Ten Warning Signs of Alzheimer’s Disease Revised by the Alzheimer’s Association

By Carole B. Larkin
Alzheimer's Reading Room

The Alzheimer’s Association of America has revised its 10 warning signs of Alzheimer’s disease.

In order to promote early detection and early diagnosis of Alzheimer’s disease the Alzheimer’s Association of America has updated its list of the 10 warning signs of Alzheimer’s disease.

The Association is doing this because early diagnosis and early intervention (read administration of Alzheimer’s drugs) provide the best opportunities for treatment, support and planning for the future.

Test Your Memory for Alzheimer's -- Self Assessment Tests

The five tests listed below are self assessment tests for Alzheimer's, dementia, and mild cognitive impairment.

If you decide to administer one or more of these tests and the results of the tests seem suspicious you should consult with your personal care physician or a neurologist for a more thorough memory examination and diagnosis.

#1 Test Your Memory for Alzheimer's Dementia in 15 Minutes (SAGE)

This is my number one recommendation for testing memory.

The latest weapon in the war against Alzheimer’s disease is not a fancy new brain scanner or a computer device. Instead, it’s a it a 15 question written exam that could have a dramatic impact on a major problem -- the early detection of Alzheimer's disease.

This handwritten self-assessment test can be taken in less than 15 minutes. SAGE is a reliable tool for evaluating memory and cognitive ability. Findings confirming the validity of the tool were reported in the journal Alzheimer Disease and Associated Disorders.

Go here to learn more about the Self-Administered Gerocognitive Examination (SAGE) including instructions, the test, and scoring system.

Also see:

• Why Test Your Memory Test for Alzheimer's Dementia is Important -- And How You Can Be a Difference Maker
• Simple Pen-and-Paper Alzheimer's Memory Test is Important News (SAGE)

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#2 Alzheimer's Clock Draw Test

Drawing a clock by hand is one of several useful screening tools that can help to detect mild cognitive impairment, dementia, or Alzheimer's. This test can help you, or your doctor, differentiate between normal aging and possible dementia.

If you administer the test on your own and find the results either disconcerting or suspicious, schedule an appointment with your personal care physician. Take the copy of the clock test with you to the doctor appointment, and show the test to the doctor.

Go here for more on the clock draw test including scoring.
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#3 Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes

This test is designed for people that live in England. Results were published in the British Medical Journal (BMJ).

The TYM is a series of 10 tasks including ability to copy a sentence, semantic knowledge, calculation, verbal fluency and recall ability. The ability to do the test is also scored. Each task carries a score with a maximum score of 50 points available. The test is designed to use minimal operator time and to be suitable for non-specialist use.

Go here for the information and follow the links for the test, scoring and scientific study.
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#4 The Mini-Cog Test for Alzheimer's and Dementia

The Mini-Cog is a simple three minute test that is useful in detecting mild cognitive impairment, dementia, or an early stage of Alzheimer's. The research study, included below, showed that the test has a high degree of accuracy (83 percent).

Go here for more information.
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#5 Dr Oz Alzheimer's Memory Quiz (Test)

This memory quiz is based of the Department of Veterans Affairs (VAMC) St. Louis University Mental Status (SLUMS) examination and is an assessment tool for informational and entertainment purposes only.

Go here to take the test.


More About the Alzheimer's Reading Room



Original content Bob DeMarco, the Alzheimer's Reading Room

Alzheimer's Caregiver Advice and Insight

By Bob DeMarco
Alzheimer's Reading Room

The Metamorphosis of This Alzheimer's Caregiver
The more I learned the more I wanted to know. I learned a great deal about Alzheimer's disease and dementia--including the science. It helped me understand a very mystifying disease. It helped me to put a frame around something that is difficult if not impossible to describe.

Communication in Alzheimer's World
Let's face it, dealing with dementia is not easy. Understanding Alzheimer's disease is not easy...

Alzheimer's World -- Two Circles Trying to Intersect
When Alzheimer's strikes communication and behavior change abruptly -- overnight. It is up to the caregiver to adjust since the person suffering from dementia is incapable of the adjustment. Understanding this need is the first big step.

Fruit Smoothie Could Improve Thinking, Memory In Alzheimer's Patients

This article on the smoothie really caught my attention. Why? I drink one of those almost every day. Oddly, when I try to get my mother, the Alzheimer's patient, to drink one along with me she refuses.

A simple fruit smoothie could soon help improve thinking and memory in Alzheimer's patients.



Fruit Smoothie Could Improve Thinking, Memory In Alzheimer's Patients

St. Louis University is the only U.S test center to study whether the drink actually works. The beverage isn't a new drug, but a nutritional drink with a combination of vitamins, antioxidants and lipids that are consumed once a day. The smoothie comes in peach or cappuccino flavors.

Dr. Theodore Malmstrom is one of three researchers looking into what could soon be a very important weapon in the fight against Alzheimer's.

"There is increasing evidence that concentrated components of natural foods can improve memory so those components have been put in a drink and we are hopeful it will help," said Malmstrom.

The goal now is to get actual patients to test it out.

SLU researchers need at least 10 Alzheimer's patients to take part in the study. They are looking for people recently diagnosed with Alzheimer's, but not currently taking medications.

Patients will be divided in two groups. One group will get a daily supply of drinks with nutritional supplements. The other group will get a similar drink but without the nutritional additions.

Results of the 24-week study will hopefully end with good news.

"There is always great hope whenever you can have new research emerging. One of the Alzheimer's Associations mission (is) to fund research programs so we are very excited," said Stephanie Rohlfs-Young, the outreach director for the St. Louis Chapter of the Alzheimer's Association.

The risk of side effects from the drink are very minor compared to side effects from the five FDA-approved medications that treat Alzheimer's.

For more information, contact Malmstrom at 314-577-8745.

Alzheimer's Disease Rate Rises to More Than Five Million in the United States

Someone Develops Alzheimer's Every 72 Seconds, According To New Alzheimer's Association Report.

The Alzheimer’s Association today reports that in 2007 there are now more than 5 million people in the United States living with Alzheimer’s disease. This number includes 4.9 million people over the age of 65 and between 200,000 and 500,000 people under age 65 with early onset Alzheimer’s disease and other dementias.


Read more about this topic at The Alzheimer's Reading Room

Many Alzheimer's caregivers seek help in God

About a third of those who take care of loved ones with the disease feel 'more religious' because of their experiences, a new national study says.


You can read this article at The CareGiver Weblog

The Alzheimer's Reading Room Weblog: Trouble identifying odors points to Alzheimer’s

One thing I noticed a long time ago was that my mother's sense of smell was gone. I am always looking for ways to take better care of myself and of course to detect any symptoms of Alzheimer's in myself and other members of my family. By now you might guess that I will be paying close attention to my ability to detect odors.

Dr. Robert S. Wilson told Reuters Health that difficulty identifying odors seems to be related the buildup of 'tangles' in the brain that appear early in the development of Alzheimer’s disease. “We found the correlation of difficulty identifying familiar odors with Alzheimer’s disease pathology even in people without dementia,” he added.


Go read the entire article at The Alzheimer's Reading Room Weblog: Trouble identifying odors points to Alzheimer’s

Exercise slows decline in Alzheimer's patients

I can attest, exercise makes a difference. My mother now has the tendency to sit around all day. On those days when I can get her to go to Gold's Gym with me she is a completely different person. The look on her face, from dull to smiling, is more than enough to tell me that exercise works to her benefit.

"Nursing home residents with Alzheimer's disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care, researchers have shown."

Read the article in its entirety at the CareGiver: The Book Weblog

Myriad Genetics Presents Additional Flurizan Phase 2 Study Data

Myriad Genetics, Inc. (NASDAQ: MYGN) (www.myriad.com) announced today that it presented additional results of its completed Phase 2 follow-on study of Flurizan™ in patients with mild Alzheimer's disease at the annual meeting of the American Association for Geriatric Psychiatry (AAGP), held March 1-4, 2007 in New Orleans.

Read the release in its entirety at The Alzheimer's Reading Room Weblog

Loneliness Increases Risk for ALzheimer's Disease-Like Dementia

"Social isolation in old age has been associated with risk of developing dementia, but the risk associated with perceived isolation, or loneliness, is not well understood," write Robert S. Wilson, PhD, of the Rush University Medical Center in Chicago, Illinois, and colleagues. "We examined these issues using data from the Rush Memory and Aging Project, a longitudinal clinicopathologic study of risk factors for chronic conditions of old age."



Source Medscape

Lonely elderly patients are more than twice as likely to develop Alzheimer's disease (AD)-like dementia than those who are not lonely, according to the results of a 4-year cohort study reported in the February issue of the Archives of General Psychiatry. However, pathology did not reveal Alzheimer's disease or cerebral infarction, suggesting that novel mechanisms may be involved.

"Social isolation in old age has been associated with risk of developing dementia, but the risk associated with perceived isolation, or loneliness, is not well understood," write Robert S. Wilson, PhD, of the Rush University Medical Center in Chicago, Illinois, and colleagues. "We examined these issues using data from the Rush Memory and Aging Project, a longitudinal clinicopathologic study of risk factors for chronic conditions of old age."

At baseline and annually thereafter for up to 4 years, 823 participants recruited from senior citizen facilities in and around Chicago, underwent uniform in-home evaluations including detailed cognitive function testing, clinical classification of dementia and AD, and assessment of loneliness with a modified version of the de Jong-Gierveld Loneliness Scale. For participants who died, uniform postmortem evaluation of the brain quantified AD pathologic abnormalities and cerebral infarction.

On the 5-item loneliness scale, mean baseline score was 2.3 ± 0.6. During follow-up, 76 subjects developed clinical AD, based on previously established composite measures of global cognition and specific cognitive functions.

Compared with persons who were not lonely (score, 1.4; 10th percentile), risk for AD was more than doubled in lonely persons (score, 3.2; 90th percentile). Controlling for indicators of social isolation did not affect this finding. Loneliness was associated with lower level of cognition at baseline and with more rapid cognitive decline during follow-up. There was no significant change in loneliness during the study, and mean degree of loneliness was robustly associated with cognitive decline and with development of clinical AD.

In 90 participants who died and had brain autopsy, loneliness was unrelated to summary measures of AD pathology or to cerebral infarction.

"Loneliness is associated with an increased risk of late-life dementia but not with its leading causes," the authors write.

Study limitations include predominantly white volunteer cohort, mean observation period less than 3 years, only 76 cases of incident AD, and only 90 autopsies performed.

"The perception of being alone was associated with cognitive decline and development of an AD-like dementia even after controlling for objective indexes of social isolation and other covariates," the authors conclude. "Neither AD pathology nor cerebral infarction could account for the association, suggesting that novel neurobiologic mechanisms may be involved."

The National Institute on Aging and the Illinois Department of Public Health supported this study. The authors have disclosed no relevant financial relationships.

Arch Gen Psychiatry. 2007;64:234-240.

Clinical Context

Little is known about the association of dementia and emotional isolation, although social isolation, defined as having a small social network, being unmarried, and participating in few activities with others, has been associated with increased risk for dementia.

This is a prospective cohort study within the Rush Memory and Aging Project, a longitudinal clinicopathologic study of risk factors for chronic diseases of old age. Loneliness was assessed using a modified version of the de Jong-Gierveld Loneliness Scale, and patients were followed up for incidence of AD and cognitive impairment, and brain autopsies were performed at death.

Study Highlights

Inclusion criteria were absence of dementia and living in retirement communities, subsidized housing, local churches, or social services agencies.
At baseline, all participants underwent structured history, cognitive testing, and comprehensive assessment for AD.
The criteria for AD were from the joint working group of the National Institute of Neurological and Communicative Disease Disorders and Stroke-Alzheimer Disease and Related Disorders Association.
A modified version of the de Jong-Gierveld Loneliness Scale with a 5-point Likert scale was used for self-reported symptoms of loneliness.
Social isolation was assessed by social network size and frequency of participation in social activity, rated on a 5-point scale.
Depressive symptoms were assessed with a 10-item form by the Center for Epidemiological Studies–Depression scale for 9 cognitive activities.
Physical functioning was assessed using the Health Interview Survey.
At each annual evaluation thereafter, 20 cognitive tests were administered including the Mini-Mental State Examination and 19 tests with 7 measures of episodic memory.
A composite measure based on all 19 test results was used to quantify cognitive decline.
Postmortem brain autopsy was performed in subjects who died.
857 subjects completed at least one follow-up evaluation.
Mean follow-up period was 3 years.
Mean age was 81 years, 76% were women, mean years of education was 14 years, 91% were white, 66% lived in retirement homes, 30% in single family homes, and 4% in assisted-living settings.
Loneliness was negatively correlated to social network size, frequency of social activity, and cognitive activity and education.
76 subjects developed dementia that met AD criteria.
Those who developed AD were older, more likely to be men, had lower cognitive function, lower income, and higher levels of loneliness and disability.
The risk for AD increased by 51% for each point on the loneliness scale (relative risk [RR], 1.51).
A person with a high degree of loneliness (90th percentile for score) was 2.1 times more likely to develop clinical AD compared with someone with a low degree of loneliness (10th percentile for score).
More frequent social activity was associated with reduced AD risk (RR, 0.52).
Loneliness was inversely related to level of cognitive activity.
The association of loneliness with AD was unchanged after adjustment for race, income, disability, and vascular risk factors.
Loneliness was inversely related to baseline level of function on each cognitive measure.
Loneliness was associated with more rapid decline in global cognition, semantic memory, perceptual speed, and visuospatial ability.
There was no significant change in loneliness during the study.
135 subjects died, and brain autopsy was performed on 90 subjects.
Baseline loneliness score was unrelated to a global measure of AD pathology identified by silver stain, percentage area occupied by amyloid plaques, and density of neurofibrillary tangles.
The authors concluded that the association between loneliness and AD or cognitive decline was not mediated by AD pathology or cerebral infarction.

Pearls for Practice

In elderly persons, those with loneliness vs those without loneliness have an increased risk for AD-like dementia.
Loneliness is not related to AD pathologic findings or cerebral infarction.

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Robert T DeMarco

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New Drug Stops Alzheimer's In Tracks

New Drug Stops Alzheimer's In Tracks

Loneliness and Alzheimer's Linked

"People who are lonely are twice as likely to develop Alzheimer's disease, a large US study has suggested."

Read this article at The Senior Reading Room

New Gene Linked to Alzheimer's

"It fits into what we believe is the main mechanism of Alzheimer's already," Gandy said. "This reinforces the idea that we're on the right track with therapies already in the pipeline, while also suggesting a totally new strategy that could be used to target entirely new classes of drugs."

To read the article in its entirety go to the The Alzheimer's Reading Room.

The Alzheimer’s Reading Room

Everything Alzheimer's Disease. This weblog is for Alzheimer's CareGivers, those touched by Alzheimer's, and those interested in learning more about Alzheimer's disease. The content on this weblog is wide ranging and includes: research, definitions, education, important articles, clinical trials, and content from other CareGiver Weblogs.

To visit the weblog follow this line The Alzheimer’s Reading Room

Decoding Alzheimer's: After a century, promising treatments at last—and whispers of a cure

This is a fascinating article that discusses treatments for Alzheimer’s disease that are on the near term horizon.

"After a century, promising treatments at last—and whispers of a cure"

Read this article in its entirety at The Alzheimer’s Reading Room

Keeping Time with Alzheimer"s

This is an excellent article that can be read in its entirety at the Alzheimer's Reading Room.


"When guilt catches up with me, I am on the bike path above the creek, ducks swimming along beside me. Guilt rolls off our backs like you know what. Alone at last, I walk at my own pace. Fast. Fast is what Ben can no longer do -- and fast is slow compared with the woman coming toward me as I near the marsh. She is wearing shorts and earphones. She smiles and I smile back. What a good idea this is, walking out in the sun and cold. What could produce better clarity? I don't have to work it out the first day. I don't have to do it right the first time."

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Alzheimer's Disease: What is it?

Alzheimer's disease is the most common cause of a condition called dementia. It is named for the German doctor who first described it, Alois Alzheimer. What is it? Who gets it? What causes it?
 

 

You can read this information at the  The Caregiver.

 

Information supplied by the Milton S Hershey Medical center and the CareGiver Weblog.

I'm 45 years old, I can't have Alzheimer's

James Smith remembers the utter shock of hearing his diagnosis.

Click to watch the video, Early diagnosis of Alzheimer's on the Rise


Other Articles

Keeping Time With Alzheimer’s

Alzheimer’s Disease: What is it? Who gets it? What causes it?

I Just Wanted to Scream, STOP!

The CareGiver: Dementia

I ran across this factsheet on Dementia from the Milton S Hershey Medical Center. The section entitled, What are the Symptoms, is particularly interesting.





Source Milton S Hershey Medical Center

Dementia


What is it?

Dementia is the gradual deterioration of mental functioning, such as concentration, memory, and judgment, which affects a person’s ability to perform normal daily activities.

Who gets it?

Dementia occurs primarily in people who are over the age of 65, or in those with an injury or disease that affects brain function. While dementia is most commonly seen in the elderly, it is not a normal consequence of the aging process.

What causes it?

Dementia is caused by the death of brain cells. Brain cells can be destroyed by brain diseases, such as Alzheimer’s disease, or strokes (called vascular or multi-infarct dementia), which decrease blood flow to the brain. Lewy body dementia is another common cause attributed to changes in brain tissue. Other causes can include AIDS, high fever, dehydration, hydrocephalus, systemic lupus erythematosus, Lyme disease, long-term drug or alcohol abuse, vitamin deficiencies/poor nutrition, hypothyroidism or hypercalcemia, multiple sclerosis, brain tumor, or diseases such as Pick’s, Parkinson's, Creutzfeldt-Jakob, or Huntington's. Dementia can also result from a head injury that causes hemorrhaging in the brain or a reaction to a medication.

What are the symptoms?

In most cases, the symptoms of dementia occur gradually, over a period of years. Symptoms of dementia caused by injury or stroke occur more abruptly. Difficulties often begin with memory, progressing from simple forgetfulness to the inability to remember directions, recent events, and familiar faces and names. Other symptoms include difficulty with spoken communication, personality changes, problems with abstract thinking, poor personal hygiene, trouble sleeping, and poor judgment and decision making. Dementia is extremely frustrating for the patient, especially in the early stages when he or she is aware of the deficiencies it causes. People with dementia are likely to lash out at those around them, either out of frustration or because their difficulty with understanding makes them misinterpret the actions of others. They become extremely confused and anxious when in unfamiliar surroundings or with any change in routine. They may begin a task, such as cooking, then wander away aimlessly and completely forget what they had been doing. Dementia is often accompanied by depression and delirium, which is characterized by an inability to pay attention, fluctuating consciousness, hallucinations, paranoia, and delusions. People in advanced stages of dementia lose all control of bodily functions and are completely dependent upon others.

How is it diagnosed?

Dementia is diagnosed through a study of the patient’s medical history and a complete physical and neurological exam. The doctor will speak with those close to the patient to document a pattern of behavior. He or she will also evaluate the patient’s mental functioning with tests of mental status, such as those that require the patient to recall words, lists of objects, names of objects, and recent events. Diagnostic tests, such as blood tests, x-rays, or magnetic resonance imaging (MRI), positron emission tomography (PET), or computed tomography (CT) scans, can help determine the cause of the dementia.

What is the treatment?

In some instances, treating the cause of dementia may successfully reverse some or all of the symptoms. This is the case when the cause is related to a vitamin/nutritional deficiency, tumor, alcohol or drug abuse, reaction to a medication, or hormonal disorder. When dementia is related to an irreversible destruction of brain tissue, such as with Alzheimer’s disease, Lewy body dementia, or multiple strokes, treatment involves improving the patient’s quality of life as much as possible. This includes maintaining a stable, safe, supportive environment and providing constant supervision. While this may be done in the home, people in the advanced stages of dementia may require round-the-clock care in a long-term healthcare facility. It is important to provide the patient with structured activities and avoid disruptions to his or her daily routine. Many patients enjoy therapeutic activities, such as crafts or games, designed specifically for people with dementia. Some medications, such as donepezil and tacrine, have been effective in improving the mental functions of those in the beginning stages of dementia. Patients with hallucinations and delusions may also be treated with antipsychotic drugs, while antidepressant medications are used to treat depression.

Self-care tips

There is currently no known way to prevent dementia associated with Alzheimer's disease. You can decrease your risk of dementia associated with stroke by maintaining a healthy lifestyle, following a heart-healthy diet, and controlling high blood pressure and high cholesterol. Healthy lifestyles, including not smoking and not abusing drugs and alcohol, go a long way in keeping most people in good health. Caring for a person with dementia is stressful. It is important to learn all you can about the disease, seek the help of support groups, and find a responsible caregiver who can give you a break when needed. There are daycare programs specifically designed for patients with dementia that are good for the patient and the family.


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This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.




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The CareGiver: Americans Fear Alzheimer’s More Than Heart Disease, Diabetes or Stroke

A recent study by the MetLife Foundation found that Americans fear getting Alzheimer's disease more than heart disease, stroke, or diabetes. Alzheimer's ranks second in the minds of American's only to cancer.



MetLife Survey Highlights

The Complete MetLife Survey on Alzheimer's: What America Thinks (36 pages)

The Major Findings of the Study included the following:

Finding 1: Americans fear Alzheimer’s disease.

Finding 2: Americans Know Little or Nothing about Alzheimer’s.

Finding 3: One-third of Americans say they have direct experience with Alzheimer’s disease.

Finding 4: Most Americans are concerned that they will be responsible at some point for someone with Alzheimer’s disease.

Finding 5: Most Americans recognize the need to create a plan to address the possibility of Alzheimer’s disease, but very few have taken steps to do so.

Conclusion

Americans fear Alzheimer’s and the impact that it could have on their lives in the coming years. And although they may recognize the need to look toward the future, the majority hasn’t started making plans.

The downside of living longer has a high price: Nearly 50 percent of those who are 85 or older are affected, and the rate of Alzheimer’s increases exponentially every five years past the age of 65. And with the aging of America’s population these numbers are sure to become even more dramatic in the future, making it imperative that individuals and institutions plan for the future.

The growing number of people with Alzheimer’s will have an impact on every part of society. The vast majority of people know that this disease may someday affect them, either directly or as a caregiver. In addition, many already know a family member or friend who has Alzheimer’s. They strongly support the concept of planning now to cope with the life-changing impact of the
disease – at least in theory.

Despite widespread agreement, few have taken steps to prepare for the possibility of developing Alzheimer’s. Only a few have a solid understanding of the disease. The overwhelming majorityhas done nothing to plan.

The survey reveals a mismatch between fear of Alzheimer’s and acting on that fear to prepare for the future. The findings from this survey suggest that there is an opportunity to build awareness and help bridge the gaps that were identified in knowledge and behavior. Americans should learn all they can about the disease that will touch so many of us and plan for the future.


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