Alzheimer's ABC's: Start With Where We've Been

This is part of a blog series by Dr. John Dougherty, to simplify and demystify Alzheimer’s disease, and help you better recognize the signs and symptoms.

As the first in a series of posts I’d like to begin my telling you a bit about myself.  I’ve been a neurologist for 25 years, and an Alzheimer’s disease (AD) specialist for more than 10 years.  As the Director of the Cole Neuroscience Center in Knoxville, TN I currently follow over 2,000 patients with AD in my practice.

I lost my mother, my uncle and my grandmother to Alzheimer’s disease.  My mother died in her mid-eighties, and had AD symptoms for almost 15 years prior to her death. My father died at age 90 and had perfectly normal cognition the day of his death.  He died suddenly from a ruptured aortic aneurism.

My desire to share my medical knowledge here with you results from my deep abiding passion for understanding the science behind Alzheimer’s disease, as well as my years of caring for those with AD, and the profound impact it has on those beautiful people who care for them.

There are a lot of myths and misunderstandings about dementia, and an overwhelming yet unnecessary fear of it.  I’d like to help dispel some of these myths and, for many of you, put your mind at ease, as well as equip you with the knowledge and power to take control of managing your brain health, and keeping your minds sharp for the rest of your lives.

Let’s start with the single most important aspect of understanding Alzheimer’s: HISTORY.  It is crucial to take a very careful history as a starting point for assessing cognitive problems.  You can do this at home with your loved ones, as it may help you to determine if it’s time to pursue further medical evaluation, or self testing in the privacy of your own home.

When I see a patient for the first time, I ask that as many family members as possible come along to the appointment, and an individualized approach to each patient and family is very important.  Not only do we return to the beginning of the cognitive problems, but we build a timeline.  I am frank with the patient about what we are assessing: “We’re checking your memory. Let’s see how this goes and then we’ll all discuss in detail.”

First I want to know: “How long ago did symptoms begin?”  Usually, if symptoms are mild (by the time they get to my office), they tend to go back about 2 years. “When did the signs of forgetfulness first start (losing keys/wallet/checkbook, or asking the same question over and over, etc.)?”

So this is the first step within the first step of building the timeline: determine the duration (Alzheimer’s disease usually results in progressive cognitive impairment).  In the next post we’ll dig much deeper into building the timeline and understanding how to read the signs of the past.

If you have comments, stories or questions please use the comment form here to interact.  I’d love to hear from you.

Dr. John Dougherty
Director, Cole Neuroscience Center


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