Early Warning Signs of Dementia and Alzheimer’s Disease

It’s never been more important to know the early signs of dementia and get care. Brain scans and spinal fluid tests can detect high levels of beta-amyloid and tau protein in the brain years before any symptoms develop. Those proteins create plaque in the brain linked to Alzheimer’s, the most common form of dementia.

Plus, the FDA approved Lecanemab, a drug that treats early-stage Alzheimer’s and mild cognitive impairment. It’s been shown to slow the progression of dementia up to 27% if given early.

“These biomarkers are a game changer,” says Shawn Kile, M.D., a neurologist with Sutter in Sacramento. “Today we can identify dementia early and treat it before a lot of brain changes occur. It makes a real difference.”

Common Early Signs of Dementia

The earliest signs of dementia are subtle:

• Asking a question over and over
• Finding it hard to pay bills or follow a recipe
• Struggling to find the right word
• Getting lost or losing things
• Becoming unusually anxious or losing interest in family or social events

If you’ve noticed these signs in yourself or a loved one, your first step is to see your primary care provider to rule out other problems. Memory problems can be caused by vitamin B12 deficiency or some common medications.

“Reversible causes of cognitive impairment should be checked because they are potentially easy fixes,” says Dr. Kile.

Diagnosing Early-Stage Alzheimer’s and Dementia

Your next step is to see a neurologist. Typically, the neurologist will screen you for sleep and other neurological disorders, do cognitive and memory tests, and check for biomarkers.

Brain scans can show biological markers to help with diagnosis and progression. You may have an MRI or CT scan to check for a stroke and to assess the size of certain structures, such as the hippocampus (memory region). The neurologist may do a PET scan to check for amyloid protein deposits in the brain, a biomarker of early Alzheimer’s.

Your neurologist may refer you to a psychologist to see if you’re depressed and to better define the pattern of cognitive impairment.

Starting Treatment

Lecanemab is an FDA-approved antibody medication that removes amyloid from the brain. If your neurologist recommends Lecanemab, you’ll get infusions every two weeks for at least 18 months. Researchers are still studying how long people can take the drug. There are potential and serious side effects — brain swelling or micro-hemorrhaging — so patients are chosen and monitored carefully with regular MRI scans.

Just as important, your care team will help you and family or friends learn compensation strategies to optimize your brain health.

“Treatment is not just about medication,” says Dr. Kile. “It’s about staying physically active, doing memory exercises, eating well and controlling depression.”

He often also refers people to a cognitive therapist who can teach memory exercises and specific strategies, such as list making and using your cell phone for reminders.

“Staying socially active is also key,” he says.

How Family and Friends Can Help

A diagnosis of dementia or Alzheimer’s can be overwhelming. If someone you care for has been diagnosed, you can help in several ways:

• Go to their medical appointments and take notes so you can help them remember what the healthcare team said.
• Try to keep a routine at home, so the household eats, bathes and dresses at the same time each day.
• Help your loved one make lists and keep a calendar.
• Get advice on how to establish a system or reminders for taking medications.
• Respect your loved one’s independence to the extent possible, while also ensuring safety. Be gentle and understanding as memory problems worsen.
• Plan activities you both enjoy and do them at the same time each day.

And remember, early treatment is critically important.

“This is when we have the greatest chance of success,” says Dr. Kile.