Forgetfulness or dementia? How to tell the difference in elderly loved ones

If you’re spending time with elderly friends and family members this holiday season, be aware of noticeable changes in their memory and behavior, as these can be early warning signs of dementia.

“If you haven’t seen your elderly loved one in a while, you might be more likely to notice changes in their memory and behavior that worries you,” said Dr. Gregory Jicha of the University of Kentucky Sanders-Brown Center on Aging.

Here are some early warning signs of dementia that you might notice in an older friend or family member:

  • It’s normal for someone to forget a date or a name but suddenly remember it later. However, pay attention if they ask for the same information repeatedly, or struggle to recall important dates (like their own birthdate).
  • Are they having trouble following a recipe? Problem-solving skills can deteriorate in someone with Alzheimer’s.
  • Do they get lost when driving to a familiar location? If they have difficulty completing familiar tasks, it might be a sign of AD.
  • Healthy people occasionally struggle to find the right word, but using the wrong word  ̶  particularly if they call something by the wrong name  ̶  merits further scrutiny.
  • Poor judgment: are they giving lots of money to telemarketers or charities?
  • Poor hygiene.
  • Personality changes: are they suddenly irrational, fearful or suspicious?

Memory infographic

If you see any behavior that worries you, talk to your doctor. To make an appointment with a UK HealthCare doctor, visit our Appointment page or call 800-333-8874 today.

More information:

The Memory Disorders Clinic at the Kentucky Neuroscience Institute

 

What women need to know about stroke

Commonly thought of as a problem primarily affecting older men, stroke is a woman’s disease. Approximately 60 percent of deaths related to stroke in the United States occur in women, and the lifetime risk of stroke is higher in women (about one in five) compared to men (about one in six) for those aged 55 to 75 years.

The good news is that stroke can often be prevented.

Although men and women have several modifiable stroke risk factors in common such as high blood pressure (normal less than 120/80 mmHg), diabetes, cigarette smoking, overweight-obesity, atrial fibrillation (an irregular beating of the upper chambers of the heart), excessive alcohol consumption, poor diet or lack of regular exercise,  several risk factors are unique to women.

Stroke risk can be increased during pregnancy, in part leading to a higher stroke risk among women of childbearing age compared to similarly aged men. Migraine with aura (neurologic symptoms such as seeing sparkling or zigzag lights) is also associated with a higher stroke risk, particularly among women who smoke or use oral contraceptives. Women who have had eclampsia or pre-eclampsia associated with pregnancy (high blood pressure, protein in the urine, and in the case of eclampsia, seizures) are at increased risk of stroke up to 30 years later.

What can women do to reduce their stroke risk?

  • Follow a healthy diet such as the DASH or Mediterranean diet.
  • Get regular exercise such as walking at a brisk but comfortable pace for 20-30 minutes most days of the week.
  • No more than one alcoholic drink per day (no alcohol during pregnancy)
  • Don’t smoke and avoid exposure to tobacco smoke
  • Have your blood pressure checked regularly

In addition, talk to your health care provider about reducing your stroke risk if you:

  • Have migraine, particularly migraine with aura
  • Have ever had eclampsia or pre-eclampsia

Memorize some common stroke symptoms using the FAST acronym:

  • Facial droop
  • Arm weakness
  • Speech slurring
  • Time call 911 – Stroke is frequently preventable and treatable, but you need to get help quickly

Larry B. Goldstein, MD

 

Larry B. Goldstein, MD, FAAN, FANA, FAHA, is the Ruth L Works Professor and Chairman of the UK Department of Neurology and Co-Director, Kentucky Neuroscience Institute.

 

 

This column appeared in the Dec. 6, 2015 edition of the Lexington Herald-Leader.

Sundown Syndrome can be a sign of Alzheimer’s disease

Have you ever noticed that a family member becomes confused, irritable or restless as night falls? Or as the night progresses, they become agitated and pace throughout the house? This person could be showing signs of sundowning, a phenomenon commonly associated with Alzheimer’s disease and dementia.

Sundowning, or Sundown Syndrome, is the materialization of different symptoms that occur at a specific time of day. Symptoms present most commonly as the day changes from day to dusk, hence the name “sundowning.” Symptoms can vary and include restlessness, irritability, becoming disoriented or confused, pacing and mood swings.

While doctors are unsure of what causes sundowning, many think that someone’s internal body clock gets altered with the progression of Alzheimer’s and dementia. In people with Alzheimer’s, doctors know that the area of the brain that controls sleep patterns (waking up, falling asleep) deteriorates. This could also explain sundowning.

Though sundowning typically occurs late in the day, other “triggers” have been shown to cause symptoms. Lots of activity or noise and even nonverbal cues from another person can cause a shift in behavior.

Although sundowning can be frustrating for everyone involved, there are many ways to cope with and reduce the gravity of the symptoms:

  • Keep the house well-lit. Shadows can cause disorientation and can be frightening.
  • Maintain a sleep schedule and try to reduce daytime napping. Keeping a daily routine will emphasize sleeping at a certain time and will make it easier for he or she to sleep at night.
  • Avoid stimulants like caffeine.
  • Avoid alcohol, which can disrupt sleep patterns.
  • At night, try to stifle any background noise or stimulation that could be upsetting.
  • Maintain a familiar environment, which can be more soothing.
  • Try to avoid over-the-counter sleep aids and other medicines, such as Benadryl or Chlor-Trimeton, which cause drowsiness.
  • Research shows that a low dose of melatonin, a naturally occurring hormone that aids in sleeping, can be helpful. However, talk to a doctor before starting a melatonin regimen.

If a loved one is presenting with symptoms of sundowning, as a caregiver it is important to remain calm and not get flustered. Nonverbal indicators of frustration can further agitate an already irritated individual. Instead, approach your loved one calmly and reassure them that everything is okay. Ask if there is anything that he or she needs to be comfortable. If he or she needs to pace, let them do so but continue to supervise them. Try to avoid arguing at all costs, which could exacerbate the situation.

If you or someone you love is showing symptoms similar to sundowning, it could be a sign of Alzheimer’s disease. Sundowning usually presents during the middle phases of Alzheimer’s disease and goes away as the disease progresses. If you are concerned, contact your family doctor or neurologist.

Dr. Ronan Murphy

Dr. Ronan Murphy

 

 

Ronan Murphy is an assistant professor of neurology at the University of Kentucky Sanders-Brown Center on Aging.