talking about what is the difference between  Alzheimer's and Dementia and Normal Aging. A  

lot of us have been home during the COVID pandemic  maybe you're interacting with your older relatives  

more than usual and you may be noticing some  memory problems and so what we're going to do  

today is talk about what are the top 10 warning  signs that you should look for if you're worried  

about somebody having an issue with their memory  so that you can get them in to a provider to have  

it checked out so the first question is what  is dementia and basically dementia is a broad  

umbrella term which means that there are a lot of  different symptoms that go into into this term for  

dementia and there are a lot of different things  that happen people are going to have difficulty  

with their memory they're gonna have trouble  with language typically you know nouns and  

naming are one of the first things that will see  them having issues with but also problem-solving  

and executive planning and executive planning  is the ability to kind of plan and execute an  

event whether it's recipe made forever or you know  what's the correct order to putting your clothes  

on so but Alzheimer's is a type of dementia and  it actually accounts for about 60 to 80 percent  

of the different dimensions that we see the  other dimensions that are most common are Lewy  

body dementia a frontal lobe dementia and dementia  related to Parkinson's but also vascular dementia  

so those kind of those types of dementia tend  to appear a little bit differently for example  

with Lewy body dementia you may see someone I'm  having trouble walking or falling more something  

where the frontal lobe dementia the frontal  lobe of your brain is kind of the stop sign  

part so these may be people that can't that they  don't have a lot of good impulse control anymore

and then somebody with vascular dementia typically  already has heart disease so you may have one type  

or you have may have a mix of things particularly  if you have like high blood pressure you've had  

many strokes in the past and you may have  Alzheimer's so you may have a combination of  

Alzheimer's type dementia and a vascular dementia  and at the end of the day for the most part these  

symptoms are pretty similar and so we're just  going to talk about the top 10 signs and things  

that you should look for if you're concerned about  somebody's memory so first one is that this memory  

problem needs to be significant enough that it's  going to interrupt this person's ability to take  

care of themselves every day so one of the most  common things and Alzheimer's is that you aren't  

able to remember new information so they're really  good with things that happened a long long time  

ago so that long-term memory is intact and so they  can tell you everything about their childhood but  

they can't tell you what they had for breakfast or  what you were just talking about five minutes ago  

so they may be forgetting important dates they  may be asking you the same information over and  

over or may be telling you the same information  over and over or you may begin to see then rely  

a lot more on memory aids and memory aid to me is  basically a compensatory strategy I have tons of  

them but basically this would be if you started  seeing sticky notes appear on the refrigerator  

you know don't forget to do this don't forget to  do that and as long as people can do that and it's  

working for them well it is a warning sign they  still have the ability to use those compensatory  

strategies so we need to let them do that versus  normal aging would be like you occasionally forgot  

somebody's name or you might forget an appointment  but you do remember it later so the second sign  

to look out for our challenges with problem  solving so this is when someone has trouble kind  

of developing a plan for work or an activity that  they want to do or they may have trouble following  

a familiar at recipe so the recipe they're known  for forever they may not remember it's two eggs  

or three eggs or have water how long I supposed to  cook it or they may have trouble keeping up with  

their monthly bills because I just don't remember  that they're supposed to deal with that or they  

may have a lot more difficulty concentrating and  it just takes them a lot longer to do things and  

then it did before versus you know with a normal  age-related change this might be someone who just  

has an occasional error in their checkbook I  kind of do that too sometimes so don't jump to  

conclusions just because one of these warning  signs might apply to you or your loved one the  

third sign is difficulty completing familiar tasks  at home or at work or even out when you're playing  

so sometimes people have trouble figuring out how  do I Drive from you know to a particular location  

someplace they've been a lot or how do they manage  their budget at work or maybe even remember the  

rules of a game that becomes more difficult and  that's different than like normal age-related  

change where you may need a little bit of help  with the settings on a microwave or you need  

help trying to record a television show which is  different than just trying to turn the television  

on so those are a little bit more complex tasks  that and if I go to my mom's house I still can't  

figure out how to use their remotes so again  yeah if they're in their own home and this is  

a new problem that you're noticing you just need  to be aware of it the next thing is confusion with  

time and place and so people with Alzheimer's  can lose track of what time it is again this  

is one of those things in the middle of kovat a  lot of us are probably you know having trouble  

keeping up with time and it's just because our  schedules and the calendars that we live and die  

by they just are in a completely different way  different saying right now this will be someone  

who didn't know that it was summer outside when  it's and they would tell you it's winter or they  

may be telling you as 1987 or telling you a  story from 1987 when it's 2020 so they also  

may have trouble remembering how they got where  they are so those aren't that's another group of  

warning signs compared to normal aging you might  get confused about what day of the week it is but  

you know to get your calendar out or pull out  your iPhone you can figure out what day it is  

so lucky for all of us encoded you know we can  figure out what day it is the next warning sign  

is there they have trouble understanding visual  images and spatial relationships so let's break  

that down sometimes just having visual problems  is a sign of Alzheimer's they may have difficulty  

reading judging distances or determining color and  contrast and this also could cause them problems  

with driving this is different than having like  a true visual impairment related to either a  

cataract or glaucoma or some age-related macular  degeneration those are truly visual problems  

but the visual part of the brain is impacted with  Alzheimer's when you're young you basically have a  

hundred and eighty degree peripheral vision and by  the time you're 65 that comes in about 45 degrees  

but what happens with Alzheimer's disease is that  visual field gets smaller and smaller so by the  

time somebody's in very advanced dementia they  basically have like my eye or they have monocular  

vision that then goes down to binocular visions if  you were to put your eye call these your dementia  

eyeballs if you were to put those on and think  about if that was all that you could see you can't  

see anything on either side of you and you know  what I tell people with my work is it also means  

they can't see the plate that's sitting right  in front of them so in very advanced dementia  

this is when we would see people reach across the  table to eat somebody else's food and everyone's  

like but your food is right here in front of you  but you think about you'd have to look down to  

see that so we have to adjust them and we'll get  to that layer with advanced Alzheimer's this is  

right now what we're talking about is early signs  so the next one is having new problems with words  

and speaking as well as writing so this may you  may see this as somebody who's having trouble  

following a conversation or they be telling you  a story and stop in the middle of it and can't  

figure out you know what they were going to do or  they may tell you the same story over and over or  

they may have difficulty finding the right word  and typically this is a noun so they might be like  

you know hand me that you know thing over there  it's kind of a small thing you can talk on it to  

call people and you're late you mean your phone  they're like yes that's my phone so that kind of  

describing all around the nail it's called circum  Lucien so you may see a little bit more of that  

and the other part of that is in normal aging you  might just have trouble finding the right word so  

a little bit different when someone's beginning to  have memory issues so the seventh warning sign to  

pay attention to if someone made misplace things  or they may lose their ability to retrace their  

steps to find it so we've all misplaced things  before but typically you and I do this with my  

kids I'm like you need to retrace your steps and  figure out where you know where you were when you  

might have lost this thing what happens a lot of  times with with people with early Alzheimer's is  

they begin to get a little paranoid and so they  may begin to hide things like I'm gonna hide my  

purse or I'm gonna put my purse you know in this  safe place and then when they go to find their  

purse they can't find it and then they blame you  for stealing it so there's that's just another  

example of how they may actually put something  away but then they can't remember where where they  

put it and this would occur you know more and more  frequently over time versus you know normal aging  

is when someone kind of they misplace things but  they are able to retrace their steps and lucky for  

us you know we always find what we were looking  for in the last place we looked which I've always  

thought was the hilarious pun alright number eight  may have decreased or poor judgments and so this  

gets back into the decision-making piece so they  may not they may think they have more ability to  

take care of themselves than they actually do they  may have poor judgment when it comes to dealing  

with money this also makes them very susceptible  to scams because you know particularly if they're  

isolated in their home someone calls them on the  phone and they may end up giving them you know a  

large sum of money when because they just didn't  have the judgment to know that they were being  

scanned or you may see this as let less paying  attention to their own personal hygiene so they  

may stop showering you know brushing their hair  that type of stuff when they used to be a very  

well-kept person and that's different than normal  aging where you may make a bad decision every once  

in a while but you're you're pretty good with  knowing what your limits are ix sign is when  

people withdraw from work or social activities  so this may be someone that you know you just  

haven't seen for a while and in Kovach that's kind  of all of us but these folks would have begun they  

would have begun to remove themselves from all  their hobbies all their social activities any  

different projects or going going out of the house  and they may even begin to have trouble following  

like their favorite team and they begin to avoid  social situations because they are very aware  

that they're having trouble with their memory and  they're afraid that you're going to find out about  

it so the way this typically would show up for me  one of the parts of the brain that that remains  

intact is this ability to do we call social  chitchat so you can be sitting in yeah I can  

be talking to to an older adult and everything's  fine we're having the social conversation how's  

the weather yeah how your kids well blah and then  I say to them okay I need to begin to ask you some  

questions ask these questions of everyone do you  know what today's date is and they would fire back  

like in super angry mode like a over reaction  to what the question is but what I did is I  

just began to ask them questions that they feel  like I'm going to find out that they're having  

issues with their memory that's a whole nother  conversation about how to handle that type of  

behavior but this may be somebody that I mean they  can go through a doctor's visit for 15 minutes and  

have and act like everything's fine so this is why  it's hard for primary care providers to pick up on  

this and they need the history from the family  caregivers around some of these warning signs to  

help provide a full picture of what's happening at  home and how well they're functioning at home but  

again if you start we're gonna do another podcast  about how to actually communicate about this that  

you may not be able to sit in the room with that  person then tell that provider because it's going  

to make make your loved one mad and versus you  know for normal aging sometimes people they just  

don't have as much energy as they used to so they  may be more tired after a work day or after going  

to family and social engagements that they are so  very much socially engaged and then the top the  

last warning sign is changes in their moods or  personality and so this could be someone that's  

very confused they could be very depressed they  could be anxious they could be scared and then  

they can be they're a lot more easily upset  when they're out of places that are part of  

their comfort zone so prior to Coba this might be  somebody that lives you know in their home alone  

they can manage things pretty fine but they go  out to eat with the family and there's a lot more  

noise in that environment and they just have like  this explosive like moment and so okay those rapid  

changes in mood you know or even their personality  where they used to be really outgoing and now  

you know they don't want to go out and see anyone  compared to normal aging when people develop very  

specific ways of doing things and they can come  pretty irritable when that routine is interrupted  

so I had two thoughts want us you know people that  are in the middle of story and forget what they  

were going to say I think that could be you know  an ad D type issue and you know this have been