4 signs of Alzheimer’s disease

Once mom or dad reaches a certain age, it's easy to get swept away by worries about memory loss. Every time she wonders where she put her keys or he forgets his glasses are right there on his head, you probably think, "This is it, the beginning of the end."

Understandable, considering there's currently no cure for Alzheimer's disease. In February, Merck halted a clinical trial for what had seemed to be a promising drug. But then investigators determined there was "virtually no chance of finding a positive clinical effect."  This disappointing news is only the latest in a string of similar letdowns for the estimated 5.4 million Americans with Alzheimer's disease and their families.

It's bleak, yes, but it's not hopeless. Early detection of Alzheimer's symptoms can still lead to early treatment with the medications we do have, used to manage symptoms. Early treatment allows patients to live well for longer, says Dean M. Hartley, PhD, director of science initiatives at the Alzheimer's Association, as well as make plans sooner for if and when the situation worsens. Early diagnosis of Alzheimer's could also land someone in a clinical trial, says Dorene M. Rentz, PsyD, associate professor of neurology at Harvard Medical School, where patients not only receive quality care but could also play a role in new discoveries in prevention and treatment. (Looking to take back control of your health? Prevention has smart answers—get a FREE book when you subscribe today.)

That's why it's important to know what to watch for. Of course, the most common sign of Alzheimer's is memory loss that disrupts daily life. That can take many forms. Some people experience confusion with time or place, difficulty planning, challenges with words, and/or poor judgment, among many other cognitive symptoms. But there are other less-obvious early signs that could tip you off that something's up before Alzheimer's progresses that far.

If you notice these signs in a loved one, a visit to a primary care physician or a neurologist can help rule out other potential causes, Hartley says, like vitamin deficiencies, reactions to medications, or even depression. Those other causes are often treatable, he says, so detecting these signs early, even if they don't end up being due to dementia, can measurably help. Here are a few early Alzheimer's symptoms to keep on your radar.

Apathy

It's possible that someone in the early stages of Alzheimer's disease may start to withdraw from the social activities that used to make them happiest, whether that was going to the movies, having lunch with friends, or playing with the grandkids. "I think they're narrowing their environment to things they feel comfortable with," Rentz says. "This reluctance can creep into the lives of Alzheimer's patients, even in very early stages of the disease." It's not necessarily that they're concerned they'll be forgetful outside of the house though, she says, but rather a growing sense of indifference. Research suggests that indifference among people with mild cognitive impairment may predict progression to developing full-blown Alzheimer's disease.

Changes in personal hygiene or appearance

That apathy may extend to some of mom or dad's typical daily habits, too. Some people with Alzheimer's might wear the same clothes for several days in a row or suddenly stop having their hair done every week. But just because mom hasn't showered in three days doesn't mean she forgot to, Rentz says. "In the early stages of Alzheimer's disease, when apathy begins to increase, the individual may become less concerned about how they look or wearing the same clothes or whether they showered." Families play a crucial role in noticing these types of breaks in the routine. "Tests in a clinic don't pick up on those behavioral changes," Hartley says, "but a family does." (This is what it's like to care for a parent with Alzheimer's.)

Anxiety and depression

If dad has started to notice a bit of his own forgetfulness, it might be making him anxious. Alzheimer's-related anxiety often takes the form of constant question-asking, Rentz says. "New environments may elevate the anxiety, so they'll ask, 'Where are we going? What are we doing? When are we leaving?'" What seems like hyper-attention to vacation details may actually be a forgetfulness cover-up: He simply doesn't remember discussing the itinerary at breakfast.

However, there also seems to be a link between a diagnosis of depression and later developing Alzheimer's disease or other types of dementia, Hartley says. It's not entirely clear yet if the depression is causing the dementia or if it's a reaction to it, so more research is needed in this area, he says.

Vision changes

An older adult in the early stages of Alzheimer's may consult an eye doctor about vision problems while driving, only to find out nothing's actually wrong with his or her eyes, Hartley says. "This can actually be a visual processing problem because the back of the brain deteriorates faster in specific forms of Alzheimer's," he says. It's possible these brain changes could also result in changes in smell or hearing in some people with Alzheimer's. Vision changes may also be signs of other types of dementia, like Lewy Body disease, Rentz adds.

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