Is forgetfulness normal when we get old?
NO! Forgetfulness is not normal at any age!
It is widely thought that forgetfulness is normal at one’s late age. On the contrary, forgetfulness is the earliest sign of one of the most common diseases of the elderly- Alzheimer’s disease.
What is dementia, and what is Alzheimer’s disease?
Dementia is an umbrella term for a number of diseases, in which the leading symptom is progressive loss of intellectual ability. By far, the most prevalent among all of dementias is Alzheimer’s disease, with short term memory loss as the first sign.
How to recognize Alzheimer’s disease?
As previously mentioned, forgetfulness is the first and the leading sign of Alzheimer’s. The onset of forgetfulness is insidious, so that at the beginning the patient is fully functional and independent, even though it requires some effort. That stage is called mild cognitive impairment or prodromal stage. The disease is clinically manifested when forgetfulness impairs proper functioning i.e. activities of daily living. The patient forgets what he has to buy in the store, meals get burned, chores neglected, can’t keep up the conversation, gets disoriented in time and place, changes eating habits, roams around and easily gets lost etc.
In the early stage the patient is aware of his forgetfulness, which will not be the case for long. That is when the patient and the family have to sort out the remaining legal issues. Soon the patient will change his personality and will not be “his old self” anymore, which the family members and peers find very hard to understand and accept. At the same time, the patient neglects his/her own personal hygiene, needs help with feeding and dressing. The fear caused by disorientation occurs in the majority of patients. In later stages, the patient is not able to recognize first the acquaintances and neighbors, and later the family members. Psychiatric and behavioral disorders that occur in this stage severely impair quality of life of not only the patients, but of the caregivers as well. Usually, that is the moment when the family members bring the patient to the doctor: when the therapeutic possibilities are quite limited.
Which are psychiatric and behavioral disorders in Alzheimer’s disease?
The most severe psychiatric symptoms in Alzheimer’s are delusions and hallucinations, and occur as a rule in the late stage of the disease. The patient claims that somebody is "sneaking around the house”, hides the objects and money, keeps locking the doors, packing and repacking his belongings etc. Aggressive behaviour, jealousy and inappropriate sexual behaviour are also common. Hallucinations are present usually at night and are very disturbing. Often the patients talk with the dead. However, these symptoms have limited duration, usually no longer than 6 months. Specific medication is used to control these symptoms and regulate sleep/ wake cycle.
Can Alzheimer’s be cured?
At present, there is no cure for Alzheimer’s disease. However, there are ways to help the patients and caregivers. Treatment depends on the severity and stage of the disease. In the mild and moderate stage, progression of the disease can be slowed down and the onset of psychiatric complications delayed by specific drugs. It is very important to diagnose the disease on time, and start treatment as early as possible. Medication is also very efficient in control of psychiatric symptoms, aggressiveness and sleep disorders.
The ultimate goal of therapy in Alzheimer’s is to provide the best possible quality of life for the patient and the caregivers. In order to achieve that, non-pharmacological measures are even more important than pharmacological treatment. The patient has to be dealt with calmly and quietly, avoiding any sort of confrontation. The surrounding has to be comfortable and simple, with as few details as possible.