Suspected dementia: Is granny just forgetful or already ill?
Passing the key or forgetting an important appointment can happen to anyone once? a certain everyday forgetfulness is normal with increasing age. But Alzheimer's goes far beyond that. How do I recognize the first symptoms of such dementia in relatives and friends, and what should I do if I have a reasonable suspicion?
1.2 million Germans suffer from Alzheimer's? Ascending trend. The disease is the most common form of dementia and occurs especially in old age. As people grow older today, more people will be affected by the disease in the future. For the year 2050 experts already count on three million patients.
What happens with Alzheimer's disease?
Alzheimer's dementia is a so-called neurodegenerative disease in which there is a progressive destruction of brain cells. As a typical symptom, deposits of clumped proteins are found in the diseased brain: Instead of being broken down, the beta-amyloid protein accumulates in Alzheimer's patients. These plaques could be responsible for the nerve cells dying and those affected becoming demented.
What are the first alarm signs?
The demise of the brain cells manifests itself above all in a reduced intellectual capacity. First, it mainly affects the short-term memory. Especially in the early stages, it is difficult to see that family members or friends could possibly be ill. There are, however, a few warning signs to look out for.
For example, when a person repeats the same question over and over again while talking, or keeps talking the same thing, even though it has already been discussed, I should be alert. Word-finding disorders can also be a sign of incipient dementia. Also typical: The person comes suddenly with everyday things such as cooking or transfers no longer cope and has problems to orientate themselves.
Which "cover-up strategies" should I look for?
But even if I do not notice such abnormalities, certain behavioral changes should make me startled: "Many patients try to hide their deficits as much as possible from relatives, friends and from the family doctor," says the German Alzheimer's Association.
Typical strategies include, for example, helping oneself more with notes or avoiding difficult-to-find activities. This can be expressed in the fact that suddenly people do not do as much as they used to or less and less engage in discussions. Often, excuses for mistakes are also invented.
Who can I contact if I have a suspicion?
If I have the assumption that a person in my environment could be ill with Alzheimer's, I should motivate him carefully to a doctor's visit. Is this difficult, is it advisable to contact the family doctor? possibly this one has another access to his patient.
The family doctor is anyway the first point of contact in case of suspicion. He can do the first tests in a so-called screening, which can confirm evidence of dementia of the Alzheimer's type. For further diagnosis, I should get an appointment with a specialized memory outpatient clinic or memory consultation. These are offered by many clinics.
How is dementia diagnosed?
To safely diagnose Alzheimer's disease, medical professionals use a variety of procedures. They combine physical examinations with neuropsychological tests. Using imaging techniques, physicians can visualize the protein deposits typical of Alzheimer's and detect reductions in specific areas of the brain. They can also check the blood for signs of the disease.
The central component of the neurological examination is the so-called clock test. The patient should draw in a given time with a large and a small pointer. There are also questionnaires that check the short-term memory. I too as a relative or friend will be interviewed in a detailed conversation. My observations can provide the medical professionals with further valuable information.
What other causes are there for forgetfulness?
Not only Alzheimer's, but also other illnesses can be behind the declining mental performance and difficulties in everyday life. Symptoms such as dementia, for example, cause strokes, brain tumors or depression. Vitamin B12 deficiency, certain medications or alcohol abuse can also be the cause. It is therefore important to exclude these by appropriate investigations.
What happens after the diagnosis?
If the doctor diagnoses Alzheimer's, the first important step is done. Although the disease is not curable, its progression can be delayed by using drugs and psycho-social measures if it is detected early. But what are the next steps?
First of all, it is important to discuss with the patient how he imagines his future in terms of care. The attending physician gives recommendations for this. Now, where it is still possible, I should clarify legal matters with the person concerned. Certain wishes and decisions can be determined for example in a preventive power of attorney, a care directive and a living will. Buy now 
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