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Date Posted 04/02/11
Question >
I am 54yrs this month and seem to be getting progressively worse with memory loss. I forget everything including when I have arranged to meet someone and then it goes completely out of my mind. I also find it really dificult to even remember what list I am writing in the first place to help me remember what I'm doing. Is this normal at my age?
Answer >
If you are concerned about a decline in memory function it is worthwhile having your memory tested. Many people of your age feel their memory function is poor and yet when tested it can often be found to be within the normal range. It can be difficult to be objective about ones' own memory function and the usefullness of testing is to try and find out if there is a problem or not.
Date Posted 03/02/11
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My Husband has Alzheimers disease but is not receiving any treament now. He was tried on Reminyl initially but this was changed to Aricept. He was not able to tolerate these tablets. Could he take part in the Alzheimers vaccine trial?
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You raise an important issue. Yes, he could potentially take part in an Alzheimer's vaccine trial but we would have to see your husband and evaluate him carefully.
The vaccines work in an entirely different way from the previous treatments that he tried.
Given that your husband has known Alzheimer's disease but is on no current treatment an Alzheimer's vaccine trial would be well worth considering.
Date Posted 03/02/11
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How long does the Alzheimers vaccine trial run for?
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Alzheimer's vaccine trials run for differnt periods of time. For example one current trial runs initially for 18 months and participants visit the centre approximately every 6 weeks.
Date Posted 03/02/11
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I am 62 years old and feel my memory is getting worse. Can I be considered for a place in the Alzheimers vaccine trial?
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The starting point is to contact the cente by telephone. Following a telephone interview you may then be offered an appointment for an initial consultation and depending on how well your memory is functioning you may be considered for a current vaccine trial.
Date Posted 02/02/11
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My 79yr old Mother in law has quite marked dementia. She no longer recognises any family members. I noticed short term memory problems away back 30 yrs ago when I first met her. Particularly asking the same questions over and over. My concern now is my 50yr old husband (her son), Over the past couple of years I have noticed slight short term memory problems. He is convinced he has never been told certain facts when infact he has had full conversations about them. He gets very defensive when this is hightlighted.He forgets to do things like pay a bill, make a phone call etc, has become very disorganised and then becomes frustrated and states "you know I can't remember things very well" I know he is genuinely concerned and can see that it is becoming a problem.Are there any tests he can have eg memory testsPlease advise.thanks
Answer >
Thank you for this question. I think on the basis of the information provided that memory testing would be worthwhile for your husband. He would of course have to agree to this.The starting point could be a discussion with the General Practitioner who then may make the approriate arrangements. A useful memory test for your husband to have would be the Mini Mental State Examination (MMSE). This should be administered by a suitably qualified person.
Date Posted 31/01/11
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My father suffered a very small stroke some years ago. His mother had alzheimers and his Father had several cva\\\'s He has been through neurology and was told it was vascular. He is having more difficulties with new learning and orientation, and gets much more anxious. He is aware that there is something wrong we don\\\'t know where to go for further help
Answer >
We know that a single stroke can cause memory deficits but the more usual cause of memory loss due to stroke is multiple strokes. A previous history of stroke can be a red herring and indeed other causes of memory loss can co-exist. The history of the events and time line are very important. MRI scanning of the brain in this situation can be very helpful. I think in this situation detailed evaluation of the memory function would be important and that this should then be monitored to see if the memory function is stable or declining. It sounds to me that you are witnessing a gradual decline in memory function and this would not be my expectation in a patient who had a small stroke a number of years ago unless there was evidence on the MRI scan of brain of significant vascular abnormalities.
Date Posted 31/01/11
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A very close friend, aged 69 and a widower is seriously diabetic and finds his memory failing. Can diabetes have an effect on the memory? He mis-spells words, makes mistakes in simple arithmetic, has to keep checking that he has locked the door, loses things frequently, leaves doors unlocked, has no idea of dates, days or even months. Would he be a candidate for treatment.
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Good diabetic control is very important for a wide range of health issues so this should be carefully evaluated. In addition it sounds as though memory testing is indicated and this should be discussed with the family doctor.
Date Posted 31/01/11
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My father is 62 years old and has frontal lobe damage to the left side of his brain as a result of professional boxing. He is suffers memory loss, anxiety and violent moods swings. He is currently attending a physciatrist but currenly takes no medication. Is there any advice or recommendations you could offer?
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As far as I am aware there a no specific treatments for this particular condition. The symptoms you describe however can be closely evaluated. It is well recognised that head trauma can lead to these problems. You do not say how extensive the memory problems are or if they are having a significant impact on daily function. It is quite possible to have memory loss and yet function at a good level. The anxiety and mood swings are important symptoms that should be carefully evaluated. I think in this situation you would wish the memory function to be measured and monitored. There are also assessment scales that allow anxiety symptoms to be monitored. Depression must be considered in this situation. Anyone who has been a boxer has been used to being fit and active. There are now good antidepressant treatments available and the appropriateness of such a treatment would be worth discussing with your fathers' doctor.
Date Posted 31/01/11
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I HAD A BRAIN TUMOUR REMOVED IN 1984 WHEN I WAS 16 AND WAS TOLD THAT BRAIN TRAUMA CAN BRING ON SHORT TERM MEMORY LOSS, AS THE YEARS HAVE PASSED I'VE FELT MY MEMORY GETTING WORSE AND WORSE I HAVE SEEN MY DOCTOR'S ON NUMEROUS OCCASIONS AND WAS TOLD 3 YEAR'S AGO THAT I HAD THE MEMORY OF AN 80 YEAR OLD SO I WAS WONDERING IF THERE WAS ANYTHING YOU CAN DO FOR ME IT CAN BE SO FRUSTRATING AT TIMES.
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Your age is now presumably about 42 years. To say that you have the memory of an 80 year old is essentially unhelpful. The removal of some tumours can lead to memory loss and I think that given your young age what you should aim to achieve is a more detailed understanding of the memory deficits, if any that you may have. You should request more detailed assessment of you memory and I think given your young age that a clinical psychologist would be well placed to evalute your various cognitive domains. It may be that the deficits if found can be possibly attributed to your previous surgery. The important point here is that by undergoing formal cognitive assessment you will have a benchmark from which to compare future test results. It is possible that if deficits are present they may be non progressive and this will be important to learn.
Date Posted 28/01/11
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I am a 29 year old girl who suffers from poor short term memory. I had as stroke November 2007 (caused by the contraceptive pill). I was told I would make a full recovery but still stuggle with my short term memory. Most of the research I have done states that there will be no further recovery after two years. Is there anything anyone can do for me?
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I am very sorry to hear this. If you have not already seen a clinical psychologist I think this would be very worthwhile. You should aim to learn in more detail what memory deficits you currently have and take advice on how these can be dealt with. Objective monitoring of your memory would be very useful. It is possbile that things could be improving but you are not aware of this. It is also important to know if things are stable because you might imagine your memory is getting worse when in might be quite stable.
Date Posted 25/01/11
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I recently turned 50, but over the past year or so, have been experiencing what I believe is a deterioration in memory loss - nothing really specific - it can range from the usual forgetting where I put things and when I do eventually find them, still can\\\'t ever remember putting them there - forgetting conversations or even meeting people from the previous evening - meeting people in the street who have stopped to say hello and I have absolutely no idea who they are - and a few other small issues such as questioning whether a word is spelled correctly, been clothes shopping and forgetting I\\\'d actually bought something. On the other hand, I\\\'ve retained an incredible ability to remember numbers and can identify a whole conversation from a few notes I\\\'ve jotted down in my time manager/diary! Until I gave up work about 10 years ago, I prided myself in my ability to remember names, numbers, places, dates, scenarios in line with my work in Crisis Management. The situation is definitely having an effect on my home life, where my partner gets very frustrated when I haven\\\'t done something I said I would, forgotten to pick up items when I\\\'ve been shopping.... My mother puts it down to having too much trivia in my life as opposed to the fast pace working environment I was once part of. I\\\'m a little worried that my situation will deteriorate significantly in the next few years - but am I too young for this to be of any signifcance at all?Apologies for the length of this question!RegsCarol
Answer >
Thank you for this detailed description of your symptoms. I would recommend having your memory tested and you could discuss this with your doctor. I am not sure if you live near our research centre but you could contact us and we may be able to assit with this.
Date Posted 20/01/11
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I have a 79 year old dad with alzheimers he has been on aricept for 3 years but does not seem to be working anymore, could you please advise me of any new treatment that may help, he also has had 2 strokes in the last 2 years.Thank you Alison Taylor
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Thank you for this question. The scenario you describe is not uncommon. Aricept is a symptomatic treatment for Alzheimer's disease. That is it can improve some of the symptoms for varying degrees of time. The recent strokes of course may have had an impact on the memory function. It is important that any risk factors for stroke are identified and appropriately treated. Depression must be watched for and can be treated effectively. In terms of other specific treatments for Alzheimer's disease Aricept and the class of drug it belongs to (the acetylcholinesterase inhibitors) remain the mainstay of Alzheimer's therapy. There are several avenues of research ongoing but the recent strokes may preclude entry into a research programme but having said that this is an avenue certainly worth exploring.
Date Posted 09/05/10
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Good morning, I support a gentleman who has for information purposes Dowm Syndrome,is 65 years old, and now assessed as having some form of Dementia, (April 2010) his speech appears to be affected his STM is very poor however his LTM seems fair,his concentration levels have diminshed,he is incontinent (doubly), balance is also affected, he has lost the ability to do anything without first being given instructions, he is reluctant to walk, and will not attempt to use the stairs, he has become anxious, verbally aggressive, he shouts out when you try and help him, he has not yet been prescriped any medication as we are waiting the results of tests, ie full bloods, ECG and Chest xray to rule out any other infections they may or could be present. My question is !i understand that there may be a patch for Alzheimers/Dementia, is this correct, and are these medications licenced for people with a handicap? And what is the prefered medication for people who may or have dementia, is it Aricept? and what is the postion of Rember?
Answer >
Thank you for your questions. There is unfortunately a link between Down's syndrome and the development of Alzheimer's disease. This is not fully understood but we know that people who have Down's syndrome can develope the plaques and tangles in the brain that are found in Alzheimer's disease. Your detailed knowledge of this person will be very helpful in highlighting the changes that have occured in this person. One of the great difficulies especially in the earlty stages of Alzheimer's is identifying the changes that have occured.
I note that tests are curently being conducted and that you are waiting for a formal diagnosis. My understanding of the treatments that are currently licensed for Alzheimer's disease is just that. They are licensed for people who have been given a diagnosis of Alzheimer's disease. If a person is deemed suitable for any treatment the potential benefits and risks have to be considered and this is a discussion to have with the local clinician.
You are correct that there is a patch available for the treatment of Alzheimer's disease. It is an EXELON patch and this contains the medicine Rivastigmine which is similar to Aricept (Donepezil).
The most widely used licensed treament for Alzheimer's disease in the U.K. and probably globally is Aricept.
With regard to Rember, the experimental medicine being developed by Tau Rx based in Aberdeen, further trials are possibly going to take place. I would suggest contacting them directly if you wish to be kept appraised of forthcoming developments.
Date Posted 30/04/10
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My brother (age 55) was diagnosed four years ago with early onset alzheimers and vascular dementia. He's been on aricept for some years. I've read various reports that stem cell treatment might be able to reverse the effects. Might you be able to offer me any advice on this?
Answer >
Alzheimer's disease is the commonest form of dementia and you say your brother has been diagnosed with Early Onset Alzheimer's disease and Vascular dementia which of course is quite possible. Many patients with Alzheimer's disease have findings on brain scanning that indicate some underlying vascular pathology. This does not necessarily mean they actually have Vascular dementia as well.
There are actual criteria that can be applied to an MRI scan of the brain that describe the changes and allow a conculsion to be reached as to whether or not the changes are significant enough to meet the diagnostic criteria for vascular dementia. Your brother is receiving treatment with Aricept which is licensed for the treatment of Alzheimer's disease and this is a positive outcome.
Some patients with vascular changes on a brain scan may simply be labelled as Vascular dementia when in fact the changes may be minor and they in fact have underlying Alzheimer's disease. The importance of this is that they may then receive no treatment.
Vascular risk factors are of course important to identify and treat.
In terms of potential stem cell treatment for Alzheimer's disease this is an area that we have no experience of.
Of more relevance possibly is the potential to participate in a vaccine programme. Such programmes are currently designed for those with Alzheimer's disease who may or may not currently be receiving treatment for the condition. The degree of vascular change would have to be asssessed because if it were too great then an individual is likely to be ineligible to participate.
Date Posted 18/04/10
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MY WIFE SUFFERS FROM ALZHEIMERS SHE CAN NOT COMMUNICATE. HER WORDS ARE ALL JUMBLED AND GETS FRUSTRATED WHEN I CAN,T WORK OUT WHAT SHE WANTS? IS THERE ANY FURTHER TREATMENT IN PROGESS THAT MAY ONE DAY GIVE ME BACK THE WIFE I LOST 4 YEARS AGO?
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I understand the great difficulties and problems this can cause. Alzheimer's disease affects the cortex, the outer layer of the human brain and it is well documented that Alzheimer's disease causes a major disturbance of language. In some patients the word finding problems remain mild for lenghty periods. In others the loss of language is rapid and this is very upsetting. An important thing to remember is that comprehension is often much better than you might imagine. We see this often in research. A person who is still functioning well yet who has a very low memory score because they cannot say the words to answer the questions. Sadly this means that many people are excluded from research studies because their memory scores are too low. You do not say if your wife is currently receiving any treatment or what recent memory scores have been. There are new treatments such as vaccines being studied but to know if your wife would be eligible to participate she would have to be properly evaluated.
Date Posted 12/04/10
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My mother-in-law is on Donepezil but it does not seem to be doing anything. She has been diagnosed as having the first stages of Alzheimer's in early 2008 but is in full denial. She keeps saying that her memory is not as good as it used to be and we both know it is abysmal. She has carers coming to see her twice a day but refuses to admit this. She gets very aggressive as a result. Her short term memory is getting worse. Does this mean that she will be reaching the second stage soon and if so, how would we know and how long would this take. Many thanks for your help and any advice will be very welcome.
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The scenario you describe is sadly not uncommon. We know that about 50%-60% of patients prescribed an acetylcholinesterase inhibitor,and donepezil (Aricept)is a drug within this class, will show evidence of response to treatment. The remainder for reasons not fully understood do not respopnd. For some doctors response is taken as evidence of stability or no deterioration. Some individuals do positively respond to treatment and this response can be maintained for varying periods of time.
It appears form what you say in your mother-in-laws case that she is not responding to treatment. You do not say what her age is, the current dose of donepezil or mention the result of the memory test that is often done. I am referring to the Mini-Mental State Examination test (MMSE). This is scored out of 30 points. The mild dementia range or early stage you refer to would normally include those individuals with score in the 20-26 range. Once the MMSE score starts to fall below 20 out of 30 then this is more in keeping with moderate dementia.
I think from a practical point of view a discusssion with those involved with her medical care might be helpful. It would be helpful to know what the current memory score is and how it has changed. Is there any room to increase the dose of donepezil? She may already be at the maximum daily dose of 10mg. You also highlight episodes of aggression and this should be discussed and monitored as we know behavioural disturbace occurs not infrequently in this condition and may be amenable to additional treatment.
Date Posted 02/04/10
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My wife is 80 and has quite advanced Alzheimers. She cannot take medication due to an irregular heart beat.Could there be any advantage to her condition by registering.She is at present under care of the local consultants.
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There are many causes of an irregular heart beat. Often this can be diagnosed from a simple ECG tracing, sometimes more prolongued recording of the heart beat is required. You mention that your wife has quite advanced Alzheimer's disease. If you feel that she would be able to visit the clinic for assessment then we could potentially arrange to see you both.
The method of contact would be for you to telephone the clinic during working hours and explain the reason for your call. A member of the research team will ask you some questions to try and ensure your wife might be potentially suitable. There will be questions about her medical history and current medications. It is possible that a research study might be available that your wife could participate in even though she has been deemed not suitable for prescription medication for her Alzheimer's disease.
Date Posted 31/03/10
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My 79 year old mother developed AMD very quickly last year and has now been registered blind, although she has very limited sight in one eye. She also has acute open angle glaucoma. At the same time that her eyesight deteriorated rapidly, her short term memory seemed to disappear overnight. She was recently assessed as 15/28 on the tests and Alzheimer's was diagnosed, although the memory clinic said it was sometimes difficult to determine between loss of memory and loss of sight in assessing her. A recent brain CT scan from the hospital where she was taken after being hit by a car, and smashing the windscreen with her head, showed evidence of brain shrinkage. She has also suffered four other blows to her head when she has fallen due to her eyesight. She will soon start a course of Aricept. I have done some research on the internet and there seems to be strong evidence of a link between AMD and Altzeimer's. Are there any other studies being undertaken at the present time with regard to this link? The doctor at the memory clinic was unaware of any link, and I wonder whether she will in fact get the correct treatment.
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This is an interesting issue that you raise. Age related Macular Degeneration is not in my experience a condition that I immediately associate with Alzheimer's disease. In fact in my experience over the 17 years that I have been involved with assessing patients with Alzheimer's disease it occurs infrequently in the Alzheimer population that I have seen. That is of course not to say that there is not an association and it is quite feasible, and certainly worthy of further investigation whether in some cases there is a link. Please see a link below to a recent article highlighting the genetics of AMD
Whilst it is commonly said that Alzheimer's disease is not geneticlly inherited, our understanding of the condition continues to evolve. It is of increasing interest to test the genetic profile of an individual presenting with probable Alzheimer's disease, the APOE4 gene being one in particular. We know in certain cases there is a strong family history of Alzheimer's. You may already have had sight of the article below that links AMD and Alzheimer's throught the APOE4 gene
http://linkinghub.elsevier.com/retrieve/pii/S0002929707607411
I would encourage you therefore to continue to take an interest in this area. Your mothers ophthalmologist may have some thoughts on this. Visual disturbance in Alzheimer's disease is well documented and you may be familiar with the recently highlighted variant of Alzheimer's disease PCA (Posterior Cortical Atrophy) suffered by author Terry Pratchett. Of course the presence of significant visual disturbance does make the diagnosis of Alzheimer's disease more challenging, but I have seen patients, registered blind who are able to read the words and copy the various diagrams often presented in the course of memory testing used in the diagnostic process.
The falls and blows to the head are of course very important in the history of this case. It would be very difficult to attribute the degree of cognitive impairment if any due to these episodes. I think offering a trial of treatment with donepezil seems very reasonable and I hope this is beneficial.
I am not aware of current studies looking specifically at the link between AMD and Alzheimer's.
Date Posted 26/03/10
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My Mother is 85 was diagnosed with Ad 2003 from mini mental test scoring 23 twice. No other medical tests carried out. Prescribed Exelon. Had B12 deficiency diagnosed 2008 now on monthly injections. Had recurrent urine infections & they wanted to put her in a home becasue of aggressiveness. 12 months later she is on permenant antibiotic and infections have stopped. She does remember who we are, she can do things herself but the system has nearly driven her to be an invalid. Only for me keeping on her case have I kept her out of a home. Following an ecoli infection last August I took her off Exelon and she improved no end. Got refered back to hospital and they agreed to keep her off it. After a fall & brain scan it appears the bits on the ends have died and the brain was described as extremely good for her age. I really dont know where to turn for help but I have her at home and she is happy. She lacks lustre & gets very lethargic. Her history from 40 years back is one of sleepless nights, restless leg syndrome, temazepam & co-proximol for years which caused some convulsions. Her night sweats, leg cramps pins & needles all went with B12 injcetions. She sleeps like a log every night now she is off Exelon, doesnt fiddle, wander or take things in & out of drawers. Can I do more for her like vitamins or Q10.
Answer >
The scenario you describe is possibly not that uncommon and highlights a number of issues. The Mini Mental State Examination is a test that is designed to give an indication of cognitive function. An MMSE score of 23 out of 30 is within the mild dementia range. You may wonder if this score was in fact due to the deficiency of Vitamin B12. Many elderly people have low Vitamin B12 levels and it is usually said that the level has to be very low for it to have an impact on memory function. However if the level is low then appropriate replacement therapy is usually given. The memory may not improve with the initiation of B12 therapy but other complications such as anaemia should be avoided. Recurruent urinary infection is common in elderly females and it is good that this problem now appears to have been dealt with. My understanding is that now your mother is on no memory enhancing medication. You wonder if vitamins may be beneficial. A good diet, exercise, fresh air, interacting with others are all important. The actual benefits of taking vitamin supplements (unless for a confirmed deficiency such as the B12 that your mother is taking) in this situation are not really known. It is important to remember that dementia is common in the over 80's and monitoring the memory function even though no treatment is being prescribed may be worthwhile.
Date Posted 18/01/10
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My mother is 67 and starting to forget quite a number of things, mainly words or conversations had etc. She has also got problems with short term memory. Is this an early sign of Alzheimers?
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Memory impairment is one of the early signs of Alzheimer's disease. The symptoms you descibe should be evaluated.
Many people as they get older experience a decline in memory function, particularly short term memory. For most this is viewed as
part of the ageing process, without significant imapct on daily life. We know however that for some the memory decline continues and eventually it becomes
clear that the problem is more that what is often termed age related memory loss.