What are the signs of early-onset Alzheimer's?

Published in Medical News Today on Fri 22 June 2018 and written by Jenna Fletcher, and reviewed by Timothy J. Legg, Ph.D., CRNP

This article is of interest to me because I had two close friends who were inflicted with early-onset Alzheimer’s and they died within 3 years of contracting this disease. It was devastating to their friends and families, and if we had known the signs perhaps they could have received help earlier than they did.

Alzheimer's disease is a type of dementia typically associated with older adults. However, early-onset Alzheimer's disease occurs before the age of 65. Alzheimer's causes memory problems and a variety of related symptoms. It is a degenerative disease, which means the symptoms will get worse over time.

According to the Alzheimer's Association, Alzheimer's is the most common form of dementia, accounting for 60 to 80 percent of all known dementia cases. Though there is no cure, there are some treatments available to ease symptoms and slow the disease's progression.

Signs and symptoms

There are several distinct signs and symptoms of memory loss that may indicate Alzheimer's. If a person experiences one or more of the following signs or symptoms, they should speak to their doctor.

  

1. Memory loss that impedes daily activities

Reliance on memory aids may be a sign of early-onset Alzheimer's.

The most common symptom of Alzheimer's is memory loss. A person experiencing memory loss may:

·     forget recently learned information

·     ask for same information repeatedly

·     have a higher reliance on memory aids, such as calendars and notes

·     forget important events or dates

 As a person ages, it is not uncommon to forget things from time to time. Typical, non-Alzheimer's memory loss may include forgetting an acquaintance's name but remembering it later on. A person with early-onset Alzheimer's will have more noticeable memory loss and may repeatedly forget the same information.

2. Trouble completing everyday tasks

Another common early sign of Alzheimer's is when a person has difficulty completing an otherwise familiar task. A person with early-onset Alzheimer's may:

·     forget how to get to a grocery store, restaurant, or place of employment

·     have problems balancing a home or work budget

·     forget the rules of a familiar game

Sometimes, natural ageing may cause a person to need help with new or unfamiliar things. For example, helping an older loved one figure out the settings on their new phone is not uncommon and does not necessarily indicate a problem. By contrast, if a person has used the same phone for years and suddenly cannot remember how to make a phone call, they may be experiencing Alzheimer's-related memory loss.

3. Problem-solving or planning difficulties

Some people with early-onset Alzheimer's find they have trouble following directions, solving problems, and focusing. It may be hard for a person to follow a recipe or directions written on a product. They may also have trouble keeping track of monthly bills or expenses.

4. Problems with vision and spatial awareness

Alzheimer's can sometimes cause vision problems, which may make it difficult for a person to judge distances between objects. It may also cause a person to have difficulty distinguishing contrast and colours. These vision problems combined can make it difficult or impossible to drive. Normal ageing also affects eyesight, so it is essential to have regular checkups with an eye doctor.

5. Confusion about location and time

Another common sign of early-onset Alzheimer's is getting confused about places or time. A person may have trouble keeping track of seasons, months, or time of day. A person may occasionally be unable to recognize where they are or have no memory of how they got there.

6. Frequently misplacing items and not being able to retrace steps

misplaced items may be due to early-onset Alzheimer's

Alzheimer's may cause a person to forget where they placed an item. Most people will lose items at some time but are usually able to locate them again by searching in logical locations and retracing their steps. A person with Alzheimer's may forget where they placed an item, especially if they put it in an unusual place.

Alzheimer's also makes it difficult for a person to retrace their steps to find the missing item. This can be distressing and may cause the person to believe someone is stealing from them.

7. Problems writing or speaking

A person may have trouble keeping up in a conversation or may repeat themselves. A person may also have trouble writing down their thoughts.  The person may stop in the middle of a conversation, unable to figure out what to say next. They may struggle to find the right word or label things incorrectly.

It is not uncommon for a person to occasionally struggle to find the right word. Typically, they eventually remember it and do not experience the problem frequently.

8. Showing signs of poor judgment

Everyone makes bad decisions at times. People with early-onset Alzheimer's, however, may display a marked change in their ability to make good decisions. Signs of poor judgment include:

·   spending too much on unnecessary items

·   showing inattention to personal grooming

·   not showering or cleaning themselves regularly

9. Mood or personality changes

A person with Alzheimer's may start to become confused, anxious, suspicious, or depressed. They may show these signs in a variety of settings, including at work, at home, and in unfamiliar places. They may become frustrated with their symptoms or feel unable to understand the changes taking place. This may present as aggression or irritability towards others.

10. Stepping away from social or work activities

As Alzheimer's develops, a person may stop participating in the social or work activities they used to enjoy.

Pandemic Flu 100 years ago

The ‘greatest pandemic in history’ was 100 years ago – but many of us still get the basic facts wrong, so starts the story at the Conversation.com  written by Richard Gunderman,  Chancellor's Professor of Medicine, Liberal Arts, and Philanthropy, Indiana University.

I like many of my generation was dimly aware of the great Pandemic of 1918-1919 and had put it out of my mind. In school, we studied the Black Plague (the 1300's) which devastated Europe, but we did not spend much time on the Pandemic of 1918. Perhaps we should have studied it to see if there are any lessons we can learn to protect ourselves from the influences attacking us today. 

In his article, Professor Gunderman lists the top ten myths and goes into details about why they are wrong.  In his introduction, he says,  "By correcting these 10 myths, we can better understand what actually happened and learn how to prevent and mitigate such disasters in the future."

I am listing the Myths below for more information go to his article, here.

1. The pandemic originated in Spain
No one believes the so-called “Spanish flu” originated in Spain. The pandemic likely acquired this nickname because of World War I, which was in full swing at the time. 

2. The pandemic was the work of a ‘super-virus’
The 1918 flu spread rapidly, killing 25 million people in just the first six months. However, more recent study suggests that the virus itself, though more lethal than other strains, was not fundamentally different from those that caused epidemics in other years.

3. The first wave of the pandemic was most lethal
Actually, the initial wave of deaths from the pandemic in the first half of 1918 was relatively low. It was in the second wave, from October through December of that year, that the highest death rates were observed. 

4. The virus killed most people who were infected with it
In fact, the vast majority of the people who contracted the 1918 flu survived. National death rates among the infected generally did not exceed 20 percent. Of course, even a 20 percent death rate vastly exceeds the typical flu, which kills less than one percent of those infected.

5. Therapies of the day had little impact on the disease
No specific anti-viral therapies were available during the 1918 flu. That’s still largely true today, where most medical care for the flu aims to support patients, rather than cure them.

6. The pandemic dominated the day’s news
Public health officials, law enforcement officers, and politicians had reasons to underplay the severity of the 1918 flu, which resulted in less coverage in the press. 

7. The pandemic changed the course of World War I
It’s unlikely that the flu changed the outcome of World War I because combatants on both sides of the battlefield were relatively equally affected.

8. Widespread immunization ended the pandemic
Immunization against the flu as we know it today was not practiced in 1918 and thus played no role in ending the pandemic. In addition, the rapidly mutating virus likely evolved over time into less lethal strains. 

9. The genes of the virus have never been sequenced
In 2005, researchers announced that they had successfully determined the gene sequence of the 1918 influenza virus. The virus was recovered from the body of a flu victim buried in the permafrost of Alaska, as well as from samples of American soldiers who fell ill at the time.

10. The 1918 pandemic offers few lessons for 2018
Severe influenza epidemics tend to occur every few decades. Experts believe that the next one is a question not of “if” but “when.”  While few living people can recall the great flu pandemic of 1918, we can continue to learn its lessons, which range from the commonsense value of handwashing and immunizations to the potential of anti-viral drugs. 

Dealing with a family member who is dying

My friend's younger brother (he is 63) has malignant mesothelioma, which is a type of cancer that has affected the tissue lining his lung. I asked my friend how his brother is doing. He said he puts on a brave face, but when he is tired, he looks like a dying man. My friend continued I don't know how long he has, the doctors think that he could have a week, a month or two or three months, but it is not good. We talked about how hard it must be on my friend and his sisters and his brothers family.

My friend agreed and he told me his brother was talking about ending his life, with assisted suicide but that his brother had not done anything concrete or taken any other action except to talk about it at this point. I could see that the discussion of his brother was not one my friend wanted to continue, so we changed the topic, and discussed the home renovations we both had to complete.

I started thinking, how do we talk about death and dying. My friends' brother had, according to my friend, made peace with the fact he was dying as my friend and his family have made peace with the pending loss of their brother. Losing a family member is not easy, but when a family member is dying the strain on the rest of the family is tremendous, and there is not much help.

My friend told me that his sisters, as part of their volunteerism, go to the hospice in their hometown and provide vigils and sit with the patients who are dying. I thought this was wonderful as it helps those who are dying to know they are not alone but came back to the question, who helps the family dealing with this loss.

Once a person dies, there are supports in place to help the family, but I wonder if there are supports in place to help family members as the person is dying. I also realized that if a family is dealing with this issue, they may not have the energy to find out more information or to seek help. So I thought I would list some ideas here. There are many supports available:

Ireland has information at http://hospicefoundation.ie/wp-content/uploads/2013/08/Supporting-Families.pdf where there are links to further supports.

Palliative Care Australia has information at http://palliativecare.org.au/resources/how-can-i-support-my-friendfamily-member 


In England, the National Health Authority has done some interesting research into this issue at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436280/

In Canada, the Virtual Hospice has information on dealing with death and dying including an article on  how to talk to a dying person
 http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Communication/Tips+for+Talking+with+Someone+Who+is+Dying.aspx 
https://www.canada.ca/en/employment-social-development/programs/ei/ei-list/reports/compassionate-difficult-times.html

Other organization also have information for families who are dealing with a person who is dying. Here are some: 
https://oceansidehospice.com/coping-tasks-for-the-family/
https://www.dyingmatters.org/
http://www.ohtn.on.ca/rapid-response-impact-of-medical-assistance-in-dying-on-family-and-friends/

Protect yourself from Frauds and Scams

To avoid being scammed you have to remain diligent and follow these steps: 

• Assess the validity of all messages that you receive from people and business that you do not know. That includes any unsolicited phone calls, people knocking on your door, emails sent you—even those that look like they are from a company you do business with, or family and friends—and letters received in the mail that look like they are official.
• Any emails and links sent to you that seem off should be checked first, by rolling your cursor over them with your mouse before actually clicking on the link. Look at the destination URL is to see if it looks legitimate or not.
• Scammers will also pose as imposters from businesses or organizations and call or approach you in person. The Consumer Financial Protection Bureau (CFPB) recently warned people about scammers posing as CFPB employees.
• Criminals will go to great lengths to try to pressure you with demands for money or payments. If you feel you are being victimized, make sure to report the scam to the proper government agency, your local Better Business Bureau office, and your local police department.

Here are some resources in Canada to help
PhoneBusters: 1-888-495-8501 www.phonebusters.com  
Canadian Antifraud Centre: 1-888-495-8501 www.antifraudcentre.ca
Canada Revenue Agency: 1-800-267-2384 

www.cra-arc.gc.ca/charities
Better Business Bureau of Mainland BC: 604- 682-2711 http://mainlandbc.bbb.org