The Alzheimer Society of Canada is warning that too many seniors are dismissing the early signs of dementia as just “normal aging,” and waiting too long to ask their doctor about their symptoms.
The society recently completed a survey of nearly 1,000 caregivers of Alzheimer’s patients, and found that about half said their loved ones waited a year or longer after their symptoms began before going to see a doctor. Almost 16 per cent waited more than two years, the survey found.
Those delays can hold up care and prevent people from accessing the medications that can help slow the disease in some patients, the Alzheimer Society says.
The online survey found that the most-cited reason for delaying diagnosis was the belief that Alzheimer’s disease symptoms, such as memory problems and confusion, were normal or would eventually go away.
Almost 40 per cent of respondents said they didn’t take the symptoms more seriously because many of the symptoms seemed to come and go.
The most common early symptoms cited by survey respondents were:
Frequent memory loss affecting day-to-day function, such as continually forgetting where the person put things or what they were doing.
Disorientation of time and place, including getting lost even in familiar places or not knowing what month or year it is.
Changes in personality or acting out of character, such as becoming suspicious, fearful or confused.
Elizabeth Allen, who was diagnosed with Alzheimer’s disease in 2006, wants patients who are noticing memory problems to seek help quickly, pointing out that the process itself of getting a diagnosis can eat up a lot of valuable time.
Allen says when she realized she couldn’t keep track of instructions when following a recipe, she went to her family doctor first, who first checked for hormone and thyroid problems.
Alzheimer’s Disease: Making a Diagnosis Click for print view
The absolute diagnosis of Alzheimer’s disease can only be made at autopsy. However, physicians at specialized centers can diagnose Alzheimer’s disease with 90 percent certainty based on clinical information. To make the diagnosis the following may need to be conducted:
A medical history and neurological exam
Neuropsychological testing involves a careful analysis of a person’s memory, problem solving, language, attention, and visuospatial ability.
Basic blood tests
Blood tests may be used to help exclude other causes of memory difficulties. For example, a person with a thyroid disorder or a vitamin deficiency may have problems with his or her memory.
A brain scan such as an MRI or a CT scan may need to be done in certain patients to detect brain tumors or strokes. These disorders may cause memory problems.
“We went through many things before she finally sent me to a neurologist,” Allen told CTV’s Canada AM Wednesday.
“And it took another year before I had the appointment. And then it took another year and half for her to finally diagnose it, because there are a lot of other things you have to rule out first,” she said.
Memory Loss and Dementia
Many people become forgetful as they become older. This is common and is often not due to dementia. There are also other disorders such as depression and an underactive thyroid that can cause memory problems. Dementia is the most serious form of memory problem. It causes a loss of mental ability, and other symptoms. Dementia can be caused by various disorders which affect parts of the brain involved with thought processes. Most cases are caused by Alzheimer’s disease, vascular dementia, or dementia with Lewy bodies. Symptoms of dementia develop gradually and typically become worse over a number of years. The most important part of treatment for dementia is good-quality support and care for the person with dementia and for their carers. In some cases, treatment with medicines may be helpful.
Alzheimer Society CEO Naguib Gouda says many of those who wait to ask their doctor about their symptoms regret that decision later.
“We found that once people understood the benefits (of early diagnosis), 75 per cent said they wished they had gone to see their doctors sooner,” Gouda told Canada AM.
While there is no cure for Alzheimer’s disease, there are medications that can work on some patients – but the drugs are typically most effective in the earliest stages of the illness.
“The earlier you have access to the drugs that are available… the more likely these drugs are to help manage your symptoms and potentially even slow down the progression of the disease,” says Gouda.
Even if the medications aren’t effective, there are other benefits of getting a diagnosis early in the disease’s progression. A diagnosis gives patients time to alert their family and arrange caregiving. It also gives them time arrange their finances and legal affairs, before memory problems make such tasks too difficult.
Ten Warning Symptoms of Alzheimer’s disease or dementia.
Memory Loss That Affects Job Skills
It’s normal to occasionally forget assignments, colleagues’ names, or a business associate’s telephone number and remember them later. Those with a dementia, such as Alzheimer’s disease, may forget things more often and not remember them later.
Difficulty Performing Familiar Tasks
Busy people can be so distracted from time to time that they may leave the carrots on the stove and only remember to serve them at the end of the meal. People with Alzheimer’s disease could prepare a meal and not only forget to serve it but also forget they made it.
Problems with Language
Everyone has trouble finding the right word sometimes, but a person with Alzheimer’s disease may forget simple words or substitute inappropriate words, making his or her sentence incomprehensible.
Disorientation of Time and Place
It’s normal to forget the day of the week or your destination for a moment. But people with Alzheimer’s disease can become lost on their own street, not knowing where they are, how they got there or how to get back home.
Poor or Impaired Judgment
People can become so immersed in an activity that they temporarily forget the child they’re watching. People with Alzheimer’s disease could forget entirely the child under their care. They also may dress inappropriately, wearing several shirts or blouses.
Problems with Abstract Thinking
Balancing a checkbook may be disconcerting when the task is more complicated than usual. Someone with Alzheimer’s disease could forget completely what the numbers are and what needs to be done with them.
Anyone can temporarily misplace a wallet or keys. A person with Alzheimer’s disease may put things in inappropriate places: an iron in the freezer, or a wristwatch in the sugar bowl.
Changes in Mood or Behavior
Everyone becomes sad or moody occasionally. Someone with Alzheimer’s disease can exhibit rapid mood swings (from calm to tears to anger) for no apparent reason.
Changes in Personality
People’s personalities ordinarily change somewhat with age. But a person with Alzheimer’s disease can show drastic personality changes, becoming extremely confused, suspicious, or fearful.
Loss of Initiative
It’s normal to tire of housework, business activities, or social obligations, but most people regain their initiative. The person with Alzheimer’s disease may become very passive and require cues and prompting to become involved.
[These warning signs were taken from publications of the National Alzheimer’s Association.]
The third benefit is simply the peace of mind that can come from getting a firm diagnosis. Then, if it is Alzheimer’s, patients can learn more about the disease and what to expect from it.
“It’s really about not suffering from the uncertainty of not knowing. And it’s about developing coping skills,” says Gouda.
Linda Finkbeiner took her husband, Jim, to the doctor six months after she began noticing he was getting more forgetful and less interested in certain activities.
She believes an early diagnosis allowed Jim to find a specialist, begin taking medication and tell his family about the disease.
“That early diagnosis gave me quality time with my husband,” she told CTV News.
Alzheimer’s disease will affect 1.1 million Canadians in the next 25 years.
The Alzheimer Society encourages Canadians to visit its Let’s face it! campaign site to learn more about the warning signs of dementia and download a Preparing for your doctor’s visit checklist.
With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip
Angela Mulholland, CTVNews.ca