WHAT’S MY NAME AGAIN?
Our brains are constantly prioritizing, sorting, storing, and retrieving all types of information… So how do you know when memory loss is abnormal…
“My memory has deteriorated tremendously in the last couple of years. I could never remember where I place my things or what people say.
I had to write everything down and the words were always at the tip of my tongue. It’s really embarrassing [because] many times when colleagues ask for certain favors, the next moment I turn around, I totally forget! My memory was getting worse and worse and I thought ‘Oh Well – that’s just old age creeping up on me’…”
Everyone has mild memory lapses from time to time. You go from the kitchen to the bedroom to get something, only to find yourself wondering what you needed. You can’t find your car keys one day and your reading glasses the next.
Lapses such as these are usually just signs of a normal brain that’s constantly prioritizing, sorting, storing, and retrieving all types of information. So how do you know when memory loss is abnormal and your brain needs additional nourishment and support?
Here are some questions to consider:
— Does the memory loss disrupt daily living? If memory loss prevents someone from doing activities that they had no trouble handling before, like balancing a checkbook, keeping up with personal hygiene, or driving around, that is an issue.
— How often do memory lapses occur? It’s one thing to occasionally forget where you parked your car, but it’s not normal to forget where you park every day or to forget appointments over and over. Frequent memory lapses are likely to be noticeable because they tend to interfere with daily living.
— What kinds of things are being forgotten? It’s normal to forget the name of someone you just met, but not normal to permanently forget the name of a close friend or relative. It also may not be normal to never remember meeting a person after you have spent a great deal of time with them. Most people have trouble remembering some details of a conversation, but forgetting whole conversations could signal a problem. Other red flags: frequently repeating yourself or asking the same questions in the same conversation.
— Are there signs of confusion? Serious memory lapses may cause individuals to get lost in a familiar place or put something in an inappropriate place because they can’t remember where it goes. Putting the car keys in the refrigerator for example.
— Is the memory loss getting worse? Memory loss that gets progressively worse over time should be evaluated by a health professional.
Memory Disorders include the following:
— Memory Loss — A mild decline in memory and the rate of information processing occurs normally with age, but does not affect daily function and does not generally progress.
— Mild Cognitive Impairment (MCI) — Whereas normal memory loss associated with aging may involve forgetting a name, memory loss associated with MCI is more severe and persistent. MCI is often a transition stage between normal aging and more serious problems caused by Alzheimer’s disease. Most, but not all, people with MCI get worse.
— Dementia — Refers to the loss of memory and other cognitive skills due to changes in the brain caused by disease or trauma. The changes can affect thinking, memory, and reasoning, and may occur gradually or quickly. Memory loss alone is not always a sign of dementia, but memory loss along with other forms of cognitive impairment is an indicator that dementia may be occurring.
— Alzheimer’s Disease — A progressive fatal illness that causes areas of the brain to shrink. The resulting symps start with memory loss and other cognitive deficits, advancing to major personality changes and eventual loss of control over bodily functions.
Signs & Symps of Mild Cognitive Impairment:
— Frequently repeating statements;
— Frequently misplacing items;
— Frequently forgetting details of conversations, events, and appointments;
Signs & Symps of Dementia:
Cognitive functions that might be affected by dementia include:
— Decision making/judgment;
— Spatial orientation;
— Verbal communication;
— Neglect of personal safety, hygiene, and nutrition;
— Coordination or balance;
A person with dementia might:
— Repeatedly ask the same questions;
— Lost or disoriented in familiar places;
— Unable to follow directions;
— Disoriented as to the date or time of day;
— Not recognize and be confused about familiar people;
— Difficulty with routine tasks such as paying the bills;
— Neglect personal safety, hygiene, and nutrition;
The Main Stages of Alzheimer’s Disease:
If you or a loved one has received a diagnosis of Alzheimer’s disease, you may be wondering what to expect with the disease as it takes its course. From the time of diagnosis, a person usually lives from three to twenty years, with an average of eight years. The three main stages of Alzheimer’s have the following defining characteristics.
Early-stage Alzheimer’s (Mild)
Mid-stage Alzheimer’s (Moderate)
Late-stage Alzheimer’s (Severe)
Memory loss or other cognitive deficits are noticeable, yet the person can compensate for them and continue to function independently.
Mental abilities decline, the personality changes, and physical problems develop so that the person becomes more and more dependent on caregivers.
Complete deterioration of the personality and loss of control over bodily functions requires total dependence on others for even the most basic activities of daily living.
People vary in the length of time spent in each stage and in which stage the signs and symps appear. Because the stages overlap, it is difficult to definitively place a person in a particular stage. However, the progression is always toward a worsening of symps.
Early-Stage Alzheimer’s Signs & Symps:
The focus of early-stage Alzheimer’s is cognitive decline. The Alzheimer’s sufferer, as well as family, friends, co-workers, and medical practitioners start to notice the changes. Memory and concentration problems are evident and measurable by cognitive tests. Communication issues surface. Changes in personality and a few idiosyncratic behaviors begin to appear. As a result, the person’s performance suffers both at home and at work. The apathy and lack of engagement that is characteristic of all three stages begins here.
Cognitive and memory problems begin to appear:
— Forgets names and words; might make up words, or quit talking to avoid mistakes;
— Repeats questions, phrases or stories, in the same conversation;
— Forgets their own history, recent personal events, and current events;
— Less able to plan, organize, or think logically;
— Increasing difficulty with routine tasks such as planning dinner, grocery shopping, and paying bills;
— Increasingly unable to make decisions; defers to others’ choices;
— Poor judgment; decline in problem-solving skills;
— Money and math problems;
— Disoriented in time and place; may become lost in familiar places;
— Trouble concentrating and learning new things; avoids change;
— Withdraws from social and mental challenges;
— Misplaces valuable possessions; hides things or puts things away in strange places and then forgets where they are;
Communication problems are observed:
— May converse “normally” until a memory lapse occurs;
— Begins to have difficulty expressing them self;
— Even if unable to speak well, can respond to what you tell them–to your emotional reactions, and to humor;
— Increasing difficulty comprehending reading material;
Personality changes are evident:
— Apathetic, withdrawn, avoids people;
— Anxious, irritable, agitated;
— Insensitive to others’ feelings;
— Easily angered when frustrated, tired, rushed, or surprised;
Idiosyncratic behaviors start to develop:
— Hoards, checks, or searches for objects of little value;
— Forgets to eat, or eats constantly, or eats only one kind of food;
Mid-stage Alzheimer’s Signs & Symps:
The focus of mid-stage Alzheimer’s is a decline in functioning of many body systems at once and a steady increase in dependence on caregivers. In mid-stage Alzheimer’s disease, the cognitive problems of early Alzheimer’s get worse and new ones develop. Memory and cognition problems become severe; communication becomes warped; and the personality is transformed. The person has a marked change in appearance and hygiene as they become less and less able to take care of themselves. Physical problems increase, including problems with voluntary control of the body, and health declines. Wandering, aggressiveness, hallucinations, and paranoia appear. This stage is the longest. Those sufferers who are able to recognize their own decline are especially at risk for becoming suicidal during this stage.
Significant cognitive decline and memory problems continue:
— Forgets recent events, forgets their own history. When they can’t remember something, they may make up something instead;
— Increasing difficulty in sorting out names and faces of family and friends, but can still distinguish familiar from unfamiliar faces;
— Still knows their own name, but no longer remembers their own address or phone;
— Loses track of their own possessions. May take others’ belongings;
— Can no longer think logically or clearly. Can’t organize their own speaking or follow others’ logic. Can no longer follow written or oral instructionsor a sequence of steps. Arithmetic and money problems escalate;
— Disoriented about the season, the day of the week, and/or the time of day;
— Disconnected from reality. Does not recognize self in the mirror. May think that a television story is real;
Impaired communication skills worsen:
— Problems with speaking, understanding, reading, and writing;
— Repeats stories, words, and gestures; repetitive questions;
— May still be able to read, but cannot respond correctly;
— Problems finishing sentences;
— May revert to their first speaking language (and need a multilingual caregiver);
Personality changes become more significant:
— Apathetic, withdrawn;
— Anxious, agitated;
— Unmannerly, aggressive or threatening;
— Suspicious, paranoid; may accuse spouse of having an affair, or accuse family members of stealing;
— Delusional, has hallucinations. May hear, see, smell, or taste things that aren’t present;
— May have an exaggeration of their normal personality characteristics;
Idiosyncratic behaviors evolve:
— Inappropriate sexual behavior: may mistake another person for their spouse, may disrobe or masturbate in public;
— Rummages through things, hides things;
— Restlessness, pacing, repetitive movements: fingers certain objects over and over; tries doorknobs; hand-wringing; tissue-shredding;
— Wandering, including chatting to oneself while wandering. May wander away from the caregiver and familiar, safe surroundings. (One-quarter to one-half of all people with Alzheimer’s, wander.);
— Disruption of the normal sleep-wake cycle: “sun downing” (naps during the day, active from late afternoon through the night);
Dependence and need for help with the activities of daily living increases:
— May eat without help, but needs help remembering to drink enough liquids and to eat enough;
— Needs help dressing appropriately for the weather or occasion. May need help putting clothing onto the correct body part;
— Needs help with grooming: bathing, brushing teeth, combing hair;
— Needs help using the toilet;
— May no longer be safe when left alone: could fall, burn self, poison self, and neglect self. Although able to care for self in some ways, needs full-time supervision for safety;
Voluntary control of the body begins to decline:
— Urinary and fecal incontinence increase over time;
— Has trouble getting comfortable in a chair or on the toilet;
— Muscle twitches;
Late-stage Alzheimer’s Signs & Symps:
The focus of late-stage Alzheimer’s is the complete deterioration of the personality. Cognitive symps worsen and physical symps become profound. The loss of brain cells in all parts of the brain leads to lack of functioning in all systems of the body. The wild behaviors of earlier stages disappear, replaced by a dulling of the mind and body.
Cognitive and memory problems decline further, and complete dependence on others is necessary:
— Doesn’t recognize familiar people, including their spouse and family members (a lack of visual ability may contribute to this);
— Needs complete help with all activities of daily living;
— Requires full-time care;
Communication skills are nearly gone:
— Appears uncomfortable, but cries out when touched or moved;
— Can no longer smile;
— Either doesn’t speak, or speaks incoherently with just words or phrases;
— May call or cry out repetitively, or groan or mumble loudly;
— Can’t write or comprehend reading material;
Voluntary control of the body increasingly disappears:
— Can’t control their movements. Muscles are rigid;
— Complete urinary and bowel incontinence;
— Cannot walk, stand, sit up, or hold up their head without assistance. Falls frequently if not assisted or propped well;
— Can’t swallow easily, may choke on food;
— No more wandering; can’t move voluntarily;
Health declines considerably:
— Frequent infections;
— Loses weight;
— Skin becomes thin and tears easily;
— Reflexes are abnormal;
The body shuts down:
— May refuse to eat or drink;
— Can’t respond to the environment;
— May quit urinating;
— Little response to touch;
— Sensory organs shut down: the organs may function correctly, but the brain can’t interpret the input;
— May only feel cold and discomfort;
— Exhausted, sleeps more;
Personality changes and idiosyncratic behavior become extreme:
— Apathetic, withdrawn (continues from early-stage Alzheimer’s);
— Dulling of the personality;
— May pat or touch things repeatedly;