Forgetting where you left your keys, not immediately remembering a person’s name or entering a room and no longer knowing what you were looking for are common situations, which can become more frequent as you age and which, in most cases, do not necessarily indicate the presence of a neurodegenerative disease. However, when forgetfulness repeats itself, concerns newly learned information or begins to compromise activities that until recently were carried out without difficulty, it is important not to automatically attribute these changes to aging.
It is precisely on the difference between normal memory changes and the possible initial symptoms of Alzheimer’s that attention is focused on the occasion of the World Day dedicated to the disease, which is celebrated on 21 September, while the new data released in Piedmont brings back to the center of the health debate a pathology that not only concerns those directly affected by it, but also involves family members, caregivers and local services.
Alzheimer’s is the most common cause of dementia, but the two terms are not synonymous: dementia indicates a set of cognitive and behavioral symptoms sufficiently important to compromise daily autonomy, while Alzheimer’s is a specific neurodegenerative disease that can progressively determine this condition. Recognizing suspicious changes promptly does not therefore mean formulating a diagnosis on the basis of some forgetfulness, but identifying the situations in which it is appropriate to initiate a medical investigation, also to exclude different disorders that can produce similar symptoms.
Alzheimer’s, in Piedmont over 92 thousand people with dementia
The data released by the Mauriziano hospital in Turin shows the size of the phenomenon: in Piedmont there are an estimated over 92 thousand people with dementia among the over 65s, of which around 61 thousand with Alzheimer’s, while another 1,700 cases concern people between 35 and 64 years old. Added to these numbers are over 74 thousand people with mild cognitive impairment, a condition known as Mild Cognitive Impairment (MCI), which involves cognitive difficulties greater than those expected for age but does not necessarily lead to a significant loss of autonomy and does not in all cases evolve towards a form of dementia.
The province of Turin concentrates over 47 thousand cases among those aged over sixty-five, confirming how much the problem requires a health and care response capable of accompanying not only the patients, but also the families who have to face the consequences of the disease in daily life.
Alzheimer’s, what are the 5 initial signs to recognise
The early symptoms of Alzheimer’s do not necessarily manifest themselves with obvious memory loss and, especially in the early stages, can be confused with absent-mindedness, tiredness or normal age-related difficulties. However, there are some changes which, when they become recurrent and interfere with usual activities, deserve medical evaluation, also because they may involve abilities other than simple memory. The Alzheimer’s Association identifies ten possible warning signs, which can be traced back to five main areas of observation.
1. Forgetting newly learned information and repeating the same questions over and over again
The first sign concerns recent memory and, in particular, the difficulty in retaining information that was learned a short time ago. A person may repeatedly forget important appointments, not remember a conversation that took place a few hours earlier or ask the same question several times without realizing that they have already received an answer, gradually coming to depend on family members to remember activities that they previously managed completely independently.
The difference compared to common age-related forgetfulness therefore does not only concern the frequency of the episodes, but also their nature and consequences on daily life. Temporarily forgetting a name and remembering it later is different from not being able to recall recent information or repeatedly losing memory of entire events.
2. No longer being able to carry out activities that were previously simple
Another possible alarm bell is represented by the difficulty in organizing and completing usual operations, especially when they require a sequence of steps or a certain planning ability. Preparing a known recipe, managing the payment of bills, organizing the shopping or following an activity that until recently presented no problems can suddenly become complex operations, in which the person loses the thread or is unable to understand what the next step is.
An occasional mistake, especially in situations of stress or tiredness, is not in itself indicative of an illness, while the appearance of recurring difficulties in established activities, accompanied by an increasing need for assistance, represents a change that should be reported to the doctor.
3. Losing orientation even in familiar places
Occasionally confusing the day of the week can happen to anyone, but frequently losing track of time, not being able to reconstruct how you got to a certain place or losing your way during a usual route are different situations, which can indicate a compromise in orientation skills.
In the early stages of Alzheimer’s, a person may show difficulty correctly placing events in time, confuse dates and seasons, or not immediately recognize an environment he or she knows well. The problem becomes particularly relevant when these episodes occur in familiar contexts, in which the person has always moved without needing directions or assistance.
4. Having trouble finding words or following a conversation
Language may also be involved in the early manifestations of the disease. It’s not simply a matter of having a word on the tip of your tongue, but of encountering recurring difficulties in finding common terms, interrupting a conversation without being able to get back to it or using inappropriate words to indicate objects and situations in everyday life.
Those who experience these symptoms may have problems following an articulated speech, repeat the same concepts several times or progressively give up participating in conversations because they are no longer able to express themselves as easily as before. Even in this case, what must draw attention is above all the presence of a change compared to the person’s usual linguistic abilities.
5. Unusual changes in mood, personality and behavior
Alzheimer’s can also manifest itself through emotional and behavioral changes, which are sometimes observed by family members before the affected person even recognizes their cognitive difficulties. Increased irritability, apparently unmotivated states of anxiety, suspicious behavior or the tendency to avoid meetings and social activities that were previously considered pleasant can accompany the progressive deterioration of cognitive functions.
These changes, taken individually, are not sufficient to suspect a diagnosis of Alzheimer’s, because they may depend on numerous other psychological or medical conditions. However, they become elements to be explored further when they are persistent, represent a significant change compared to the usual personality and are accompanied by memory, language or orientation difficulties.
Forgetfulness or Alzheimer’s: when it is necessary to contact the doctor
The presence of one or more of these signs does not necessarily mean you have Alzheimer’s, but it should prompt you to contact your doctor when difficulties are recurring, tend to get worse or interfere with normal daily activities. Sleep disorders, depression, side effects of some medications, vitamin deficiencies and other medical conditions can in fact cause memory or concentration problems, which can sometimes be improved through appropriate treatment.
The first point of contact is the general practitioner, who can collect information on the onset and evolution of symptoms, evaluate general health conditions and prescribe initial clinical examinations or cognitive tests. When a suspicion of cognitive impairment emerges, the process can continue at the Centers for Cognitive Disorders and Dementia (CDCD), where specialists carry out the necessary investigations to distinguish the different possible causes of the disorders.
A timely evaluation allows us to identify any treatable conditions and, in the presence of a neurodegenerative disease, to plan the most appropriate therapeutic and healthcare interventions, also helping family members to understand how to deal with the evolution of the pathology.
Alzheimer’s, the role of prevention and modifiable risk factors
Alongside the importance of early diagnosis, Piedmont data draws attention to the weight of modifiable risk factors: according to estimates reported by the Mauriziano hospital, 51.7% of dementia cases in the region can be attributed to factors on which it is possible to intervene, including physical inactivity, social isolation, hypertension, obesity, diabetes and air pollution.
A figure which does not mean that more than half of cases can be automatically avoided, but which highlights how brain health is also influenced by living conditions and the prevention of cardiovascular and metabolic diseases.
The World Health Organization highlights the importance of intervening on risk factors throughout life, through healthy behaviors, the control of medical conditions associated with cognitive impairment and the reduction of exposure to environmental risks.
Practicing regular physical activity, not smoking, following a balanced diet, maintaining social relationships, controlling blood pressure, blood sugar and cholesterol and addressing any hearing problems are some of the measures that can help reduce the risk of cognitive deterioration and dementia, even without offering an individual guarantee of prevention of the disease.
The challenge, therefore, does not only concern the ability to promptly recognize the first symptoms, but also that of accompanying an aging population through adequate health services, prevention programs and greater attention to the needs of families. It is precisely to these themes that World Alzheimer’s Day on 21 September will be dedicated, on the occasion of which the Ministry of Health has organized an institutional meeting on the future of the National Dementia Plan and on the strategies necessary to improve the health and care response.
