dr. ken freundlich

There are currently more than 5 million people in the United States suffering from Alzheimer’s disease. As the population aged 65 and older continues to increase, the number of people with Alzheimer’s, the most common form of dementia, can be expected to increase as well. But millions more senior citizens who forget a name or where they put their keys worry that every memory lapse might be an indicator of the onset of Alzheimer’s.

“Forgetfulness is common as we age,” says Dr. Kenneth Freundlich, clinical neuropsychologist with Morris Psychological Group. “And being alert to the warning signs of dementia is prudent. Fortunately, we now have much improved diagnostic tools that can not only help us identify Alzheimer’s but also distinguish it from other conditions that cause similar symptoms, some of which are readily treatable.”

Symptoms of Alzheimer’s include not just memory loss but confusion, disorientation, and mood and behavioral changes. The earliest symptom is most often difficulty remembering newly learned information because damage to brain cells typically begins in the cortex, the part of the brain that affects learning. As it spreads to other parts of the brain, memory loss intensifies and other symptoms appear.

“There is no single diagnostic test that is definitive for Alzheimer’s,” says Dr. Freundlich. “And there are dozens of conditions that mimic its symptoms – everything from the side effects of medication to substance abuse to a buildup of fluid in the brain – so it takes a bit of detective work on the part of physicians and psychologists to isolate the underlying cause of symptoms. But the first step is for the patient or family members to recognize when professional help is needed.”  As a general rule, memory lapses associated with normal aging do not interfere with the performance of daily activities or the ability to live independently. And warning signs of Alzheimer’s typically include not just the inability to remember but the inability to understand, communicate and reason.

Dr. Freundlich provides tips on differentiating normal behavior vs. more troublesome signs:

  • Forgetting the name of a friend or acquaintance is normal, especially if it is remembered later. Forgetting newly learned information is a common early warning sign of Alzheimer’s.
  • Forgetting why you walked into a room is normal. Confusion when performing familiar tasks, such as preparing a meal or doing the laundry is not.
  • Making an occasional bad decision is normal. Showing repeated poor judgment in important matters like managing money is not.
  • Occasionally forgetting where you were going is normal. Getting lost in your own neighborhood or forgetting where you are or how you got there is not.
  • Occasionally having trouble finding the right word is normal. Having trouble putting thoughts together to communicate effectively is not.
  • Occasionally feeling sad is normal. Dramatic mood swings and personality changes – for example, becoming excessively fearful or suspicious – are not.

When signs of dementia are apparent, either to the individual or to friends and family members, it is important to obtain a diagnosis as soon as possible to rule out other causes and to take advantage of treatment and support options that can improve quality of life. Diagnostic tools typically include a complete physical and neurological exam, brain imaging and neuropsychological tests to assess mental status, thinking and memory.  An initial screening might take only a few minutes and indicate whether a full-scale dementia evaluation is warranted.

“In addition to testing memory and cognition, one of the things we look for in these evaluations is signs of depression,” says Dr. Freundlich. “Depression can sometimes cause symptoms similar to those of dementia and we also know there is an association between depression and dementia. For reasons that are not yet understood, people who develop depression late in life are more likely to develop dementia.  Treating the depression won’t necessarily prevent the onset of dementia but it will have an immediate positive affect on the patient’s health and quality of life.“

Kenneth Freundlich, PhD., a clinical neuropsychologist with more than 30 years of experience, is the managing partner of the Morris Psychological Group and head of the neuropsychology division. His clinical practice is devoted exclusively to neuropsychological evaluation and consultation. Morris Psychological Group, P.A. offers a wide range of therapy and evaluation services to adults, children and adolescents. www.morrispsych.com