by Doug Brunk for Clinical Psychiatry News:

Robust behavioral changes are not common in presymptomatic familial Alzheimer’s disease, but increases in certain behaviors such as agitation, apathy, and appetitive changes can accompany early cognitive changes, results from a large ongoing study demonstrated.

The findings “are consistent with observations in late-onset Alzheimer’s disease and support behavioral changes in familial Alzheimer’s disease being a state associated with incipient Alzheimer’s pathology rather than a life-long disposition,” Dr. John M. Ringman said at the annual meeting of the American Academy of Neurology.

“It’s well established now that the neuropathology of Alzheimer’s disease begins 15-20 years prior to overt symptoms,” said Dr. Ringman, a neurologist at the Mary S. Easton Center for Alzheimer’s Disease Research at the University of California, Los Angeles. “Symptoms of depression, anxiety, apathy, and irritability are more frequent in persons with mild cognitive impairment (MCI). Further studies suggest that the presence of such symptoms in the context of MCI may better predict who will progress to develop Alzheimer’s disease.”

by Carol W. Berman M.D. for Huffington Post:

At first, denial can be a healthy defense against admitting that your loved one has dementia.

Denial involves not acknowledging what you see or hear and/or unconsciously negating what you see or hear. Denial helps you block the more painful aspects of reality. However, if denial continues too long, then it can be life-threatening to you and your loved one.

Here’s what happened to me, a psychiatrist, and my husband who died seven months ago from Lewy body dementia.

One day he tried to cut my bangs, something he always did for me in between hairdresser appointments. We both enjoyed this ritual. Although he was an attorney by trade, he was pretty handy with scissors, knives, and other tools. I combed my hair and sat down in front of him, ready for my bang trim.

With his usual confidence, he grabbed my bangs and moved the scissors toward me. My eyes were closed, but fortunately I opened them just before he began to cut. He had the angle all wrong. I was shocked as I grabbed his hand and asked what he was doing. I saw a blank stare. My husband was a gentle man and would never hurt me, that’s why I’d chosen to be with him, but he was unaware of how close he’d come to gouging my eyes out. His senses of distance, danger, and appropriateness were all thrown off.

This incident — which occurred a year into the diagnosis — literally opened my eyes to the dangers of denial.

by Carol Bradley Bursack for AgingCare:

With Alzheimer’s so much in the news, it’s natural to ask yourself sometimes whether you could be on the brink of the disease or some other dementia. This worry is compounded in people who have early onset Alzheimer’s in their families. After all, who hasn’t forgotten keys, messed up a checkbook or even neglected to pay a bill?

Don’t panic. Stress can be a huge culprit when it comes to memory problems, as can medications, infections and sleep deprivation. So it’s important to take a realistic look at your situation.

Check for changes in behavior

If you always mess up when you balance your checkbook, you probably shouldn’t be too concerned if you do it again. However, if you are an accountant and the numbers no longer make sense, then it’s time to consider a checkup.

by Newswise for Johns Hopkins University School of Nursing:

Behavior changes are among the most visible, disruptive and distressing symptoms of Alzheimer’s disease and other dementias. From confusion, repetitive questioning and combativeness to wandering, hallucinations and loss of inhibition, the symptoms carry their own risks of injury.

They affect patient’s quality of life and that of the family caregiver. These symptoms have been a challenge to physicians, particularly since many medications carry significant risks and have been found to be relatively ineffective. Screening for early manifestations of behavioral symptoms is not routinely conducted and risk factors for behavioral occurrences may be missed and ultimately precipitate placement in a nursing home or other costly long-term care facility.

by Pam Belluck for The New York Times:

Scientists studying Alzheimer’s disease are increasingly finding clues that the brain begins to deteriorate years before a person shows symptoms of dementia.

by Christian Nordqvist for Medical News Today:

When somebody starts losing their sense of smell, it could be one of the first signs of Parkinson’s or Alzheimer’s disease, or another neurodegenerative disorder, researchers from Perelman School of Medicine at the University of Pennsylvania reported in PLoS One.

The common cold and upper respiratory tract infections are the main causes of loss of smell. Some studies have indicated that regular smokers’ sense of smell is weaker than non-smokers. Researchers in this study found a link between an impaired sense of smell and MG (myasthenia gravis).

Myasthenia gravis is a long-term autoimmune neuromuscular disease in which the patient experiences fluctuating levels of fatigue and muscle weakness. The muscles that weaken are those under the body’s voluntary control. MG is caused by a breakdown in the normal communication between nerves and muscles.

by Health Aim:

It has been estimated that about 1.3 million people have Lewy body dementia, but no one knows for sure due to the difficulty in diagnosing the condition.  Lewy body dementia often poses a diagnostic challenge and is frequently misdiagnosed as Alzheimer’s, Parkinson’s disease, or a psychiatric disorder.  Dr. James Galvin, a neurologist at NYU Langone Medical Center, said, “This is not an uncommon disease,” but many health care professionals remain unfamiliar with the disorder.

Dr. Galvin has published extensively on the subject of Lewy body dementia.  Dr. Galvin said, “I don’t fault physicians for misdiagnosing it.  It’s not that easy.”  He added that cognitive decline that does not take the classic form of memory loss is a cue that you may not be dealing with Alzheimer’s.  Lewy body dementia affects considerably more men than women and seems to progress more rapidly than Alzheimer’s.

by Lesly Bailey for NWI Times:

End-of-day anxiety and the search for comfort is a lifelong experience that can increase with aging, particularly for those with Alzheimer’s or other forms of dementia.

Sundowner’s Syndrome is a facet of the diseases that magnifies a feeling of being at “loose ends” when the day is wrapped up and there is anticipation for tomorrow, says Barbara Dzikowski, director of Alzheimer’s & Dementia Services of Northern Indiana Inc.

“Sundowner’s can include increased agitation, anxiety, some kind of confusion and sudden mood shifts,” Dzikowski says. “Not everyone with dementia has Sundowner’s, but it’s so prevalent that it is very much identified with dementia.”

by Salynn Boyles for WebMD:

Extreme agitation, aggressiveness, and psychosis are common among people with Alzheimer’s disease — especially in its later stages — and they are among the symptoms most often associated with admission to nursing homes.

Antipsychotic drugs are often prescribed to treat these symptoms, but their use remains controversial. Federal regulators recommend that patients take the drugs for no more than six months, but new research published online today in the New England Journal of Medicine questions the wisdom of abruptly stopping treatment.

People with Alzheimer’s whose symptoms improved while taking the antipsychotic drug risperidone (Risperdal) had a high risk for relapsing when taken off the medication.

The study suggests that the common practice of arbitrarily ending treatment after a few months may cause harm to patients, says researcher D.P. Devanand, MD, of the New York State Psychiatric Institute and Columbia University.

by India.com:

Every person is unique and dementia affects people differently – no two people will have symptoms that develop in exactly the same way. An individual’s personality, general health and social situation are all important factors in determining the impact of dementia on him or her. Symptoms vary between Alzheimer’s disease and other types of dementia, but there are broad similarities between them all. The most common signs are memory loss and the loss of practical abilities, which can lead to withdrawal from work or social activities. If you think that these problems are affecting your daily life, or the life of someone you know, you should talk to your doctor.

The most common early symptoms of dementia are:

Memory loss

Declining memory, especially short-term memory, is the most common early symptom of dementia. People with ordinary forgetfulness can still remember other facts associated with the thing they have forgotten. For example, they may briefly forget their next-door neighbour’s name but they still know the person they are talking to is their next-door neighbour. A person with dementia will not only forget their neighbour’s name but also the context.