Alzheimer’s Disease and What Comes Next

As the population continues to live longer, more and more people are being diagnosed with “dementia.” Think of dementia as a broad term used to describe change or loss of cognitive function. The most common form of dementia is Alzheimer’s Disease, accounting for 60-80% of all patients diagnosed with dementia. Early in the disease, patients with Alzheimer’s Disease struggle with memory impairment.

Patients or family members may notice more difficulty recalling recent events. This is often mentioned at a visit with their primary care provider (PCP) during a routine visit, such as an annual physical. Brief cognitive testing may be performed at that visit, along with basic labs to check for causes of poor cognitive function.

Patients are then often referred to a neurology provider to have further discussions. The discussions during neurology appointments are focused on how the patient is doing at home, are they safe to be living on their own, are they safe to be able to drive, make decisions on their finances, etc. This is not to start taking away the patient’s independence, but to ensure they are safe. Many patients are unaware of the fact they may be struggling to recall information that could be detrimental to their health or safety.

Imaging of the patient’s brain will be performed either by their PCP or the Neurology provider to assess the physical health of the brain. The result of the imaging does not confirm the diagnosis of Alzheimer’s or another form of dementia. Instead, it is used to make sure there is not a reversible cause of memory loss, think a tumor or stroke. In some patients, atrophy, or shrinkage of the brain, does help support the diagnosis of Alzheimer’s, but this may not be present early in the disease process.

After a neurology provider informs a patient that they are likely to have Alzheimer’s Disease, there is obviously a flood of worry and emotions. Patients and family members have questions about what their future holds and what they can do to help slow down progression. To date, there is no cure for Alzheimer’s Disease or other forms of dementia. Medications prescribed by healthcare providers have been shown to slow down the rate of cognitive decline. This is nearly impossible to test to determine if the medications are working, as the patient’s memory is not expected to improve with the medications.

Future visits continue to focus on safety and improving the quality of life of the patient and their caretakers. Often, a care team assembled of a Neurology provider, the patient’s PCP, and a Psychiatry/Psychology provider work with patients and families to meet goals and treat symptoms or concerns that can arise, i.e., mood changes, sleep issues, etc. Social workers and outside facilities may help navigate how to get the patient more help at home, performing household chores, dressing, bathing, taking medications, etc.

Receiving the diagnosis of memory loss can be scary, but we are here to help you and your loved ones navigate this scary time. If you or a loved one is concerned about possible memory loss, please talk with your primary care provider. They can guide the next steps, including testing, referrals, and connecting you with resources for support.

Symptoms of Early Memory Loss

1. Memory loss that disrupts daily life.
Early Alzheimer’s often shows up as forgetting recently learned information, important dates, or asking the same questions repeatedly. Many people start relying on notes, devices, or family for things they once managed alone. What’s a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.

2. Challenges in planning or solving problems.
Trouble following a plan, working with numbers, or concentrating. Tasks like recipes or paying bills may take longer than before. What’s a typical age-related change? Making occasional errors when managing finances or household bills.

3. Difficulty completing familiar tasks.
Daily activities can become harder, such as driving to a familiar place, making a grocery list, or remembering game rules. What’s a typical age-related change? Occasionally needing help to use microwave settings or to record a TV show.

4. Confusion with time or place.
Lose track of dates, seasons, or how they arrived somewhere, especially if it isn’t happening right away. What’s a typical age-related change? Getting confused about the day of the week but figuring it out later.

5. Trouble understanding visual images and spatial relationships.
Vision changes can affect balance, reading, judging distance, or seeing contrast, making driving difficult. What’s a typical age-related change? Vision changes related to cataracts.

6. New problems with words in speaking or writing.
Conversations may be hard to follow, with repeated questions, trouble finding words, or using incorrect names for familiar items. What’s a typical age-related change? Sometimes having trouble finding the right word.

7. Misplacing things and losing the ability to retrace steps.
May put items in unusual places, lose them, or even accuse others of stealing as the disease progresses. What’s a typical age-related change? Misplacing things from time to time and retracing steps to find them.

Connor Golden, PA-C
Neurology Department
Medical Associates Clinic

Sources:
https://www.alz.org