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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 4131
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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can a person demonstrate the symptoms of early onset alzheimers

Resolved Question:

can a person demonstrate the symptoms of early onset alzheimer's disease and still do well on neurological designed to check for it
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.

Dr. Bob :

Yes. In the early stages this can happen, especially if the individual is starting from a very high level of functioning. On the other hand, other things can mimic early Alzheimer's, so it can be a bit tricky sorting it out. What symptoms do you have in mind and how long have they been present?

Customer:

increasing frequency over the past 2.5 years he is highly educated and very intelligent. he is having long and short term memory loss, mood swings, impatience, paranoia etc. he's is good at covering up memory problems. they went from once or twice a month to one to three times a day 4-5 days a week. he blames me and denies absolutely any problems.

Dr. Bob :

But he was able to pass his neuropsychological tests?

Dr. Bob :

Is he on any meds? Is alcohol an issue?

Dr. Bob :

Are you still there?

Customer:

yes. he is good at holding it together for awhile. he has had a sleep study and has obstructive sleep apnea. he uses the c-pap every night and it's helped with the snoring but he still wakes up3-4 times a night-not to urinate or get a drink or anything like that. no alcohol except a beer at a baseball game. he had been on the same hypertensive med for years with no problem. the two things that worry me the most are the short and long term memory loss and the paranoia- these are way out of character for him. his mother has llate onset alzheimer's- probably started in her mid70's, she is very close to dying now. sorry this is so disjointed, but i am pretty shaky. yes, i'm still here. should i be doing something?

Dr. Bob :

As you probably know, one of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over;relying on memory aides (e.g.,reminder notes or electronic devices) or family members for things they used to handle on their own. Long term memory loss, if it occurs at all, is usually a late sign.

Dr. Bob :

If there are signs of short and long term memory loss, as well as paranoia, this would point to some other psychiatric diagnosis, or perhaps a different type of dementia.

Customer:

what kind of dememtia

Dr. Bob :

Keep in mind that depression can cause what is known as "pseudo-dementia" because it looks like dementia with both short term and long term memory loss, but is actually due to a mood disorder. Similarly, some psychoses marked by paranoia, can lead to distraction regarding tasks at hand and the appearance of poor memory.

Dr. Bob :

There are many causes of dementia, including neurological disorders, blood flow-related (vascular) disorders such as multi-infarct cognitive impairment, inherited disorders such as Huntington's disease, and infections such as HIV. The most common causes of dementia include:



  • Degenerative neurological diseases, including Alzheimer's (about 50-60% of dementia cases), frontotemporal lobar degenerations, dementia with Lewy bodies, Parkinson's, and Huntington's

  • Vascular disorders, such as multi-infarct dementia, which is caused by multiple strokes in the brain

  • Infections that affect the central nervous system, such as HIV dementia complex and Creutzfeldt-Jakob disease

  • Chronic drug use

  • Depression

  • Certain types of hydrocephalus, an accumulation of fluid within the brain that can result from developmental abnormalities, infections, injury, or brain tumors

Dr. Bob :

It usually takes a neurologist or psychiatrist to sort out these various possibilities.

Dr. Bob :

I would ask his doctor for a referral to a psychiatrist, especially if there are elements of paranoia. In the meantime, his family doctor should do a "dementia work-up" including basic blood tests to rule out other causes (e.g. diabetes, low thyroid, low vitamin B12, etc) and a head CT to rule out small strokes or increased intracranial pressure.

Dr. Bob :

He might also check his testosterone levels as these typically begin to fall in one's 40s and can get quite low by the late 50s.

Dr. Bob :

This can sap one's energy, interfere with one's sleep and sex drive, and contribute to cognitive decline.

Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 4131
Experience: Neurology & Int Medicine (US Trained): 20 yrs experience
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