Is it too early to be Alzheimer’s?

Even in people as young as their fifties or sixties, increasing memory lapses can be a worry.

Researchers now know that the very earliest signs of Alzheimer’s disease can become evident some time before the symptoms start, and that these can be very subtle symptoms: forgetting names, struggling to find a word or consistently losing car keys.

They’re conducting a clinical study into early Alzheimer’s Disease, at the Memory Clinic at the Royal Adelaide Hospital (RAH). It is hoped that one day a medication may be able to slow the progression of these first signs, before they turn into full-blown dementia.

In the meantime, if you are concerned about a friend, spouse, parent or family member, there’s some good advice here from Kathy Robinson, Clinical Practice Consultant and Clinical Trial Manager at the RAH Memory Trial Centre, about how to bring it up – sensitively.

Of course, a lot of the signs you might think are indicative of a worrying memory, are also symptomatic of a stressed out person with a busy lifestyle and a lot on their mind.

Kathy says there are three key things to look out for

  1. “If they’re repeating themselves or struggling to find the words – saying the same information two or three times over, when most people would remember if they said it just once.”
  1. “When they’re not managing their social calendar or diary, and missing appointments. If you catch up with them for coffee and say, ‘oh mum, how was the doctor?’ and you find out she didn’t go, or you might notice they’ve missed taking their tablets on some days.”
  1. “Other people noticing that they’re struggling is a key factor that something may be a bit a wry. Maybe they’re failing at work, or they’ve been let go from work because their colleagues or employer recognise that they’re not keeping up.”

Any of these scenarios are understandably upsetting and confusing for the person having the memory lapses. Things are changing beyond their control and they can’t figure out why or how to get a grip. They might battle on without saying anything, or simply not realise that much is wrong because they can’t remember.

“Some people have the attitude that they’d rather not know, and there’s nothing you can do to change that,” Kathy says. She suggests broaching the subject with a soft sort of question, something like, “How do you think your memory is going?”, “Are you noticing any problems?”, or, “Are you struggling with anything that I can help you with?”, and suggesting a doctor’s visit.

Kathy says the person you’re talking with needs to understand that you are serious about the issue, that it’s affecting the people they love too, and that there’s not necessarily anything wrong, but it’ll be something you can work through together if there is any sort of diagnosis made.

If you both decide to go ahead and have it looked at further, then the GP or clinical trial site that you visit needs to know that you’re serious about getting an answer too.

“It’s all too easy for a GP to overlook a patient’s memory problems if they visit with a long list of things to discuss.” Kathy recommends going with the specific agenda to focus only on memory lapses. Attending with their son/daughter, partner or friend can also help the patient feel supported and talk about their experiences.

As part of the GP appointment, blood tests may be taken – this will eliminate the possibility of any reversible memory problems like an infection of some sort, and a Mini Mental test conducted – that’s 30 simple questions which can help determine whether referral to a specialist is needed to find out more.

The specialist they’ll see could be a neurologist, geriatrician or neuropsychologist. They can do MRI scans and things to build a picture to get a diagnosis. This process can take 6-9 months, but is so worth it for peace of mind, and in the case of a positive diagnosis, for planning and treatment to help make the future smoother.

“If you have this investigated, you can better prepare so there’s no urgent scramble to get help when things get progressively worse. If left too long, until the patient is struggling to take care of themselves, it can result in a social services admission to hospital when an emergency happens and the whole diagnosis process becomes condensed into a high-pressure, short time frame.”

And there’s no reason to leave it five years until they’re within the traditionally thought of Alzheimer’s age bracket.

“Young onset Alzheimer’s – genetic strains – can occur at any age. There are also some 55 year olds who have been identified as on the path to Alzheimer’s even without any genetic history.”

There are a number of clinical trials underway throughout Australia and New Zealand looking at the very earliest signs of Alzheimer’s Disease.

Kathy says of these trials, “The great thing about participating is that they’re potentially disease-modifying, where treatment can’t change the course of the disease. Trials afford participants free healthcare, constant monitoring and the best advice on hand if a patient’s circumstance was to change”.

There’s also the legacy aspect of taking part in a trial. Mum might not want to know if she’s on the path to Alzheimer’s, but from a family history and genetic perspective, you might want to.

“People find themselves in lots of different scenarios. No-one can be pushed into anything, but if you’re serious about finding out what’s wrong, then getting in touch with a clinical trial site or going to see your GP is the best next step.”

Have a look at our Memory Quiz if you would like to find out more, for yourself or on behalf of somebody you care about. As Kathy says, “In my opinion, it’s always better to know.”

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