So far we’ve talked about Stages 1 and 2 possibly being questionable as to whether or not a person does have Alzheimer’s disease. Stage 3 becomes easier to determine if it is Alzheimer’s and not a related problem such as anxiety disorders, depression, sleep problems, or medication. According to the Alzheimer’s Association, Stage 3 is Mild Cognitive Decline.

Because everyone is different, in Stage 3 it is not possible to definitively diagnose Alzheimer’s disease in everyone. In Stage 3 deficiencies are noticed by friends, family or co-workers, but also by anyone who has a meaningful conversation with the person. In a clinical testing or a detailed medical interview, problems with memory or concentration may be measured. Common difficulties listed by the Alzheimer’s Association  include:

• Word- or name-finding problems noticeable to family or close associates

• Decreased ability to remember names when introduced to new people

• Performance issues in social or work settings noticeable to family, friends or co-workers

• Reading a passage and retaining little material

• Losing or misplacing a valuable object

• Decline in ability to plan or organize

Recently, I went to visit a 90-year old church member and his wife. For the past couple of years, this member has been saying his wife has dementia and he was very concerned about her. Each time they attend a Sunday service, she has difficulty remembering and finding her shoes (we take off our shoes at our temple) and deciding which is her coat. However, in visiting and having a conversation with him, I realized that he also has a problem with dementia. He kept asking the same question several times. He was unable to remember the time sequence of our topic of conversation.

But the reason for the visit was because he unknowingly wore my husband’s shoes home after a Sunday service. Granted, they were both black and the same brand. However, he had a blue insert in his shoes and his was definitely newer and less worn. We had questioned him on his way out of the temple, but he insisted it was his (and my husband could not say for sure that it was his either and did not want to create a scene). Later in the week, after I had checked to make sure that the pair of shoes with the inserts was still at the temple, I called him to ask him if his shoes had inserts and he said he thought they did. So off I went to exchange the shoes.

While visiting, his wife was in the kitchen making coffee. It took her a long time and when I brought the dishes back to the kitchen, I discovered it was instant coffee that should’ve been prepared in no time at all.

This is a sad situation because both husband and wife are affected. Fortunately, they are already in a senior community with assisted living facilities. At least one child is close by. His keys have been confiscated so he can no longer drive. Hopefully, the child is prepared for the future.

In my previous post, I wrote about focusing on the caregiver. If you’re not physically and mentally healthy, finding the strength to take care of an Alzheimer’s disease (AD) patient is a monumental challenge. Even if you are in the best of health, I know it’s still difficult, but at least you’re healthy and can think more clearly. Recently, the Alzheimer’s Association in my area sent me a request to renew my 2010 Champion membership — i.e., please send more money.  Attached to this request was a list — 10 Symptoms of Caregiver Stress. I was happy to see the focus on the caregiver. Here are the symptoms of caregiver stress.

1. DENIAL about the disease and its effects on the person who has been diagnosed. “I know Mom’s going to get better.”
2. ANGER at the person with Alzheimer’s or others that no effective treatments or cures currently exist and that people don’t understand what’s going on. “If he asks me that question one more time, I’ll scream.”
3. SOCIAL WITHDRAWAL from friends and activities that once brought pleasure. “I don’t care about getting together with the neighbors anymore.”
4. ANXIETY about facing another day and what the future holds. “What happens when he needs more care than I can provide?”
5. DEPRESSION begins to affect the ability to cope. “I don’t care anymore.”
6. EXHAUSTION makes it nearly impossible to complete necessary daily tasks. “I’m too tired for this.”
7. SLEEPLESSNESS caused by a never-ending list of concerns. “What if she wanders out of the house or falls and hurts herself?”
8. IRRITABILITY leads to moodiness and triggers negative responses and reactions. “Leave me alone!”
9. LACK OF CONCENTRATION makes it difficult to perform familiar tasks. “I was so busy, I forgot we had an appointment.”
10. HEALTH PROBLEMS begin to take their toll, both mentally and physically. “I can’t remember the last time I felt good.”

The Alzheimer’s Association offers a brochure that tells you how to manage caregiver stress and how to be a healthy caregiver. Click here to obtain the brochure. The Alzheimer’s Association has a toll-free number should you wish to speak with someone. 1.800.272.3900. I wish you the best. Please take care.

Although there is still no conclusive test for the determination of Alzheimer’s disease (AD), there is hope and occasionally, new information. Last month, Science Daily reported that:

Elderly people exhibiting memory disturbances that do not affect their normal, daily life suffer from a condition called “mild cognitive impairment” (MCI). Some MCI patients go on to develop Alzheimer’s disease within a few years, whereas other cases remain stable, exhibiting only benign senile forgetfulness. It is crucial to develop simple, blood-based tests enabling early identification of these patients that will progress in order to begin therapy as soon as possible, potentially delaying the onset of dementia.

A group of investigators, led by Professor Massimo Tabaton of the University of Genoa, Italy, have data that sheds light on this issue. The results of their research are published in the October issue of the Journal of Alzheimer’s Disease.

The investigators report that the concentration in blood of amyloid beta “42,” the toxic molecule that is believed to be the main cause of Alzheimer’s disease, is, on average, higher in MCI cases that went on to develop Alzheimer’s disease approximately three years later. The values of amyloid beta in blood vary considerably among the patient groups examined (MCI that develop Alzheimer’s disease; MCI stable; normal subjects). “This variability is likely very important,” Dr. Tabaton noted and went on to add, “but means that this needs further work before we can use this test for a definitive diagnosis.” For example, the scientists are going to set up a test that picks up a variant of amyloid beta potentially more specific of the disease.

There’s progress, but we still have a long ways to go to find an effective test. A conclusive blood test would certainly be ideal. But even if we were to have a conclusive test, doctors still have very few effective treatments for Alzheimer’s disease. And still, as it has been for a long time, only an autopsy will reveal definitively whether or not a person truly had Alzheimer’s.