By JUDD MATSUNAGA, ESQ.
A recent survey revealed that nearly half of adults aged 40 and older think they will likely develop dementia. An estimated 6.9 million Americans aged 65 and older are living with dementia. That is about one in nine people (10.9%) of the U.S. population, according to an article on the CDC website (www.cdc.gov/alzheimers, Aug. 14, 2024).
According to the CDC website, it is common to experience changes in functioning as we get older, including some changes in memory. With normal aging, your overall memory, thought, and brain functions stay intact. This includes the knowledge and experiences you gained over years, old memories, and language.
As we get older, subtle changes in your memory can be frustrating. Such as occasionally forgetting where you put your car keys, forgetting the name of an acquaintance, struggling to find a word but remembering it later, and forgetting the most recent events. These are considered “normal aging,” which may also include weakening muscles and bones, stiffening arteries and vessels, and some age-related memory changes.
But dementia — which blocks a person’s ability to remember, think clearly, or make daily decisions — is NOT a normal part of aging. People with dementia have problems with one or more of these things:
- Memory
- Attention
- Communication
- Reasoning, judgment, and problem solving
- Vision problems such as depth perception, processing visual cues, or recognizing objects.
If you (like me) are concerned about your mental health, there are couple of things I wanted to point out that could bring all Rafu readers some comfort. First, there are three advantages of having Alzheimer’s…
1. You can hide your own Easter eggs.
2. You get to meet new people every day.
3. You can hide your own Easter eggs.
Second, although there still is no cure for Alzheimer’s, there is significant hope for a cure as researchers are making progress on new treatments and a better understanding of the disease.
Hundreds of clinical trials are underway all over the world to test new drugs and therapies. I believe science will find a cure for Alzheimer’s. “The LORD said, ‘If as one people speaking the same language they have begun to do this, then nothing they plan to do will be impossible for them.’” (Genesis 11:6 NIV)
New drugs that target and clear amyloid plaques are becoming available, and research is advancing on other fronts, including therapies that target tau protein and stem cell interventions.
New lithium-based compounds have shown potential in reversing Alzheimer’s and brain aging in mice by avoiding the plaque-binding that occurs with natural lithium, reports Harvard Medical School.
Several drugs that remove amyloid plaques from the brain have been developed and are now available for early-stage Alzheimer’s. They may help slow the progression of the disease.
Trontinemab is a potential new Alzheimer’s drug made by drug company Roche, a global healthcare company headquartered in Switzerland. It’s still in development, with a trial due to start in towards the end of 2025.
In the U.S., researchers are working on blood tests and other biomarkers for early detection that have been approved by the US Food and Drug Administration (FDA) to help identify Alzheimer’s. University of Texas Medical Branch (UTMB) researchers have developed a nasal spray that uses an antibody to target and clear toxic tau protein buildup in the brain, a major driver of neurodegeneration. The ultimate goal is to move towards prevention, with researchers focusing on identifying and treating the disease much earlier.
From all I’ve read about Alzheimer’s and other dementia, early detection seems to be 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
Now, people often think this is normal with aging, but actually it’s not. And 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.
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. So for instance, we often see that older adults with early Alzheimer’s are still able to remember their childhood or information they’ve known for a long time, but they often have trouble remembering new things.
(2) REPEATING THE SAME STORIES
In particular, repeating the same stories over and over again is a total warning sign for me. Now, why might a person be repeating the same story when they have early Alzheimer’s? I think it’s often about a few things.
One is that they may not remember that they just told you the same story recently. Another thing that I think drives this for some people is that even though they’re having trouble with memory or thinking, they still feel a drive to be socially respectable. And so they wanna 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 (IADLs) are the life skills that we often learn as teenagers. They include things like managing finances, grocery shopping, cooking, home maintenance. And 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, like planning and cooking a meal, making reservations for a vacation, getting the bills paid on time, getting the yard cleaned up, and so forth.
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 to 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
No. 5 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 Alzheimers is delusions, also known as false beliefs. Delusions often have a paranoid flavor, meaning they involve suspicion and fear of harm from others. It’s often something that seems far-fetched or impossible to most of us, something really bizarre to their family or doctors. But the elder can become quite convinced that this is true.
Some of the early delusions I’ve encountered or heard about from families include that people are entering the house, especially at night, that their medications are being replaced by poison, that their spouse is having an affair, that people are out to get them or harm them, that a deceased person has come to visit.
(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 of Alzheimer’s. 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 to start having trouble naming things or finding the right word for things. Now, anyone can have trouble remembering a word every now and then. We’ve all had those, what is it called again? Senior moments. And they do generally become more common as we age.
But 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 “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, “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. One important next step, if you’ve noticed worrisome signs, is to help your parent get an adequate medical evaluation so that your parent and your family can find out what is causing the memory loss or other symptoms. But that, of course, can be tricky.”
Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.