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It can be tempting to brush off early warning signs of cognitive decline in yourself or a loved one as no big deal. Many early symptoms of Alzheimer’s disease, for example, can be chalked up to normal aging. Memory loss, misplacing things—happens to us all, right?
Not so fast, says Monica Moreno, senior director of care and support at the Alzheimer’s Association. While this ostrich-like approach is understandable, it’s not the best way to go. “As much as someone may be afraid of what’s causing their cognitive symptoms, there’s always relief in knowing what you’re dealing with and so much benefit in having a diagnosis,” says Moreno. “If it is Alzheimer’s disease, getting an early and accurate diagnosis can help you feel more empowered as you move forward, seek treatment, and talk with your loved ones about what you want as your need for care increases.”
But in order to access this early intervention, you have to know which early warning signs to look for. “Too many people think the early signs of Alzheimer’s disease are a normal part of aging,” she says. “And while we know there are age-related changes that happen in the brain, these symptoms may signal changes that aren’t normal.” If you’re noticing even one of these signs, it’s important to talk about them and schedule an appointment with your doctor for a cognitive evaluation.
1. Memory loss that disrupts life
We’ve all experienced a lapse in memory at some point—accidentally blanking on the neighbor kid’s name or a friend’s birthday. Occasional memory lapses in which we are able to recall what had eluded us just moments before is normal, says Moreno. What you want to look out for when it comes to possible Alzheimer’s-related memory loss is when it impacts everyday activities. “If you’re forgetting how to do some of the things you’ve done all your life, like simple math or cooking, for example, that’s a sign,” she says.
Moreno once worked with a woman who suddenly started having difficulty helping her grandkids with their grade school math homework even though she had formerly been vice president of a bank. She also worked with an award-winning chef who forgot how to make an omelet. “Another common sign is when someone repeats themselves, unable to remember the answer to a question so they ask it over and over again,” says Moreno.
2. Poor judgment or changes in decision-making
Moreno recalls an incident in which a woman diagnosed with dementia mistook a can of cleaning spray for cooking spray — and spritzed it in the pan she was about to use as if it were olive oil. (Luckily, a family member was there and caught the mistake.) This kind of decreased or poor judgment can manifest in many ways. For example, someone who used to be conscious of her finances may make a number of extravagant purchases.
Changes can also happen in how someone presents themself, such as paying less attention to grooming or even keeping themself clean. “You want to pay attention when behaviors become noticeably different from what had been the norm,” says Moreno. “If there are big changes in someone’s behavior, that’s something to focus on when you’re looking at possible warning signs of Alzheimer’s.”
3. New trouble speaking, writing, or planning
Again, the key here is noticing what’s new about the behavior. For example, people with Alzheimer’s may have trouble following a conversation or joining in when there’s an opening. They may also stop mid-sentence and be unable to continue, or they may struggle with vocabulary, re-naming familiar objects (a “watch” might become a “hand-clock”) or using the wrong word altogether.
This isn’t simply struggling to find a word, says Moreno. “It’s more like someone who’s been a voracious reader all her life noticing that she reads a paragraph or sentence and can’t recall what she just read,” she says. “Or someone who struggles to put their thoughts on paper when it had never been a problem previously.”
Problem-solving or completing tasks with multiple steps may also become tougher. “Following a recipe or planning a dinner party can become a challenge because you’re not able to follow the steps necessary to ultimately complete the task,” says Moreno. “For some, simple problem-solving tasks, like opening a PDF or changing a password on the computer, may become impossible.” If these kinds of things used to be easy for someone to do but now they’re a big deal, it’s a red flag.
4. Confusion with time or place
In the early stage of Alzheimer’s, forgetting how to get somewhere familiar—say, the church you’ve gone to for years or the mall 20 minutes from your house—can happen. “Someone may get lost going to a place they’ve been to hundreds of times before,” says Moreno. Not remembering where you need to be (and when) is another warning sign. “It can become difficult to keep on top of appointments,” she says. “Someone might start missing events or not showing up at agreed-upon times.”
5. Inability to retrace steps when something’s been misplaced
If you’re like most people, you sometimes have “senior moments” where you forget where you put your purse or keys. To find the missing item, you recall where you were or what you were doing when you last saw it—and there’s a good chance you find your purse in your car or your keys in your jacket pocket. These normal hiccups happen to everyone at any age. “However, if you notice you or a loved one misplaces things and can’t retrace those steps, it’s a warning bell,” says Moreno.
6. Changes in mood and personality
Changes in mood or personality can vary greatly from person to person, so it’s important to pay attention to any deviation from the norm. To wit: Someone who’s always been measured and mellow is suddenly reactive and easily angered.
People living in the early stage of Alzheimer’s can become confused, suspicious, fearful, anxious, or depressed—and they can get easily upset with others when they feel out of their comfort zone. “These personality changes are not the person trying to be difficult, it’s the disease affecting their brain,” Moreno says.
7. Withdrawal from work and social activities
It’s common for work to become challenging for many people living with early-onset Alzheimer’s. “We hear stories about someone living with the disease who was fired because they’re no longer able to produce at the level they were before,” says Moreno. For those who are retired, you might notice a hesitation about participating in social activities—even those that the person used to look forward to and enjoy.
“This may be because someone has more difficulty following conversations or engaging like they used to,” Moreno says. “Rather than struggle, they withdraw from those activities and friends because it’s not as comfortable as it used to be.”
Exhibiting one or more of these warning signs does not mean you or a loved one has Alzheimer’s disease, but it’s best to have it checked.
If you are having trouble raising this potentially sensitive issue with a loved one, the Alzheimer’s Association offers tips and conversation starters to help. The Association advises it is best to talk about concerns before a crisis arises. Doing so offers the best opportunity to get an accurate diagnosis, begin an appropriate treatment plan, and discuss plans for managing the future so you can live your best life.
For more information, visit the Alzheimer’s Association’s 10 Early Signs and Symptoms of Alzheimer’s. The Alzheimer’s Association also provides a free 24/7 Helpline (800-272-3900) or live chat available day or night, 365 days a year. Through this free service, specialists and master’s level clinicians offer confidential support and information to people living with the disease, caregivers, families, and the public.
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