The onset of Alzheimer’s disease is typically characterized as increasing memory loss, growing forgetfulness, and difficulty with concentration and reasoning. While many people in the early stages of Alzheimer’s disease do exhibit these symptoms, some people present changes in personality or behavior before any memory-related issues are evident.
Researchers from the University of Calgary in Canada suggest that changes in behavior that can arise prior to any noticeable impairment in thinking or memory could be a warning sign of possible dementia.
Linking behavioral changes with dementia and Alzheimer’s is not a new concept. Many Alzheimer’s patients experience behavioral symptoms such as depression, aggression, anxiety, or loss of inhibition, to name a few. But the idea that behavioral changes could precede the memory-related symptoms of Alzheimer’s is new.
The researchers developed a symptom checklist to help doctors assess behavioral problems in older patients. The main assessment categories include: decreased motivation or loss of interest, emotional symptoms like depression or anxiety, social issues such as lack of empathy, problems with impulse control or obsessive behavior, and perception problems including delusions or hallucinations.
If any of the symptoms on the checklist persist for six months or more, the individual may have mild behavioral impairment, which the researchers believe could be an early indicator of decline into dementia.
Experts have relied on cognitive assessments in diagnosing dementia, focusing on memory and thinking skills. But now, the newly developed behavioral impairment checklist could provide another diagnostic tool for early detection of the onset of dementia. The checklist still needs to be tested in studies to determine how well the results actually predict outcomes.
While there remains no way to prevent or cure Alzheimer’s, early detection is important to ensure the best treatment and support options are employed in order to enhance the patient’s quality of life for as long as possible.
With the onset of behavioral symptoms, some medications may be explored to address, for example, depression or anxiety. It may also be possible to relieve symptoms through environmental changes. For instance, a patient might find excessive sunlight agitating or certain noises might trigger anxiety.
Maria C. Carrillo, Ph.D., chief science officer of the Alzheimer’s Association, believes this new checklist could help achieve faster and more accurate diagnoses.
“This proposed new checklist describes and helps identify a new clinical stage in the disease and has the potential to represent a paradigm shift in formal neurodegeneration testing – away from a sole focus on the memory to also encompass behavior,” she says.
“By looking beyond memory-related issues to closely evaluate the behavioral issues included in the checklist, physicians could reach a more efficient and accurate diagnosis, sooner.”
Additional information about the study led by Dr. Zahinoor Ismail of the University of Calgary’s Hotchkiss Brain Institute in Canada can be found here: https://www.alz.org/aaic/_downloads/Sun445ET-Mild-Behavioral-Impairment-Checklist.pdf