TLDR: This list does not automatically mean someone has dementia—other causes may include drugs, stress, mental illness, or other medical conditions. Seek medical help before jumping to conclusions.

1. Apathy: nothing is interesting.
2. Affective dysregulation: sad, anxious, crabby.
3. Lack of impulse control: frustrated, angry, irrationally stubborn, obsessive.
4. Social inappropriateness: shockingly uninhibited or rude in words, deeds.
5. Abnormal perceptions or thoughts: suspicious, hearing or seeing things that aren’t there.

I wish I’d had this article 10 years ago. 20/20 hindsight, my partner in her early 50s went through years of prodromal (beginning signs of) Alzheimer’s before receiving a diagnosis at age 61. The list is scary-accurate.

A very beautifully moving, articulate first-person piece by Greg O'Brien, a journalist with Alzheimer's.

I cannot give you a TLDR, because this piece offers the texture, the experience, of what it's like to live with Alzheimer's. He says, "when the brain fails: write and speak from the heart, the place of the soul."

TLDR: Some studies on what causes Alzheimer’s disease are examining the link between the early presence of one of the hallmark chemical brain chemicals (plaques—or clumped buildup—of the protein beta-amyloid) and later development of the disease.

People 18 to 65 who experience high stress, anxiety and depression seem to have greater amounts of this marker protein, and statistically greater risk of developing Alzheimer’s in later years.

Does untreated mental illness tend to cause higher rates of Alzheimer’s? Does impending Alzheimer’s (accompanied by increased beta-amyloid) cause mental health issues? Can early intervention lessen the risk of developing Alzheimer's later? Is the connection mere coincidence?

The cause-and-effect connection is still unclear. (Caveat: No, if you’re depressed, this does not mean you’re headed for dementia-land.)

I can attest to my own experience with my partner, who was officially diagnosed with early-onset Alzheimer’s at age 61. She had about a decade’s worth of whack-a-doodle mental health issues prior to the diagnosis. None of the conventional therapies (drugs, counseling) seemed to work.

We know she had a hereditary predisposition (her father and 2 aunts had some form of dementia). We know she had a childhood that caused anxiety and depression. Perhaps it was a snowball effect—the biochemistry of mental health issues poking and prodding the genetic component into action. Or perhaps the mental health and Alzheimer's symptoms merely overlapped.

Some further reading on current research into links among beta-amyloid, mental illness and Alzheimer’s:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534102/

https://pubmed.ncbi.nlm.nih.gov/25629787/

https://pubmed.ncbi.nlm.nih.gov/34877794/

There’s a test for that: the Holmes and Rahe Stress Scale. You can look up that term online for more information. I’ve linked to one source that has a decent, short explanation, and the complete scale itself. Other sites can offer more in-depth perspective.

You may need to adjust some of the items for your specific circumstances. Note that the scale indicates that even “good” stuff in our lives (as well as, duh, “bad” stuff) can contribute to overall feelings of being off-kilter, out of it, not quite firing on all cylinders.

This article concerns one of the part-owners (19% share) of the skilled nursing facility my partner with Alzheimer's is in. His name is Ephram Lahasky. The place is Comprehensive Rehabilitation and Nursing Center at Williamsville, NY. (I call it the Roach Motel.)

The article notes that he owns a similarly-named nursing home conglomerate in western Pennsylvania. That conglomerate is trying to sell off properties.

In a nutshell, the conglomerate has cheated workers, patients and Medicare/Medicaid. It's trying to sell off properties before a judgment is rendered in the lawsuits, so it won't be liable. These are allegations only, not established fact—but yeah, where there's smoke…

Beware placing anyone in a nursing home where this guy is among the owners. Many nursing homes are a shady exercises in profiteering.

“Why Neurologists Are Calling Quest Rapid Alzheimer’s Test ‘an Absolute Catastrophe’”

TLDR by a real person:

Quest Diagnostics has released its Quest AD-Detect™ blood test for $400.

Problems:

1. The test has a high rate of false positives—29% false positives.

2. Tests are easy to misinterpret. They only tell you if you MIGHT get Alzheimer’s… with a 29% false positive rate.

3. The test looks for beta-amyloid proteins, one hallmark of Alzheimer’s. But the buildup of these proteins hasn’t been studied in a large enough cross-section of the population to lead to any conclusions.

4. Symptoms that look a lot like Alzheimer’s can be caused by a wide range of other things. If you misinterpret the test as meaning you have Alzheimer’s, you could miss some other serious conditions.

The Dutch “dementia village,” De Hogeweyk, discussed in a paper delivered at the annual meeting of the Society of Architectural Historians:

https://www.e-flux.com/architecture/treatment/410336/deception-and-design-the-rise-of-the-dementia-village/

An Al Jazeera video on a care home in the northern Thai city of Chiang Mai:

https://www.aljazeera.com/program/101-east/2020/5/1/thailands-last-resort/

I don’t want to claim that meditation is the answer to every mental health problem. But it’s helped me, and I sometimes recommend trying it, particularly mindfulness. (And you can do mindfulness seated and at rest, or walking, or any number of routine activities—just not driving, please!).

I’ve heard a number of people say “But I just can’t still my thoughts! My mind is racing, and I give up feeling more defeated than ever!”

Mindfulness is not about forcing your mind to stop thinking. Rather, it’s about becoming aware of what you’re thinking… and then letting the thought go.

I’ve linked an article I found recently that explains it really well. TLDR (though it’s worth reading in full): A Tibetan Buddhist monk, chosen as the reincarnation of a revered predecessor, absolutely loathed being a monk as a teenager. He was angry, snarly, irritated, and a great vexation to his teachers. Angry thoughts constantly interrupted his meditation practice (and everyone around him).

One teacher gave him some advice: when you meditate, don’t be like a dog; be like a lion.

“When you throw a stone at a dog, what does he do?” he asked.

“The dog chases the stone,” I replied.

He said that was exactly what I was doing, acting like a dog—chasing each thought that came at me…

“When you throw a stone at a lion,” he continued, “the lion doesn’t care about the stone at all. Instead, it immediately turns to see who is throwing the stone. Now think about it: if someone is throwing stones at a lion, what happens next when the lion turns to look?”

“The person throwing the stone either runs away or gets eaten,” I said.

“Right you are,” said my teacher. “Either way, no more stones!… Instead of chasing the anger, grabbing it, and holding on, just be aware. Just be very gently aware of the anger instead of getting involved. Don’t reject it, but don’t dwell on it either. Just turn your attention to look gently at the thought. At that moment of turning inward to just observe, the thought will dissolve. At that moment, just exhale and rest.”

TLDR (by a real person!):

Aphasia is the inability to put one’s thoughts into the right words—you know what you want to say, but brain damage (traumatic brain injury, tumors, dementia, etc.) derail conversations. It can be isolating and maddeningly frustrating.

How to talk to someone with aphasia

1. Acknowledge capacity. People with aphasia remain smart, capable—but there’s a short-circuit in expressing thoughts.

2. Partner up. It takes two to talk. With a few strategies, you can ease the way for satifying conversations. Keys: • Speak normally—tone, volume. • Acknowledge stumbling blocks with respect, rather than ignoring them. • Write down (or repeat) key words to keep chat on track. • Draw, or use gestures; point; use more body language. • Use yes/no questions to confirm understanding. • Sum up main points at intervals.

3. Respect the human right to communicate. Written or spoken language is a hardwired need.

4. Ensure accessibility. Make sure speed, loudness, complexity of information (etc.) allow for comprehension, participation.

5. Include people in conversations and events. Don’t leave people out because you assume they might feel uncomfortable. Offer choices and they will tell you.

"Researchers at the Francis Crick Institute and UCL have shown that hundreds of proteins and mRNA molecules are found in the wrong place in nerve cells affected by Motor Neuron Disease (MND), also known as Amyotrophic Lateral Sclerosis (ALS).…

[N]ew research published today in Neuron shows that the problem is much broader. This 'mislocalization' affects many more proteins than first thought, especially those involved in RNA binding. The mislocalization extends to mRNAs too, molecules that deliver instructions to make proteins from the DNA in the nucleus."

New tools for early detection and prevention in progress.

Blood test: https://www.reuters.com/business/healthcare-pharmaceuticals/quest-diagnostics-launches-alzheimers-blood-test-consumers-2023-07-31/

Vaccine: https://neurosciencenews.com/vaccine-alzheimers-23722/

Gut microbiome: https://www.nia.nih.gov/news/changes-human-microbiome-precede-alzheimers-cognitive-declines

Protein markers in genetically-transmitted Alzheimer’s: https://www.alzforum.org/news/research-news/proteomics-discerns-sporadic-familial-alzheimers-disease

Dementia / Alzheimer's Medication Class Action

"A $56 Million Class Action Settlement has been settled with pharmaceutical companies that manufacture and market certain Alzheimer's disease medications. The class action lawsuit alleged that pharma companies including Actavis, Merz, Teva, Dr. Reddy's, and Wockhardt conspired intentionally to keep generic versions of Alzheimer's medication off the shelves in order to drive up the cost of Namenda Alzheimer's medication. In the United States, the generic version of Namenda Alzheimer's disease drug is also known as Memantine."

Page contains a link to join the class action suit.