ALL ABOUT ALZHEIMER'S: An Introduction     
By Betty Weiss

Until my husband came down with Alzheimer's, I knew little about it and had scant interest in learning.  So someone forgets--big deal.  I forget things all the time, my car in a parking garage; words that elude me, only to pop into my head hours later.  I lose my keys, glasses, checkbook, important papers, any item smaller than a Clydesdale.  Most of the time I can't remember birthdays, names, appointments, once I forgot to go in for surgery!  Standing in the middle of the bedroom, I wonder why did I come in here?  I go to the store for bread and come home with everything but. 

Let me assure you, I do not have Alzheimer's and neither do you if you're the same way and, no, it doesn't start out that way.  These daily memory lapses are because some of us are easily distracted especially in our modern society.  We keep calendars, make lists, carry day planners, BlackBerries, have all sorts of little alarms and reminder gadgets, you can even get a service to phone and remind you of things.  Who remembers more than a few phone numbers anymore?  Speed dial does it for us.  We rely less and less on our own mental memories, and that's not good.  Yes, sometimes the elderly get a little forgetful, but that's not always Alzheimer's either. 

Alzheimer's is often called the Disease of Forgetting, but that's misleading and frightening, because normal people forget all the time, but then remember later.  With Alzheimer's, the victim doesn't remember later because the memory is lost, it doesn't exist anymore.  And if it doesn't exist, it can't be retrieved.  The one Alzheimer's blessing, if you can call it that, is that patients don't remember that they can't remember.  It is left for those of us who love and care for them to watch that tragedy.  And, yet, there are times when the patient remembers, appears to be perfectly normal.  Maybe it isn't Alzheimer's after all.

Alzheimer's is extremely difficult to diagnose.  Doctors do a variety of verbal, physical, blood, urine and brain scan testing, mostly to rule out anything else that may be causing unusual behaviors.  They are looking for brain tumors, stroke, other brain diseases, excessive drug or alcohol use, lack of certain vitamins or supplements, side effects of medications, infections, head injury, any bodily illness such as kidney, liver or lung disease.  If they can't find anything else, they often give the diagnosis of 'probable' Alzheimer's.  How can it be 'probable,' isn't it either one way or the other?  Well, not exactly, these methods are considered 80% to 90% accurate.  The only 100% certain diagnosis is through a brain biopsy, usually  done at autopsy, hence the 'probable' modifier.

A new brain scan is said to be able to track the progress of Alzheimer's from the very beginning.  That's good, because the sooner it is detected, the sooner medications and monitoring can begin and, hopefully, delay the progression.  Otherwise, there is no way that any one doctor or layman can possibly see the very beginning symptoms of Alzheimer's.  They are too gossamer, too vague, too easily dismissed as aging, stress, depression.
The disease attacks the brain decades before the difficult behaviors come roaring out.  Sometimes colleagues are the first to notice.  A worker who never missed a thing becomes a bit forgetful and confused.  Since it's not all the time, others will often cover the mistake.  Few think it's a brain disease, maybe a fight with the wife, or financial concerns. 

Or question Mom's family members and many will admit that from time to time, she has seemed a bit forgetful.  But it can't be Alzheimer's, she's just getting old, isn't that normal?  Most of the time, yes.  Short-term and remote childhood memories aren't usually affected by aging.    Forgetting a word is just a 'hiccup' in the aging memory, it will often be recalled later.  Frustrating, but not usually serious.

Memory loss that is not a part of aging may be trouble learning new things, forgetting how to do things done many times before, repeating phrases or stories in the same conversation, problems handling money, not being able to keep track of daily happenings.  A doctor's visit may be in order. 
Betty Weiss is the author of the best selling Alzheimer's Surgery: An Intimate Portrait, and When The Doctor Says, "Alzheimer's:” Your Caregiver's Guide to Alzheimer's & Dementia. She does not give medical advice.                           

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