Sure, everyone forgets car keys now and then but paranoia, refusal to take medication, and a sudden disinterest in hobbies or activities are all possible early warning signs of dementia and Alzheimer’s disease.
“Sometimes it’s a result of normal aging, but more often than not it’s a result of some mental disorder,” says Dr. Daniel Chueh, a Santa Ana psychiatrist. “With the elderly, Alzheimer’s is the most prevalent type of dementia. We try to assess the behavior and find out if an obvious behavioral change is the normal effect of aging, depression or dementia?”
Smart Business spoke with Chueh and his colleague, Dr. Mike McKinnon, co-medical directors of the Golden Years Program at Coastal Communities Hospital, about warning signs of dementia and what an adult child can do to help a parent who may be suffering from a mental illness.
What is dementia?
McKinnon: Dementia is declining cognition and a declining ability to care for one’s basic needs. There are 300 types of dementia, of which Alzheimer’s is probably the most common. At the very extreme end of the definition are ailments like mad cow disease, which is actually a type of dementia.
What are the significant warning signs that one or more parents may have a mental illness?
Chueh: If they have any type of physical decline, they should be evaluated. Behavioral changes or changes in attitude are major signs that something is wrong. An example might be a mother who used to be very active and going out all the time with friends but now doesn’t leave the house very often.
Not doing things they enjoy or not wanting to be with the people they normally care about are significant signs of depression or dementia. Other possible signs might be a declining loss of some normal physical functions, such as not driving a car well (or not driving at all), unsteadiness on their feet, or impaired vision.
Early signs would be not doing their hobbies as much, loss of interest in food, decrease in appetite, not going out as much things along those lines. Of course, there are many more obvious signs like short-temperedness or loss of memory. When they start having memory loss or they wander off away from home and have to be returned by the police, those are much later signs. It is always a good idea to have your loved one evaluated whenever you sense changes in behavior or attitude.
How do you suspect that someone has dementia?
McKinnon: Strong signals of possible dementia include repeating questions, forgetting answers, or becoming more suspicious of others. Another example would be that the person starts accusing people of stealing things from them. A lot of times patients will hide things away, they can’t remember where they’re placed, and they start making accusations that someone has taken those things from them.
Another example is they can’t balance their checkbooks or they can’t make it to their appointments that they normally have made in the past.
In Alzheimer’s, a person’s short-term memory is more impaired than long-term memory. A person with Alzheimer’s will see a family member and won’t recognize him or her because that person has changed as he or she has aged. The parent might recognize a picture of that person from 20 years ago, because that’s in long-term memory, but he or she can’t recognize that person now because it’s in short-term memory.
I often see a patient looking at his daughter and thinking it’s his wife because the daughter looks like the wife did 30 or 40 years ago and he doesn’t have the recent memory of what the daughter looks like.
Something family members can do when that happens is show the parent a picture of the person from 20 years ago. That might help re-orientate the parent a little bit.
How do you assess or evaluate someone for dementia?
McKinnon: A patient needs a global assessment. You need a third person to provide a history of the patient, like a family member or friend. The patient will need an MRI of the brain and lab tests to rule out different ailments that might cause memory loss or confusion. In addition, the person usually needs near-sight testing, which measures memory impairment and helps pinpoint exactly where he or she is having problems and what might be going on.
Is there any way to treat dementia or improve a parent’s situation?
McKinnon: Two classes of FDA-approved medications do help slow the progression of the symptoms, but they are not a cure. Some studies show that a change in diets or supplements can slow the progression of the illness. If a patient has dementia related to Alzheimer’s, sometimes there is treatment.
DANIEL CHUEH, M.D., and MIKE McKINNON, M.D., are psychiatrists on staff at Coastal Communities Hospital. For a patient evaluation, the physicians can be reached at (714) 754-5503.