Understanding and recognizing Alzheimer’s disease

December 29, 2023 Swedish Neuroscience Team


In this article:

  • An estimated six million people in America have Alzheimer’s disease. It’s the seventh leading cause of death and the most common form of dementia in adults 65 and older.
  • Warning signs of Alzheimer’s often progress slowly over time. It may be challenging to recognize them as a serious health issue when they first begin.
  • Knowing whether you’re experiencing warning signs of Alzheimer’s or just normal age-related changes can be difficult to determine. The Medical Director at the Swedish Center for Healthy Aging shares tips that can help you identify the signs.

Where did I leave my keys? Is today Wednesday or Thursday? Why did I come into this room?

When you ask yourself questions like these regularly, it can be a little disconcerting – especially if you’re old enough to be getting a senior discount or Social Security. That’s when those seemingly simple questions can get a little more serious.

Do I have Alzheimer’s disease, or am I just getting older? How can I tell the difference? Is there anything I can do to prevent it from happening?

An estimated six million people have Alzheimer’s. It is the seventh leading cause of death in the United States and the most common form of dementia among adults age 65 and older, according to the National Institute on Aging. And yet, many people don’t understand what it is or how to recognize the early warning signs.

We talked to Nancy Isenberg, M.D., MPH, to get answers to common questions about Alzheimer’s. Dr. Isenberg is the medical director of the Center for Healthy Aging at Swedish. She specializes in Alzheimer’s disease and other forms of dementia, providing comprehensive care that addresses the physical, emotional and social challenges it brings to patients and their families. Here’s what she shared.

What is Alzheimer’s disease?

Alzheimer’s disease is a brain disorder that slowly erodes your memory and reduces your ability to process information, communicate and carry out the normal activities of daily living. It is a form of dementia that affects your cognitive function and ability to think, remember and reason.

“Dementia means, strictly speaking, loss of cognitive function in two or more areas that impacts your overall ability to function independently in the world. It’s an umbrella term. Alzheimer’s disease is the most common neurodegenerative cause of dementia, and it is frequently associated with vascular dementia,” says Dr. Isenberg.

Warning signs

For most people with Alzheimer’s, their symptoms begin in their mid-60s or later. If the condition occurs before age 65, it is considered early-onset Alzheimer’s, which is rare.

Alzheimer’s tends to worsen over time. It typically progresses in stages, starting with mild symptoms and progressing to moderate and, finally, severe or late-stage Alzheimer’s.

Early warning signs may include:

  • Severe memory loss.
  • Losing track of location, dates or time.
  • Taking longer than normal to complete routine tasks and activities.
  • Mood and personality changes.
  • Challenges solving problems or planning.

As the disease progresses and moves into its later stages, symptoms may include:

  • Inability to communicate or effectively process information.
  • No memory of family, friends or other acquaintances.
  • No awareness of surroundings or recent experiences.
  • Physical decline, including skin, dental and foot problems.
  • Loss of bladder and bowel control.
  • Difficulty swallowing.

If your symptoms are affecting your relationships, work or life check with your physician to determine your next steps.

Is it Alzheimer’s or age-related changes?

Recognizing the difference between Alzheimer’s disease and normal, age-related memory and thinking changes can be challenging. This chart from Dr. Isenberg can help you determine whether the issues you’re experiencing require professional care.

Alzheimer’s disease

Normal age-related changes

Memory loss that disrupts daily life

Occasionally forgetting names or appointments but remembering later

Challenges in planning or solving problems

Making occasional errors when managing finances and bills

Difficulty completing familiar tasks

Occasionally needing help to operate technology

Confusion with time and place

Getting confused about which day of the week it is, but later remembering

Trouble understanding visual images or spatial relationships

Visual changes for other reasons

Treatment and prevention

There is currently no cure for Alzheimer’s disease. The most successful treatment is collaborative and comprehensive. It may include medication, lifestyle and culinary medicine and support services for the patient and their family, according to Dr. Isenberg.

“My role is to work collaboratively with patients and their families to develop a personalized, evidence-based diagnostic and treatment plan. There are lifestyle and dietary approaches that can improve thinking, improve blood flow to the brain and build new brain cells. Sometimes, people are taking medication for other issues, which may worsen memory issues and increase the risk of dementia. So it is also important to complete a careful medication review,” says Dr. Isenberg.

“To me, comprehensive care means that you are considering all aspects of what can help and what can harm. Collaborative means considering the person, their family and, more broadly, their community. It includes planning for the future so you may live as well as possible and with as much support as you need as the dementia progresses over time,” she explains. “Being comprehensive and holistic is key to care.”

Disease-modifying medication

Lecanemab is an innovative medication that was recently approved by the U.S. Food and Drug Administration to treat early-stage or mild Alzheimer’s disease. It removes the protein responsible for the progression of Alzheimer’s (amyloid beta) from your brain and slows how quickly your symptoms worsen.

Lecanemab is administered intravenously every two weeks. It’s used only in people with a well-established diagnosis of Alzheimer’s and should not be given to people with other cognitive issues, including Parkinson’s disease and Lewy body dementia.

Dr. Isenberg recommends talking to your doctor to determine if lecanemab is a viable treatment.

“Patients may receive the twice-monthly infusion after careful evaluation by our multidisciplinary eligibility and safety monitoring review board to make absolutely sure that the potential treatment benefits outweigh the risks,” she says.

Seven healthy habits

Roughly 40% of dementia cases are preventable, according to Dr. Isenberg. She encourages all adults to adopt seven lifestyle tips designed to promote brain function and improve your overall health and wellbeing. These steps, combined with regular care from your doctor, can help lower your chances of developing Alzheimer’s and dementia or reduce their effects.

The seven healthy habits are:

  • Eat a heart-healthy diet.
  • Do aerobic exercise 30 minutes a day, five days a week.
  • Get at least seven hours of uninterrupted sleep every night.
  • Continue to nourish and challenge your mind with new activities, hobbies or community involvement.
  • Maintain a positive outlook and healthy mindset.
  • Stay connected to friends and family.
  • Address physical, mental and emotional health with collaborative care from a multidisciplinary team of caregivers.

“The brain and the body are connected through neural pathways and made up of neurotransmitters, hormones and chemicals. These pathways transmit signals between the body and the brain to control our everyday functions from breathing, digestion and pain sensations to movement, thinking and feeling,” says Emma Dotson, DNP, ARNP, nurse practitioner at the Center for Healthy Aging.

“When we prioritize our physical health we prioritize our mental health and vice versa,” adds Dr. Dotson.

Center for Healthy Aging

The Center for Healthy Aging on Swedish Cherry Hill Campus provides comprehensive, compassionate care for people with Alzheimer’s disease and their caregivers.

Services include:

  • In-person and virtual evaluations and testing.
  • Cognitive rehabilitation.
  • Advanced neuroimaging and diagnostics.
  • Medication when needed.
  • Lifestyle and culinary medicine.
  • Social services.
  • Behavioral health support.

“Our goal is to empower our patients with the tools and skills they need to help them stay as healthy as they can and age well throughout their lives,” explains Dr. Isenberg. “Aging is inevitable, but how we age is not.”

Learn more and find a provider

If you have a confirmed diagnosis of dementia or Alzheimer’s disease, ask your physician for a referral to the Center for Healthy Aging. For more information about services and programs, call 206-320-7200.

Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction, and follow up as needed. If you need to find a provider, you can use our provider directory.

Information for patients and visitors 

Related resources

New research brings hope for detecting and preventing Alzheimer’s disease

Dementia Isn’t a Certainty: Learn How to Modify Your Risk

Four medications that can affect your memory

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

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About the Author

From deep brain stimulation to focused ultrasound to pediatric neurology, The Swedish Neuroscience Team is recognized as national experts to help people address a wide array of neurological conditions. Our goal is to provide useful and helpful advice and tips on non-surgical and surgical options to treat any disease of the mind.

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