When Does Forgetfulness Become Cause for Concern?

It’s not uncommon to forget things from time to time, especially as we age. If you’re like most, you’ve forgotten someone’s birthday at one point, or to pick up something at the store, or maybe to think of the name of a certain movie or song.  

Forgetting things on occasion shouldn’t be a reason for concern, but if the forgetfulness starts to occur on a regular basis, it could indicate something more serious:  

Alzheimer’s disease.  

What is Alzheimer’s Disease? 

Named after Alois Alzheimer – a German psychiatrist and neuropathologist – Alzheimer’s disease falls under an umbrella of what is more commonly referred to as dementia. In fact, it is the most common form, accounting for 60 to 70 percent of all dementias.   

“Dementia isn’t a disease; it’s an umbrella term for a group of symptoms,” explained Mike Garrigan, Dementia Specialist and Life Enrichment Supervisor at ThedaCare-owned The Heritage and Peabody Manor. “There are over 200 different types of dementia, with Alzheimer’s being the most common. All dementias affect the brain, but in different ways. The hallmark symptom of Alzheimer’s disease is memory loss, specifically memory loss that disrupts daily life. Everybody has a little bit of memory loss or natural difficulty in recalling certain things as they get older. When it affects your activities of daily living, you should pay attention to it.”   

The hallmark symptom of Alzheimer’s disease is memory loss, specifically memory loss that disrupts daily life.

Mike Garrigan, Dementia Specialist, ThedaCare 

How Does Alzheimer’s Disease Progress? 

Before someone even starts exhibiting symptoms of Alzheimer’s, changes are already taking place in the brain. This pre-clinical stage can last for years before moving into the three main stages of progression. Even then, the speed at which each affected person moves through the various stages may differ. But by understanding common signs and symptoms associated with each stage, loved ones, caregivers and medical providers can help offer the appropriate level of care and support. 

Early (Mild) Stage. Symptoms at this stage are often dismissed as normal forgetfulness that happens as people age. For those with Alzheimer’s disease, however, the forgetfulness can impair their ability to carry out normal, everyday tasks. People with early-stage Alzheimer’s are still able to live independently, and even hold down a job, but may have one or more of the following symptoms: 

• Remembering names or recent events 
• Managing money 
• Remembering where they put a valuable object, or even where they last put their keys 
• Making plans and staying organized 

The affected person may be aware of this forgetfulness and make excuses for why it’s happening, but their family, co-workers, and friends may begin to take notice of the changes in behavior.  

“When we lose something, we can go back and think about where we’ve been or what we’ve done by retracing our steps,” Garrigan said. “When you have Alzheimer’s disease you’re not able to go back and retrace your steps. It’s a debilitating kind of memory loss where you have no clue what you just did for the last hour or so, or why you walked into a certain room in the house like the kitchen, or bathroom, for example. Some may even read something and then not be able to recall what they just read. A person in those early stages might also be at work and suddenly wonder where they are or what they’re doing there.” 

When you have Alzheimer’s disease you’re not able to go back and retrace your steps. It’s a debilitating kind of memory loss.

Mike Garrigan, Dementia Specialist, ThedaCare 

Middle (Moderate) Stage. This is typically the longest stage of Alzheimer’s, often lasting many years. An individual’s symptoms may include: 

• Trouble remembering their own name and details about their own life, such as their address and phone number 
• Trouble with speaking, reading, writing, and working with numbers, as well as learning new things 
• Increasing trouble remembering events 
• Difficulty planning complicated events like a dinner or party 
• Exhibiting a decrease in judgment, leading to making poor decisions 

“All of these things tend to lead to social isolation because the person may try to hide it out of embarrassment and withdraw,” Garrigan said. “Which ends up changing their mood or personality.” 

As the moderate stage progresses, the individual may: 

• Recognize familiar people but forget their names, including the names of their spouse, significant other, children, or pets 
• Lose track of time and place where they may not know if it’s day or night and whether they should be making breakfast or dinner 
• Experience changes to their circadian rhythm, such as getting up at midnight, getting dressed and ready to start their day, but then feeling exhausted and ready for bed by noon 
• Need help choosing the right clothing and getting dressed 
• Need help with daily activities, such as brushing their teeth, or brushing their hair 
• Become moody or withdrawn 
• Be restless, agitated, anxious, or tearful, especially in the late afternoon or at night 
• Become suspicious of other people and their motives, even loved ones 
• Have hallucinations, paranoia, or delusions   

“A person in this stage may start to wander; they’ll walk out the door with the intent to go somewhere, forget where they are or where they were going, and may also forget how to get back home,” warned Garrigan. “That’s why we have Silver Alerts so often in our state. The middle stage is considered the most dangerous time because they still have that combination of lucidity and increasing signs and symptoms of Alzheimer’s.” 

Late (Severe) Stage. At this stage, a person may: 

• Lose many physical abilities, including walking, sitting, or eating 
• Become incontinent 
• Be able to say some words or phrases, but not have a conversation 
• Need supervision and help with all activities 24/7 
• Be unaware of their surroundings and recent experiences or events 
• Be more likely to get infections, especially pneumonia and urinary tract infections, because they can’t communicate to someone that they’re not feeling well  

“At this stage, the caregiver has to be more intuitive and anticipate needs because they’re not being communicated to them,” said Garrigan. “Hospice or palliative care is also appropriate at this stage.” 

Act Early 

If you suspect that you, or a loved one, may be in the early stages of Alzheimer’s, you should see a doctor as soon as possible.  

“While it’s incurable, there are things that can be done to slow the disease down,” said Garrigan. “By receiving the diagnosis, you’ll have the opportunity to start moving ahead with plans for the future, while you or your loved one is still cognitively intact.” 

While it’s incurable, there are things that can be done to slow the disease down.

Mike Garrigan, Dementia Specialist, ThedaCare 

He also recommends that people visit alz.org.  

“They have more information than you could ever need,” he said. “It’s important to get educated so you can better understand the illness and advocate for yourself or on your loved one’s behalf.” 

For example, keeping the brain active during the progression of Alzheimer’s is helpful when you learn something new.  

“Alzheimer’s disease destroys connections in the brain, but new connections around it can sometimes be made if you’re doing something you’re not as familiar with,” said Garrigan. “Try doing a different kind of puzzle, learn a new language, learn to play an instrument, something new that you’ve not done before.”  

Local Resources  

Fox Valley Memory Project is a collaborative nonprofit organization operating and supporting programs and services that improve quality of life for those experiencing dementia, as well as their family, care partners, and friends.  

One such program is that of Memory Cafés. Memory Cafés consist of facilitated activities, informal conversation, and light refreshments. They are designed to be interactive, where the person with memory loss and their caregiver, family or friends can interact with each other in ways they had before the memory loss occurred. Because every participant is going through the same thing, there is a feeling of belonging and acceptance. There is no cost to participate. 

View a listing of local Memory Cafés and other available resources on the organization’s website.