Cognitive Changes in AD: Apathy and Delusion
In the last post we considered the cognitive change of depression, and how it can affect those with Alzheimer’s disease (AD), as well as some tips to help discern between pure depression and AD.
Today we’ll consider other cognitive change often seen along with AD – apathy and delusion.
Some AD patients develop frustration, agitation or combativeness, which can be extremely difficult to treat and manage (if you are a caregiver for an AD patient with these symptoms, you are all too aware of the strain this can create). Sometimes change in personality with agitated features can be an early manifestation of AD so pay close attention to this. Read More
Depression and Alzheimer’s
In the first three posts (1, 2, 3) of this series we explored how to identify and understand many symptoms of early Alzheimer’s disease (AD), as well as how to use them to build a historical timeline. These posts provide a good foundation for moving forward in our basic understanding of AD.
In this post we move into the topic of cognitive changes associated with early AD, and include an exercise you can try with your loved ones at home. Read More
In the last post we began to take a closer look at some of the more widely known symptoms of Alzheimer’s disease (AD), as well as to explore the differences between normal aging and cognitive impairment within those symptoms. In this post I am going to provide you a list of areas in your day-to-day life where symptoms of AD appear, to help you better distinguish normal aging from the signs of something more serious. Read More
This is the second post in a blog series by Dr. John Dougherty, intended to simplify and demystify Alzheimer’s disease, and help you better recognize the signs and symptoms.
In the last post we learned that the single most important place to begin our understanding of Alzheimer’s is history. I start the process by building a timeline from symptom onset with the individual (and family members). In the next few posts we’ll take a look at Alzheimer’s symptoms. We begin the list today with some of the more widely known symptoms, but we examine more closely how to distinguish signs of normal aging from those of possible impairment within them.
Repeated and persistent signs of forgetfulness
As people age they frequently complain of losing keys, losing a wallet or purse, a checkbook, or some other staple item. With normal aging you may forget where you parked your car after shopping, or you may forget a turn or two in the car but not be lost. Read More
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. Read More
As a neurologist of 25 years, I have specialized in Alzheimer’s Disease (AD) for almost fifteen. I currently follow over 2,000 AD patients in my practice and have personally experienced the immense toll that this disease takes on care givers. It was painful watching my own mother suffer with AD for more than 15 years.
When my mother was diagnosed our medical understanding of AD was very different, far more limited than what we know today. At the time (and still to a large extent today), physicians relied on a basic paper-based test called the Mini-Mental Status Evaluation (MMSE), to diagnose people with AD. The MMSE was developed over 30 years ago and has been shown to be less than 70% effective in diagnosing AD.
As our AD knowledge base expanded I began doing more research and in 2002, created the Self Test, an AD screening test which demonstrated 97% accuracy in clinical trials in differentiating between people with cognitive impairment or AD and otherwise healthy individuals. The success of the Self Test offered a much more effective means of screening for AD, but I was dismayed to know that 60% of people with AD are still going undiagnosed in a primary care setting.
There are many reasons for this, including a lack of sufficient health care coverage, difficulty getting primary care physicians to screen for AD before full onset of the disease, resistance by elders to be screened, and many others. This number is not only unacceptable, it is unnecessary. Read More
I had a conversation last week with a trainer for a large Assisted Living Facility corporation. She has the daunting task of re-training the staff of all the facilities in that organization on their approach with residents. In particular, she is working to train them to understand that their approach has a great impact on whether a resident will comply or take part in activities geared towards stimulating their cognition.
We talked about how she struggles to help the staff understand that, while it may seem easier in the short run, doing tasks FOR the residents actually has a negative impact on them long term. It may seem easier to just take a senior by the hand and lead them where they need to go, or to manage their time and take responsibility for when/where they need to be. But doing this causes them to relinquish the responsibility and starts a slow process of atrophy in the cognitive domain associated with that task. Read More
The caregivers of my patients frequently ask me about the safety of their loved ones getting behind the wheel after receiving a diagnosis of Alzheimer’s Disease (AD). This is a sensitive topic for patients, but a very important one in terms of both safety and liability, as I will discuss here.
First, my own research has recently revealed that driving in moderate and late stage AD is a much larger problem than we first feared, and this is not attributable merely to aging. In fact, we have seen that 16 year old males have a higher incidence of accidents than healthy non-demented individuals over the age of 75. However, in mild cognitive impairment (MCI) and the early stages of AD, we do not see increased accident rates. But as early AD progresses into moderate AD accident rates rise sharply. Read More
Anosognosia is a term used to describe a person who is unaware of or denies the existence of their condition or problem. Some researchers estimate 20% of Alzheimer’s Disease (AD) patients suffer from Anosognosia. My own research puts this estimate closer to 50%.
If you have a loved one suffering with Anosognosia you are probably very familiar with this concept, even if you didn’t know the medical term for it. AD patients with Anosognosia will argue with you if you point out deficits in memory or basic functioning. They tend to believe that they can function normally – still manage the finances, for example, when it is apparent to you that their cognitive deficits impair this ability. Read More
Mild Cognitive Impairment, or MCI, has become better understood in recent years. It is broadly considered to be a transitional stage between normal, age-related cognitive changes and dementia. We have learned some key things about individuals with MCI that are very important to understand for long term quality of life. Believe it or not, if you have received a diagnosis of MCI, this is actually very good news. It means that you are one of the few people who have been brave enough to get yourself tested for memory concerns. And because of this, you have learned at the earliest possible stage of some potential future problems. It’s great news because at this stage we have a lot of options for treating you and others like you.
As a physician, I can tell you that almost 8% of people diagnosed with MCI convert to Alzheimer’s Disease (AD) within 1 year. However, 20% of people diagnosed with MCI revert to normal memory within 1 year. So a diagnosis of MCI is not a cause for panic so much as it is a call to action. Read More
