Is This Normal? Or Could it Be Alzheimer's?

These conversations are comforting in that they show us that plenty of smart people we know have these lapses. It’s normal for the brain to slow down a bit as you age, just as the body does. But deep down, when you forget a name or wonder what you just went upstairs for, you can’t help but ask yourself, is this normal? Am I getting Alzheimer’s?

Alzheimer’s and dementia

Dementia is an overarching term for a collection of symptoms that can be caused by a number of brain disorders affecting memory, relationships, and a person’s ability to function. Alzheimer’s is the most common form of dementia, accounting for 60-80% of dementias. In fact, an estimated 6.7 million Americans aged 65 and older – roughly one in nine – are living with Alzheimer's. Still more people struggle with other types of dementia, such as Lewy Body Dementia, Vascular Dementia, or the later stages of Parkinson’s disease.

Alzheimer’s is caused by an abnormal buildup of two proteins in the brain: amyloid and tau. Amyloid forms plaques around brain cells while tau causes tangles within the cells themselves. The damage begins years before symptoms develop. Over time, the buildup of these proteins starts to interfere with neuron function. As neurons become damaged and die, brain tissue experiences inflammation and shrinkage.

Alzheimer’s or ADHD?

Is it Alzheimer’s, another form of dementia, or simply typical sings of aging? There could be a third possibility: You could have Attention Deficit Syndrome, or ADHD. ADHD has become better understood and more commonly identified in recent decades, but many adults 50 and older have never been diagnosed. One sign that you may have ADHD is if your children have it, since ADHD tends to run in families. Some of the symptoms of ADHD may resemble those of dementia or even normal aging. While ADHD often involves inattention, distractibility, disorganization, and impulsivity, Alzheimer's is characterized by progressive cognitive decline, particularly memory loss.

Importance of early diagnosis

As scary as it is to take that first step and see a doctor, doing so is critical. Only a doctor can conduct a thorough assessment of your symptoms to differentiate between Alzheimer’s, another type of dementia, ADHD, or typical age-related changes. Your symptoms could also be due to conditions such as depression, urinary tract infections, vitamin deficiencies, thyroid problems, or a brain tumor.

If you are concerned that you or a loved one may have Alzheimer’s, an early diagnosis makes it possible to:

• Access emerging treatments. Recently approved medications may slow cognitive decline and are more effective when given in the early stages of the disease.
• Potential access to clinical trials of promising new medications
• Plan for the future and review finances and legal affairs
• Find resources and support
• Maximize quality of life
• Explain the situation to family, friends, and colleagues
• Join a support group for people with early Alzheimer’s

Understanding the Symptoms

Treating Alzheimer’s

Treating early-stage Alzheimer's focuses on slowing disease progression and managing symptoms. Advanced-stage treatment emphasizes comfort, safety, emotional stability, and palliative care. Initially, one or more of the below medications may be prescribed:

• Cholinesterase inhibitors help slow memory loss by protecting a chemical messenger involved in cell-to-cell communication. The medicines are taken by mouth or through a patch on the skin.
• Memantine (Namenda) focuses on a different brain cell communication network than cholinesterase inhibitors and helps slow the progression of moderate to severe Alzheimer’s. It may be prescribed in combination with a cholinesterase inhibitor.
• Antidepressants and antianxiety medications may be prescribed to treat emotional symptoms such as depression or agitation that come with coping with Alzheimer’s. However, these medications can interact with other medications commonly taken by older adults or cause sleepiness, which raises the risk of falls.
• The FDA has recently approved two new drugs that help slow Alzheimer’s progression by targeting amyloid plaques in the brain and preventing them from clumping. They're prescribed for people with mild cognitive impairment.
  • Lecanemab-irmb (Leqembi) was approved by the FDA in 2023. It is given as an IV infusion every two weeks.
  • Donanemab-azbt (Kisunla) received FDA approval in 2024. This medicine is given as an IV infusion every four weeks.

More research was being done on the potential risk factors of taking lecanemab and donanemab and on the possibility of giving these medicines preemptively to people who have a parent or sibling with Alzheimer’s and are at an elevated risk for the disease. Research is underway in the following areas:

• A medicine initially developed as a possible cancer treatment — Saracatinib, is now being tested in Alzheimer's disease. It appears to reverse some memory loss in mice.
• Production blockers are substances that may reduce the amount of beta-amyloid formed in the brain.
• Clinical trials are in process for tau vaccines and medications that keep tau from forming plaques.
• Sargramostim, a drug used to reduce the risk of infection during chemotherapy, is being studied as a potential way to stimulate the immune system and protect the brain from harmful proteins.

Safe at home

It is not always possible for a person with Alzheimer’s or any type of dementia to continue living at home, especially if they live alone. However, while they are still independent enough to remain at home, these tips will help with organization and memory issues.

• Keep all keys, wallets, mobile phones and other valuables in the same place at home.
• Keep all important papers in one place and make copies to give to a family member for safe keeping.
• Keep medicines in a secure location and use a pill counter to keep track of daily doses.
• Arrange for finances to be on automatic payment and automatic deposit.
• If the person with Alzheimer’s is independent enough to leave home, make sure they carry a mobile phone with location tracking and program important numbers into the phone.
• Have them carry ID and/or wear a medical alert bracelet.
• Install alarm sensors on doors and windows.
• Try to make regular medical appointments on the same day at the same time whenever possible.
• Use a calendar or whiteboard to track the daily schedule and check items off as they are accomplished.
• Remove furniture, clutter and throw rugs that are not essential.
• Install handrails in bathrooms and on the stairs.
• Turn the water heater temperature down to avoid scalding – it should be set at no higher than 140° F.
• Make sure footwear is comfortable and provides good traction.
• Reduce the number of mirrors – they can be scary or confusing for people with advanced Alzheimer’s.

If you or a loved one are experiencing symptoms that you think may indicate Alzheimer’s or dementia, it’s important to take steps now. Call your doctor to schedule a screening and discuss your concerns. If you don’t have a primary care doctor, you can find one here.

This article first appeared in the June 2025 edition of the HealthPerks newsletter.