Symptoms of Alzheimer's include not just memory loss but confusion, disorientation, and mood and behavioral changes. The earliest symptom is most often difficulty remembering newly learned information because damage to brain cells typically begins in the cortex, the part of the brain that affects learning. As it spreads to other parts of the brain, memory loss intensifies and other symptoms appear.
"There is no single diagnostic test that is definitive for Alzheimer's," says Dr. Freundlich. "And there are dozens of conditions that mimic its symptoms - everything from the side effects of medication to substance abuse to a buildup of fluid in the brain - so it takes a bit of detective work on the part of physicians and psychologists to isolate the underlying cause of symptoms. But the first step is for the patient or family members to recognize when professional help is needed." As a general rule, memory lapses associated with normal aging do not interfere with the performance of daily activities or the ability to live independently. And warning signs of Alzheimer's typically include not just the inability to remember but the inability to understand, communicate and reason.
Dr. Freundlich provides tips on differentiating normal behavior vs. more troublesome signs:
When signs of dementia are apparent, either to the individual or to friends and family members, it is important to obtain a diagnosis as soon as possible to rule out other causes and to take advantage of treatment and support options that can improve quality of life. Diagnostic tools typically include a complete physical and neurological exam, brain imaging and neuropsychological tests to assess mental status, thinking and memory. An initial screening might take only a few minutes and indicate whether a full-scale dementia evaluation is warranted.
"In addition to testing memory and cognition, one of the things we look for in these evaluations is signs of depression," says Dr. Freundlich. "Depression can sometimes cause symptoms similar to those of dementia and we also know there is an association between depression and dementia. For reasons that are not yet understood, people who develop depression late in life are more likely to develop dementia. Treating the depression won't necessarily prevent the onset of dementia but it will have an immediate positive affect on the patient's health and quality of life."
Kenneth Freundlich, PhD., a clinical neuropsychologist with more than 30 years of experience, is the managing partner of the Morris Psychological Group and head of the neuropsychology division. His clinical practice is devoted exclusively to neuropsychological evaluation and consultation. Morris Psychological Group, P.A. offers a wide range of therapy and evaluation services to adults, children and adolescents. www.morrispsych.com
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