs of early-stage Alzheimer's disease. Other early signs include forgetfulness about recent events (loss of short-term memory), trouble with tasks such as housework or balancing a checkbook, and poor judgment.

In the later stages, people with Alzheimer's disease begin to have trouble caring for themselves and recognizing friends or loved ones. They may become confused, agitated, or aggressive.

The Alzheimer's Association lists these 10 warning signs to be aware of:

• changes in mood and behavior
• changes in personality
• difficulty performing familiar tasks
• disorientation of time and place
• loss of initiative
• memory loss affecting daily functions
• misplacing things
• poor or decreased judgment
• problems with abstract thinking
• problems with language

Making the Diagnosis

Unfortunately, there's still no safe, definitive test for Alzheimer's disease. The diagnosis is made based on the type and progression of symptoms and by eliminating the many other possible causes of dementia, which include:

• vascular dementia - caused by small strokes that damage brain tissue
• nutritional and vitamin deficiencies, such as pernicious anemia or pellagra
• liver, kidney, heart, lung, or thyroid disease, which can all cause temporary or permanent mental impairment
• dementia pugilistica - "boxer's brain," caused by repeated head trauma
• Parkinson's disease, Huntington's disease, or end-stage multiple sclerosis - Parkinson's in particular can be hard to distinguish from Alzheimer's disease, as they share many symptoms
• depression - this very treatable condition is sometimes mistaken for Alzheimer's disease
• medications - several medications can cause symptoms (e.g., agitation, confusion, or disorientation) that look like Alzheimer's disease (These medications include some pain medications and certain medications used for depression or anxiety. Talk to your doctor or pharmacist to find out whether a medication you or a loved one is taking could cause these symptoms.)

These and other possible causes of dementia can mostly be identified with a few tests and questions. If the symptoms of Alzheimer's are present, and there's no other explanation for them, the physician will give a diagnosis of "probable Alzheimer's disease." Don't cling to false hopes if you or a loved one get this diagnosis - it's right 9 times out of 10.

Treatment and Prevention

Because there is currently no cure for Alzheimer's disease, treatment focuses on relieving symptoms and maintaining the quality of the person's life. Certain medications can help maintain brain function. However, the course of the disease is such that it eventually continues to worsen.

Fortunately, there are a number of ways to help people with Alzheimer's disease that do not involve medications. These include:

• reminder notes
• personal organizing tools, such as date books and beepers
• providing instructions for activities such as bathing, eating, and dressing
• family counseling and support
• behavior training for inappropriate behaviors

The behavior changes of Alzheimer's disease can be very distressing to people and their families or caregivers. Medications may be used to control severe agitation or behaviors which may result in physical harm or are very distressing to the person. However, in many cases agitation can be controlled without medications.

Not enough is known about the causes of Alzheimer's to provide clear advice about how to prevent it. Research into the effects of tobacco and alcohol is just getting underway, but there's still no hard evidence one way or the other. These drugs are clearly linked to other forms of dementia, however - it's a good idea for people who want their brains to stay healthy to avoid both.

Contact your local Alzheimer's society for more information on new advances in research and suggestions for helping a person who has Alzheimer's disease.