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Dementia symptoms and early signs of the disease

People in the early stages of Alzheimer’s disease, the most common form of dementia, have difficulty turning while walking, according to new research.

This unique insight has prompted Liz Clifton, 43 years old and living in South Wales, to describe the early signs of the disease, which she did not recognise in her late grandmother and which she attributed to old age, normal forgetfulness and the grief and stress of losing her husband, Liz’s grandfather.

In the new small study, experts at University College London (UCL) used virtual reality to study navigation errors in people with the early signs of the disease, in the hope of developing simple tests for the disease.

They compared 31 healthy younger people with 36 healthy older people and 43 patients with mild cognitive impairment. All three groups were asked to complete a task while wearing virtual reality goggles that allowed them to perform real movements.

Participants walked along a route guided by numbered pylons consisting of two straight paths connected by a curve. They then had to return to their starting point, guided only by their memory. This was repeated under three different conditions.

The study, published in Current Biology, found that people with early-stage Alzheimer’s consistently overestimated the number of turns on the route and showed greater variability in their sense of direction.

Read more: Chris Hemsworth’s high-protein diet plan may “help reduce Alzheimer’s risk” (Yahoo Life UK, 5 minutes reading time)

The author, Dr Andrea Castegnaro of the UCL Institute of Cognitive Neuroscience, acknowledged that there is already evidence that navigation problems are an important early symptom of Alzheimer’s disease.

“We added here that there are certain aspects of navigation in Alzheimer’s that are particularly impaired,” the expert told the PA news agency. “In particular, we found that people with early-stage Alzheimer’s consistently overestimated the turns on the given route and showed increased variability in their sense of direction.”

“In other words, when Alzheimer’s patients (with mild cognitive impairment) are asked to rotate a certain amount, they seem to think they have rotated much further than is actually the case.

“More importantly, by including healthy older people in the study, we also found that these specific aspects are not an extension of healthy aging (which, as we know, also involves a decline in navigational ability), and rather they appear to be specific to Alzheimer’s disease.”

Dr. Castegnaro pointed out that these are initial results that the team is working to confirm, but added: “Our findings open up a new approach for the early diagnosis of Alzheimer’s disease by focusing on specific navigation errors.”

“I thought it was because of my grandfather’s death, but my grandmother was actually showing signs of dementia.”

Before Liz realized her grandmother's behavior was due to dementia, pictured from left to right are Liz's mother Liz and her nanny holding their eldest daughter in 2002. (Provided)Before Liz realized her grandmother's behavior was due to dementia, pictured from left to right are Liz's mother Liz and her nanny holding their eldest daughter in 2002. (Provided)

Before Liz realized her grandmother’s behavior was due to dementia, pictured from left to right are Liz’s mother Liz and her nanny holding their eldest daughter in 2002. (Provided)

Early signs of dementia – a syndrome involving a progressive decline in brain function that has many different causes and many different types – can be difficult to detect and often appear simply as a sign of old age.

Liz was unaware that some of her late grandmother’s behaviors were early signs of dementia (in her case, Alzheimer’s), she tells Yahoo Life UK. “One of the first signs was that she would forget what she had said and we just put that down to her bad memory, as she had always claimed. It could be little things like going to the kitchen to make a cup of tea and then coming back with nothing,” Liz recalls.

“Sometimes she would fill the kettle but forget to turn it on and then pour herself a cold cup of tea.

“It also happened that she would go away and my uncle would come home and the house would be empty. Until she went to a nursing home, he had to stick little notes next to the door to remind her not to open it.

“After my grandfather died in 2005, their self-talking behavior reached new levels, as did their love of background noise. Throughout my life, they had always kept a blue budgie, always called Bertie. Whenever one died, they would get a new one and pretend it was the same bird.”

Liz now realizes that her grandfather did this for her grandmother, as her memory was already impaired and in later years she sometimes forgot who Liz and her daughters were or confused them.

During visits to her care facility (before it closed during the pandemic), Liz says her grandmother could still sing beautifully and remembered many hymns from her childhood. “Early signs of this (she now recognizes) were that she would occasionally choose to sing instead of speaking her responses, or she would get distracted and start singing in the middle of a conversation.”

Read more: Signs and symptoms of dementia: Bruce Willis’ wife talks about the actor’s condition (Yahoo Life UK, 8 minute read)

Liz's youngest daughter with her nanny in her first care home in 2019. (Supplied)Liz's youngest daughter with her nanny in her first care home in 2019. (Supplied)

Liz’s youngest daughter with her nanny in her first care home in 2019. (Supplied)

In addition to attributing the early signs to forgetfulness, Liz adds: “At first we thought it was due to the death of my grandfather, which of course caused her a lot of stress and distress. However, it didn’t seem to be getting better, instead it was quietly getting worse.”

“The development was quite slow at first, so we didn’t realize how far things had progressed until she started wandering away. Until then, her behavioral change was generally considered to be natural aging.”

Liz’s grandmother, her beloved nanny, was in her mid-80s when she was diagnosed and passed away shortly after her 89th birthday in 2020.

Dementia diagnosis

Although it is understandable to confuse the symptoms with aging, the condition not a natural part and can affect memory, thinking or speech, as well as affect mood, emotions, perception and behaviour. One in four people with dementia struggle with symptoms for more than two years before being diagnosed, according to previous research by the Alzheimer’s Society.

The charity, in collaboration with leading clinicians, including the Royal College of General Practitioners, produced a checklist (RCGP) to help people recognise potential symptoms and get a diagnosis.

The sheet can be printed out and taken to the doctor to help both patients and doctors diagnose the condition. It contains a series of tick-box questions with the options ‘Tick if affected by’, ‘Tick if it affects daily life’ and ‘How long has it been present’.

Signs one to five include forgetting things more often, losing track of dates and times, poor word choice, withdrawal and lack of sociability, and difficulty completing familiar tasks.

Signs six through ten include leaving things in unusual places, difficulty understanding what you see, trouble making informed, careful decisions, regular distraction and loss of concentration, and changes in mood and behavior.

Read more: A brisk daily walk or bike ride “could reduce the risk of Alzheimer’s in older people” (Yahoo Life UK, 5 minutes reading time)

(Alzheimer Society)(Alzheimer Society)

Do you know the 10 signs of dementia? (Alzheimer Society)

“If you keep asking yourself the same question, it’s not called getting old, it’s called getting sick,” says Kate Lee, executive director of the Alzheimer’s Society.

“If you are worried about yourself or a loved one, take the first step – contact the Alzheimer’s Society and get support.”

Lee admits that receiving a diagnosis can be daunting. “I know I was terrified when my mum was diagnosed. But it’s worth it – over 9 in 10 people with dementia told us they benefited from the diagnosis – it gave them crucial access to treatment, care and support and valuable time to plan for the future,” she says.

“With diagnosis rates plummeting due to the pandemic, it’s more important than ever to seek help. You don’t have to face dementia alone, we’re here to support everyone affected.”

Read more: Study shows: You should stay fit and prevent dementia in these decades (Yahoo Life UK, 2 minutes reading time)

(Alzheimer Society)(Alzheimer Society)

Certain lifestyle changes can help reduce the risk of dementia. (Alzheimer Society)

Although it can be normal for memory to be affected by stress, tiredness, certain illnesses and medications, if you’re becoming increasingly forgetful (especially if you’re over 65), the NHS says it’s a good idea to speak to a GP about the early signs of dementia.

The Alzheimer’s Society is urging anyone who is worried about themselves or a loved one to take the first step and contact the charity for support. Support and more information about a diagnosis is just a call or click away. Visit alzheimers.org.uk/memoryloss or call 0333 150 3456.

Check out the full checklist of possible dementia symptoms.

Watch: Rugby union star talks about his battle with dementia