“What are the warning signs of Alzheimer's?”

Alzheimer's disease can present in many different ways: short term memory loss, poor attention, deficits in judgment and reasoning, disorientation to place and time etc... These symptoms cause deficits in ability to complete daily tasks like paying bills, driving, cooking or taking medications as prescribed amongst other things. Take him to a geriatrician or a neurologist for cognitive testing.

Often, the early signs tend to be short-term memory loss, word finding deficits, difficulty navigating spaces, and possibly mood changes or anxiety. There is a long list of medical and neurological conditions that can lead to confusion so ideally he needs a full work up which at a minimum would include blood work to rule out reversible causes of mental status changes, possibly a CT or MRI brain, psychiatric or neurological evaluation, and possibly formal cognitive testing. There are many types of dementia and accurate diagnosis helps with treatment and life planning.

I suggest doing a MMSE exam It is not very sensitive re High IQ individuals, but if the score is <30 it is significant and medication (Aricept if Alzheimers) should be started. Studies show, if no intervention, a 3 point/year deterioration. Dose should be increased from 5 mg to 20 by day 61. Studies have shown if a patient is continued on 20 mg for 34 years, decrease in MMSE may be as little of 3 points, but if then stopped, within 3 months scores drop another 9 points in 3 months. That is to score expected if Aricept was never used. There are multiple causes of dementia, eg Pseudodementia due to depression, not just Alzheimer's disease. Some are treatable and reversible, such as Vitamin B-12 deficiency which is reversible if treated early, and Wernicke's encephalopathy due to alcohol, which untreated with Thiamine 100 mg tid for 3 months, become irreversible (Korsakov's syndrome). Hope this helps.

Sincerely, Robert Lynn Horne MD