While genetics and an unhealthy lifestyle profoundly influence brain functioning, early symptoms of Alzheimer’s have been known to affect people as young as 30. Regular incidences of memory loss that represent more than just misplacing the keys or occasionally forgetting to sign a check are probably the first signs that something is wrong with the brain, specifically the hippocampus, blood flow and neuronal connections.
Experiencing random memory lapses is a normal part of the aging process for people over 50. However, healthy adults in their 20s, 30s and 40s should not be routinely forgetting names, where they put their keys, or words they regularly use.
Examples of memory and cognitive impairment issues that may indicate early symptoms of Alzheimer’s include:
- Difficulty concentrating or understanding concepts they once had no trouble comprehending (for example, reading a story in a newspaper but not being able to relate its main points)
- Forgetting the rules of a card or board game that is regularly played
- Decreasing ability to judge distances with fairly good accuracy, something that can negatively affect an individual’s driving skill
- Appearing to have trouble following conversations, especially if the conversation involves more than two people
- Placing items in strange places (a TV remote in the refrigerator, for example)
- Using poor judgment when spending money or lending money.
While we all make bad decisions regarding money once in a while, someone suffering the early symptoms of Alzheimer’s will readily fall for a scam or loan someone they barely know large sums of cash.When someone becomes aware that their ability to remember or think clearly is declining, they may start to withdraw from friends and family due to feeling depressed, anxious and even suspicious about their memory problems. Alzheimer’s patients frequently refuse to take the blame for misplacing items and accuse others of trying to aggravate them.
Medical Conditions Mimicking Alzheimer’s Symptoms
Because so many disorders and diseases exist that generate symptoms similar to Alzheimer’s disease, doctors will perform an Alzheimer’s test to determine the correct diagnosis.
- Degenerative disorders affecting the central nervous system (brain tumors, Huntington’s disease, Parkinson’s disease, epilepsy and stroke
- Vitamin deficiencies and metabolic diseases–liver or kidney failure, hypoglycemia, hypothyroidism and malnutrition
- Substance abuse, side effects of medications or drug interactions
- Serious infections (syphilis, meningitis or encephalitis)
No single test is available to diagnose whether early symptoms of Alzheimer’s actually indicates the disease. However, frequently used tests include the SLUMs test and a mini mental status examination.
The St. Louis University Mental Status Examination is an exam given to individuals suspected of experiencing early symptoms of Alzheimer’s disease or dementia. Part written, part oral, SLUMs is used by doctors to determine whether further testing should be conducted and can also be accessed for free online (SLUMs Test).
Examples of questions asked on the test include:
- Please name as many animals as you can in one minute (score is determined by how many animals are correctly recalled–zero to four animals scores a 0, five to nine animals scores a 1 and so on)
- What state are we in?
- You have $100. You purchase a dozen apples for $3 and a tricycle for $20. How much did you spend and how much money do you have left?
- A square, a triangle and a rectangle are shown on the test. The taker is asked to place an “X” in the triangle.
Although short and seemingly unobtrusive, the SLUMs was compared with the MMSE (Mini-Mental Status Examination) by giving both tests to a group of 700 men who were 60 years of age or older. Results of the study found that while both exams detected cognitive problems indicating dementia, it was the SLUMs that initially detected early symptoms of Alzheimer’s consisting of mild memory and cognitive difficulties.
The Folstein Mini Mental Status Examination is also accessible online (MMSE) and involves asking the patient to perform a series of tasks involving cognition.
Examples questions include recalling the date, repeating the names of three objects stated by the examiner, asking the patient to count backwards from 100 in increments of 7 (only five numbers need stated by the patient) and showing the person a paper printed with the words “close your eyes”. Scoring 24 and above is considered normal, while scoring a 22 or 21 may indicate the person is experiencing the early stages of Alzheimer’s.
Additional methods of testing for Alzheimer’s includes blood testing for the presence of antibodies responding to cell destruction, brain imaging techniques such as CAT scans and MRIs and a thorough physical examination testing reflexes, coordination, sense of sight and touch and balance.
The Importance of Early Diagnosis
Detecting Alzheimer’s disease in its earliest stages provides doctors and patients with the ability to start treating the disease with medications that can effectively slow its progression. Current medications that effectively impede symptoms of early Alzheimer’s are cholinesterase inhibitors (Cognex, Exelon and Aricept) and memantine, a drug that regulates glutamate, a neurotransmitter involved with memory and learning. The U.S. Food and Drug Administration has approved both drugs for use in alleviating dementia related to Alzheimer’s.