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Alzheimer’s False Alarms

dementia and rememberingRaise your hand if you are a caregiver and have never misplaced your car keys. Raise your hand if you are a caregiver and have never been concerned that the forgetfulness of an older loved one might be a sign of Alzheimer’s or some other form of cognitive impairment. I am thinking that we went from no hands up to nearly all hands raised. But the practical fact is that for those of you with care receivers of a certain age it is common that there will be keys misplaced or names forgotten and more. Yet, that is not necessarily an indication of anything organically wrong with your loved one’s memory. So, how does one know? Here are some warning signs according to the experts:
1. Experts talk about the differences between “retrieval” and “storage” problems in memory. Forgetting someone’s name is retrieval and it is not a warning sign of Alzheimer’s. Forgetting that you know the person at all, however, is a storage problem, and it can be a sign of a more serious brain issue. Or misplacing the keys is a retrieval issue, but forgetting what the keys are supposed to do is a storage problem that should prompt closer attention.
2. There also is a difference between losing the car keys and losing the ability to do something that always came pretty naturally. Misplacing the keys, according to the experts, can happen to just about anyone, but forgetting how to start the car and put it in gear can be cause for concern. Or the loved one who was always good at math forgetting how to multiply also may be concerning.
3. Just plain confusion with normal daily activities also is a potential sign, according to the scientists who study these things. If your loved one gets confused on the way back to your table from the restroom while dining out, that may be cause for concern. You should also look for smaller signs as basic as their stride. If their steps begin to more resemble a shuffle this may be a sign of a more fundamental uncertainty…or the unexplained fall likewise can be a precursor of cognitive decline.
4. Finally, look for what may be as subtle as changes in personality. The loved one who used to be the animated conversationalist, but who now is more subdued may be responding to their own confusion in trying to follow what everyone is saying. Agitation in a person who was once a cheery individual also can be a sign of changing mental abilities.
Against all of these potential warning signs, be careful about a hasty judgment. A change in mental acuity that is rapid in its onset is better classified as a delirium – not dementia. These episodes can arise from urinary tract or other infections, dehydration or even some hormonal imbalances. Certain medications like steroids or combinations of medications can precipitate short term mental imbalances. Caregivers should be alert to these, but not jump to the wrong conclusions. And beware of your loved one’s healthcare provider who prescribes any of the Alzheimer’s agents for “organic dementia” or “delirium” or anything short of a definitive Alzheimer’s disease diagnosis. So, raise your awareness before you raise your hand.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to


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