If you have concerns about an aging parent’s memory, you’ve probably wondered if they have Alzheimer’s disease or another dementia. After all, you already know it’s fairly common for older people to start slipping mentally, and the Alzheimer’s Association estimates that the lifetime risk for a woman in her 60s is one in six.
What to do about your concerns and worries? Whether you search online or ask friends, most advice boils down to this: Tell the doctor.
This advice isn’t wrong. But, it’s incomplete.
Yes, you should tell the doctor you’re worried. (If you’re worried about upsetting your parent, send the doctor your concerns in writing. No HIPAA authorization is needed for you to share your concerns with a parent’s health professional.)
But if you, your parent and the doctor truly want to get to the bottom of things, you can take a simple approach that is incredibly effective. Start taking notes on the eight behaviors known to correspond with Alzheimer’s.
By doing so, you’ll be gathering the kind of detailed information that doctors (like myself) need in order to confirm thinking problems and detect the likely disease.
8 Alzheimer’s Behaviors to Track
For each of the behaviors we’ll discuss, try to jot down the following:
- Whether there’s been a decline or change compared to the way your parent used to be
- Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities
- When you – or another person – first noticed problems, and what you observed
- What kinds of problems you see your parent having now
Note: If you don’t notice a problem in any of the following eight areas, be specific in documenting this. (E.g., “No such problem noted.”) That way, you and your family will know you didn’t just forget to consider that behavior.
The Eight Behaviors
- Poor Judgment
Have you noticed any behaviors or situations that seem to indicate bad decisions? Any unusual or excessive spending? Or perhaps a poor understanding of safety concerns that everyone else is worried about? Write down anything you or another person close to your parents has reported or observed.
- Reduced Interest in Leisure Activities
Have you noticed that your parent no longer seems as interested or involved in his hobbies? Did your mother read voraciously but now hardly makes progress on her novel? Has your dad given up his bridge games? Any change in hobbies or leisure activities should be noted, especially if such a change doesn’t seem to be related to a problem with physical health.
- Repeating Oneself
Any repeating of stories? Any asking the same questions repeatedly? Has your parent been declaring the same thing (“I really love those roses you gave me.”) over and over again? If so, jot that down.
- Difficulty Learning to Use Something New
Any difficulty learning to use a new gadget, such as a smartphone? Any trouble with a new appliance? Make note of what your parent has difficulty adapting to and how he tried to manage.
- Forgetting the Year or Month
Any difficulty keeping track of the current year or month? If it happens more than once, make a note of that especially.
- Difficulty Managing Money and Finances
Have you noticed any problems managing bills, expenses or taxes? You might have to ask your parents about this if you aren’t usually involved in their finances.
- Problems with Appointments and Commitments
Has your parent missed any appointments or forgotten about a get-together that you’d planned? Everyone forgets something occasionally, but if this has happened repeatedly, be sure to document when it started and how bad it’s gotten.
- Daily Struggles with Memory or Thinking
It’s normal for older adults to have a lapse here and there. But if your parent seems to experience a memory or thinking problem every day, make a note of this. It’s a good idea to add specific examples describing what you – or another person – observed.
Why Tracking These Behaviors Can Help Detect Alzheimer’s Disease
The eight behaviors above correspond to the brain ability’s to manage memory, judgment, learning or complex tasks.
To diagnose Alzheimer’s or another dementia, your parent’s doctors must document that your parent has been having persistent difficulties in two or more areas related to brain function. (This is necessary but not sufficient for diagnosis – the doctors must also rule out other causes for thinking problems.)
Now, doctors can assess the different aspects of brain function through certain office-based thinking tests. However, research has found that asking family members about the behaviors above can be just as effective when it comes to spotting probable dementia, including Alzheimer’s disease.
In fact, a questionnaire covering the eight behaviors above has been extensively tested by dementia experts. It’s called the AD8 Informant Interview.
Getting this type of observational information from family members helps doctors determine whether the behavior is a persisting, and maybe even worsening, problem. This matters because a single office-based test only provides a snapshot of how your parent’s brain is doing on that day.
Last but not least, geriatricians such as myself love getting these kinds of behavioral observations from families. Why? Well, it’s practical information related to people’s daily lives. By knowing more about what kinds of problems an older person has been experiencing, we can make useful recommendations right away to help families with safety, independence and even family conflicts.
How to Help Your Family Get the Right Care
Doctors who are knowledgeable about dementia will ask a family about problems related to the eight behaviors above.
Unfortunately, many primary care doctors aren’t experienced in evaluating dementia. I’ve had worried families tell me that other doctors waved off their concerns or told them this is just what happens when people age.
Such things happen partly because families are often a bit vague when they voice concerns. This means the doctor has to do more work in investigating the concern and in documenting specific problems that can help diagnose Alzheimer’s. Some doctors will do this work, but since office visits are often rushed, many of them won’t get around to it.
Unless that is, you bring detailed information to help the doctors take further action. The more specifics you can share regarding what you’ve observed, the more likely you’ll get the help your parent and your family need.
Plus, whether or not Alzheimer’s caused these behaviors, they often cause anxiety and frustration within families. So it’s important to bring them up to a doctor so that you can get help understanding the cause and learn what to do next.
Don’t go on for too long with the worrying and the wondering. Take notes so that you can then take better action.