Unlike age-related memory loss caused by specific factors, Alzheimer’s disease is characterized by a loss of daily autonomy, manifested by a loss of recent memory as well as spatial landmarks. time-consuming, addictive. When should we be worried?
What are the characteristics of normal age-related memory loss?
It is memory problems that will occur in particular circumstances, explains the specialist: stress, fatigue, insomnia, sleep apnea, taking medication such as anxiolytics, excessive alcohol consumption but “which will not have any impact on the person’s daily autonomy“. If everything is biologically normal, the elderly person has less memory capacity than a 15-year-old. The WHO considers that a person is old from over 65 years old, now with the evolution of technologies, people are over 80 years old. “If the person has a coherent speech, shows a good graphic memory, a good sense of direction, we can consider that it is not Alzheimer’s.”
What are the characteristics of memory loss in Alzheimer’s disease?
In Alzheimer’s disease, memory loss concerns recent memories, “for example, not remembering an event that took place the day before or even the fact of being confused, disoriented in time and spaceno longer recognize the places where you go or even your home, experience difficulty recognizing loved ones.” The characteristics of memory loss result in impaired cognitive functions: the person no longer has organizational and planning skills, she may give up some daily chores, she begins to isolate herself. “I have in my patients a 69-year-old lady who has started to restrict her car movements, she plans her route before leaving, she is aware that she can get lost, these are indeed signs that should alert“, insists the neurologist.
When to worry?
You have to worry when there starts to be dependency, i.e. loss of daily autonomy. “Some people come to consult on their own, because they have family members affected by this disease, so certain benign disorders such as forgetting their card, keys, credit card code will scare them and push them to consult..” Often, it is the children and the spouses who trigger the consultation with the general practitioner because they noticed that the person no longer put the objects in their place, that there was a disorganization during the day with a loss of spatio-temporal landmarks, these are elements that alert those around them.
Who to consult?
“First, you have to contact the general practitioner, who will send to a specialist, usually a neurologist, geriatrician, psychiatrist.” Depending on the diagnosis, management can be disciplinary. “We rely on a psychological, radiological, brain imaging (MRI) assessment to detect brain and vascular lesions”. The best is the brain scan which will highlight the functioning of the brain and in particular the defect of the temporary associative areas observed in Alzheimer’s disease.
To slow down the disease, social ties are important and you must continue to practice daily physical exercise.
What tests to tell the difference?
“We have many tools and devices at our disposal. There are two so-called global tests: MMSE or Folstein test and MOCA“, underlines the neurologist. In general, the MMSE is a test of cognitive evaluation and memory capacities composed of about thirty questions which will make it possible to obtain an overall score by analyzing 6 cognitive functions orientation in time and space, learning abilities and immediate memory, short-term memory, praxis abilities, -knowing how to use a fork), language abilities with the naming of words, attention and reasoning. The second test named MOCA developed by Canadians presents itself as an accurate screening tool that allows you to identify mild neurocognitive decline. There are also tests that will explore immediate memory, such as the Dubois 5-word test, to read, to remember and to restore spontaneously, continues the Doctor. Then, the patient repeats the exercise 5 minutes later. This allows to evaluate the 3 stages of memorization, recording, or encoding, storing and retrieving information. “The other test used is that of Grober or RL-RI 16 consisting of 16 words which measures encoding problems in memory. : This test assesses the presence and nature of verbal episodic memory difficulties in order to detect worsening or progression to dementia in individuals with mild cognitive deficits.
Can we delay Alzheimer’s disease?
“There are drug treatments offered to certain patients beginning the disease and meeting specific criteria, it is indeed necessary that the diagnosis is certain.“, explains the specialist. To slow down the disease, social ties are important, you have to see family, friends, keep talking, practice daily physical exercisebeing part of a group, taking care of your nutrition, “patients are advised to Mediterranean diet based on fruits, vegetables, fish“of the reading, games (crosswords, arrows, mandalas, sudoku) keeping a daily diary, traveling to stay independent as long as possible. “Caregivers also need to stay in shape, for this there are day and night receptions and even backpacking experiences in some regions.“. The principle? A specialized companion replaces the carer at home for several consecutive days (24 hours a day) taking care of the person being cared for in order to allow the carer to take advantage of a moment of respite.
Thanks to Doctor Jean-Philippe Delabrousse-Mayoux, neurologist at the Center Hospitalier Samuel Pozzi in Bergerac.