Mood and personality change might be the first indicator of dementia.
Many people associate memory loss as the first sign of dementia. However, researchers at the Alzheimer's Association International Conference in Toronto indicated that "mild behavioral impairment" might actually be the first symptom.
The Associated Press reported that this group of Alzheimer's experts proposed a 34-question checklist for doctors and families to reference. Some of the signs on the list include feeling apathetic, agitated, aggressive, irritable and temperamental.
"Historically those symptoms have been written off as a psychiatric issue, or as just part of aging," Dr. Zahinoor Ismail of the University of Calgary said during his presentation. "When it comes to early detection, memory symptoms don't have the corner on the market anymore."
A new diagnosis
Researchers believe there should be a new diagnosis for the disease, one that involves recognizing and measuring changes in mood and behavior – signs that could foreshadow memory and other thought issues.
Nina Silverberg, director of the Alzheimer's Disease Centers program at the National Institution on Aging, analyzed the checklist and believes it could effectively inform families about the many signs and symptoms of dementia.
"I think we do need something like this," she said. "Most people think of Alzheimer's as primarily a memory disorder, but we do know from years of research that it also can start as a behavioral issue."
This proposal would make mild behavioral impairment a clinical designation leading to mild cognitive impairment.
Outweighing the pros and cons
When comparing two cases of mild behavioral impairment, Ismail told the Times that the person with mood changes would experience dementia faster than the one living with only mild cognitive impairment.
Although the researchers stated that changes in mood could be an indicator of dementia, they made it clear that not everyone experiencing a personality shift with age is developing the disease. According to Ismail, to be considered a case of mild behavior impairment, the symptoms must be a "fundamental change" and last for a period of at least six months.
While many researchers believe this will be beneficial in diagnosing dementia early on, others worry that it could lead to over-diagnosis. That could then cause anxiety and concern in older adults, family and doctors. Dr. Kenneth Langa, a professor of internal medicine at the University of Michigan, weighed on the pros and cons of this proposal with the Times.
"There's the potential benefit of early diagnosis, identifying people more likely to decline," he said. "The flip side is over-diagnosis, labeling someone and getting people in the clinical cascade, where you start doing the test and people start doing more brain imaging and being at the doctor's more and getting more concerned."
For example, he discussed how some people who were given the diagnosis of mild cognitive impairment didn't develop dementia even after a decade. He also stated that 20 percent of those people were even reconsidered cognitively normal. This could be due to increased stress on the day of the initial screening. Because of this, Langa suggested the checklist be tested by doctors before it gets implemented.
Source: Sunrise Senior Living