Have you been worried about an older person’s memory or thinking skills? If so, you’ve probably found yourself wondering if this could be Alzheimer’s, or another dementia.
What to do next? If you look online or ask people, the advice is generally this: tell the doctor.
This advice isn’t wrong, but it’s incomplete. Yes, you should tell the doctor. But you’ll dramatically improve your chances of getting to the bottom of things if you come to the doctor with useful information on what you’ve observed.
In fact, research has found that interviewing family members about the presence or absence of eight particular behaviors can be just as effective, when it comes to detecting possible Alzheimer’s, as certain office-based cognitive tests.
8 Alzheimer’s Behaviors to Track
For each of these behaviors, try to make note of the following:
- Whether there’s been a decline or change compared to the way your parent used to be
- Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities
- When you – or another person – first noticed problems, and what you observed
- What kinds of problems you see your parent having now
If you don’t notice a problem in any of the following eight areas, make a note of this. (E.g., “No such problem noted.”) That way you’ll know you didn’t just forget to consider that behavior.
Have you noticed:
- Signs of poor judgment? This means behaviors or situations that suggest bad decisions. Examples include worrisome spending, or not noticing a safety issue others are concerned about.
- Reduced Interest in Leisure Activities? This means being less interested and involved in one’s usual favorite hobbies and activities. You should especially pay attention if there isn’t a physical health issue interfering with doing the activity.
- Repeating Oneself? Has your parent started repeating questions or stories more than he used to?
- Difficulty Learning to Use Something New? Common examples include having trouble with a new kitchen appliance or gadget. This can be a tricky one to decide on, given that gadgets become more complicated every year. But if you’ve noticed anything, jot it down.
- Forgetting the Year or Month? Especially once one stops working, it can be easy to lose track of the date or day of the week. But if you notice your parent forgetting the year or month, make a note of this.
- Difficulty Managing Money and Finances? Common examples include having trouble paying bills on time, struggling to balance the checkbook, or otherwise having more difficulty than one used to have managing finances.
- Problems with Appointments and Commitments? If you’ve noticed that your parent is having more trouble keeping track of appointments and plans, make note of this.
- Daily Struggles with Memory or Thinking? It’s normal for older adults to take a little longer to remember things, since many brain functions do slow a bit with aging. But it seems that your parent often can’t remember things that happened, or otherwise seems to be more confused with thinking, make note of this.
For more on diagnosing Alzheimer’s and other dementias
If you’re worried that your older relative might have dementia, I recommend you learn more here:
How We Diagnose Dementia: The Practical Basics to Know
My book, “When Your Aging Parent Needs Help“, also comes with worksheets to help you check for signs of dementia, a handy checklist of what information to bring to the doctors, and more.
Remember, being proactive usually leads to better results and less stress overall!
I particularly like this approach because it emphasizes empowering the caregiver or family member. Arriving at your doctor’s office with specific information and helpful hypothesis is a great approach. Thanks!
My mil I believe has Altzheimers Disease and LBD set in. The other relatives who sponsored her here from another country, dismiss the possibility of any type of neurological disorder. When she is checked out, it will be for medical assessment not mental assessment. All of the Medical tests come out normal, so they She is fine. They won’t do a mental assessment. This is wrong. I have no control over her mental needs. If I ask for help they either ignore me or yell at me saying I am complaining. Her ins would cover the proper mental treatment that could effect her medically in the future. They are doing what they think is right to do. I see no love, compassion or proper conduct. I will never forgive them. Me Nd my husband are left to “Carry The Burden.” Absence Without Heart!?
Hm, well if she is having memory or thinking problems, she should have an assessment that checks for medical causes but also documents her cognitive state and addresses any abnormalities.
If you are not in charge of what happens with her evaluation, that can be very frustrating, especially if you are being asked to take care of her.
You could consider looking for a therapist or professional, to help you discuss this issue within the family, or at least to help you set some limits on how you will be helping. Geriatric care managers are professionals that have experience with memory issues, they can’t do the complete evaluation or diagnosis on their own, but they would at least be well positioned to back up your concerns (or to reassure you). Good luck!
Alzheimers and dementia run rampant in my family. I feel like I’m in a catch-22 situation. I’m 55. Male. I was diagnosed with bipolar II a couple of years ago after decades of depression and severe chronic insomnia. Drugs used to treat both are often associated with decreased cognitive function and memory loss. Depression and insomnia wreak havoc on the brain by themselves. So this seems like a “choose your poison” type of scenario. Do you have any advice?
Thank you
The connection between use of medications and Alzheimer’s or other causes of cognitive impairment has been studied extensively, but we still don’t have a clear picture. It seems that the effects of medications like antihistamines, benzodiazepines and anticholinergics on cognition are real, but probably mostly short term and reversible.
Depression seems to be associated with the development of dementia, especially if the depression is recurrent, or comes on in later life. There isn’t good evidence that this is a causal relationship, and in fact late life depression could be the earliest symptom of dementia, rather than a cause of dementia.
My advice to a middle-aged person with a mood disorder who’s concerned about dementia risk, is to strive for an active lifestyle, avoid smoking and excessive alcohol use, eat a healthy, Mediterranean style diet and manage mood symptoms as well as possible. This may include taking antidepressant mediations for many people, which is preferable to having poorly managed mental health issues that get in the way of healthy habits.
I live with a 75 year old man I am 62 .and the day to day situations are beyond ridiculous, hes paranoid verbally abusive,rude ,expects me to do everything for him but treats me bad ,I am spent and will probably leave to get my own place in June, he has two sisters who do nothing for him but steal his money,
I’m sorry to hear about your partner. If you think he is living with dementia, an evaluation by a medical professional might be helpful. Check out this article about getting a dementia diagnosis.
You might also be interested in this one about capacity if you think huis sisters are taking advantage of him financially. or this video about elder abuse.
Remember to have a plan for your own safety in this situation. Thanks for reading the article and stay safe.
Hello. Our brother lives in another state. He lives alone. We have noticed during the past several years that his cognitive abilities are declining. Could you give us some guidance as to how we should approach the situation? He is a proud person who wouldn’t be open to us scheduling a cognitive assessment. He is also a hoarder and values items that have not real value. We are at a loss.
~ His brothers and sisters
It’s never easy to bring up the issue of changes in memory with a family member. This article might be helpful to learn more about how a dementia diagnosis is made.
If your brother has a family doctor or other primary care provider, it might be a good idea to share your concerns with him or her. The doctor might not be able to share info with you, without your brother’s permission, but you can share letters or documents with them, without violating privacy legislation. You can let the provider know about the hoarding as well, although this is often a longstanding pattern and can be along and painstaking process to deal with.
You might also want to check out Dr. Kernisan’s new book: “When Your Aging Parent Needs Help: A Geriatrician’s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, & More” . The communications strategies and steps to take to figuring out the best way to help a family member could be applied to a sibling or a parent.
You can pre-order the book here:
https://www.amazon.com/Aging-Parent-Needs-Step-Step/dp/173615320X/ref=sr_1_fkmr0_1?dchild=1&keywords=dr+leslie+kernisan&qid=1611329842&sr=8-1-fkmr0
My sister is demonstrating all the eight signs of Alzheimer’s listed above. I have tried to discuss my concerns with her however when I do, she becomes extremely defensive and refuses to discuss any possibility of a problem with her memory. I am at a loss for what to do for her. Her primary care physician told her she felt she was paranoid and she refused to see her anymore. She lives alone and I am extremely concerned about discissions she makes concerning her finances. What should I do??
What a stressful situation you’re in. It’s too bad that she’s fired her family MD, as that’s often a great route to go to express your concerns.
In some regions, you can call Adult Protective Services and ask for a worker to be assigned to your sister’s case. Unless there’s serious self-neglect though, they may not be able to do very much.
Dr. Kernisan’s new book is for children who are helping aging parents, but many of the issues the book covers could be applied to helping other family members too. The book provides advice on how to communicate with someone who’s living with dementia and resisting help.
Why cant I stop obsessing that I have dementia? The MOCA came back at 22. I should be fine. Right? So why am I so afraid? Most days I can function pretty well even though I had to give up practicing law. . What if it’s just the insomnia and anxiety? I can’t put my finger on anything really wrong. A little memory problem. Uncharacteristic bursts of anger. Can’t keep track of my bills and my money anymore A few other things. But a lot of little quirks don’t necessarily add to to anything right? My daughter won’t talk about it. She says wait till after the neuropsych test. That’s 3 months away. How can I wait!!! Is there anything I can read or do to rule out this supposed thing so I know one way or the other ? I just want to know
It’s really difficult to wait for test results, especially for weeks or months. I see a lot of people in my practice who have major anxiety about their cognitive performance, and the irony is that that anxiety can worsen cognitive performance! So it can be a bit of a vicious cycle.
The diagnosis of dementia is based on memory testing but also on the history of the changes that are being observed, and sometimes a brain scan can help, but usually mainly to rule out other conditions.
The truth is that without a brain biopsy (that we don’t do routinely), you may never know for 100% certain if you do or don’t have dementia, until enough time passes to see how things change, whether they improve or worsen. In the meantime, maintaining healthy habits for your brain is the best way to relieve stress and prevent vascular events that can increase the risk of dementia or worsen its course.
I hope that helps to reassure you and I hope you get good news!
My Father died 3 months ago, yesterday, after having been in the hospital for over a month.
Two weeks later I had to put my horse down – I was there when she was born 27 years ago.
In the next month or so I realized my mother had beginning dementia. My father had been doing EVERYTHING for the past several years – shopping, cooking, paying the bills, etc. My 84 year old mother lost her drivers license a couple of years ago, having totaled 2 cars. They paid a lawyer $4500 to help her get her license back – she should not have been driving, but, my father said he would never hear the end of it if they didn’t try. She proceeded to badly fail the driving test 2 times and was told in writing that she would not be tested again. She blames the test giver and insists she’s going to get a license again… Her memory is poor, yet she insists it’s perfect. Three credit cards have gone to collection, but, she insists she can pay the bills. The only reason the water and gas are still on is because of COVID-19. I am an only child, I have no POA, and she fights me on everything…
Help!?!
My father was also 84 – on one of his good days in the hospital, he told me I be sorry if he died.
Now I know why…
It sounds like you have a lot on your plate right now and I’m so sorry for your losses.
An older parent’s driving is a tough issue for many families. Dr. K has a new book ““When Your Aging Parent Starts Needing Help: a geriatrician’s step by step guide to memory loss, resistance , safety worries and more” which is an excellent resource for someone in your position. You can find out more about it here.
There are no quick fixes when an aging parent shows signs of poor decision making, and it takes careful assessment and information gathering to know the best way to start. A Geriatrician or primary care provider would be a great ally in the process, if your mom would agree to go. Sometimes focusing on a physical rather than a cognitive issue is a more successful strategy. I made a video about the driving issue, which you can watch on my YouTube channel, here: https://youtu.be/VX4AiEQG9UY
Hope these resources help!