Memory deficits - physiology question. Is this typical with dementia?

Imho, I just lost my sister in law to the horrible disease of Alzheimer's, which, sadly, was not her COD (she got COVID from a caregiver). However, after speaking to her son recently, he verbalized the fact that she had said "What is wrong with me?" That said, there may be fleeting moments of lucidity of the individual.

Dear Sparkielyle,
I write from the patients perspective. I was diagnosed with Early Onset ALZ 5 yrs ago. My most recent Neuropsych Exam says I am in Moderate to Severe ALZ. Be that as it may. I first began complaining about my memory in the winter of 2011. The doctors blew me off saying it had to do with Sleep Apnea, too little sleep etc. Finally in February of 2016, I was fired from my last job for failure to meet my goals. I had been in the travel industry for 38 yrs. The doctors started paying attention I had my first Neuropsych Exam in 1962 at the age of 2 I began having seizures and I had difficulty learning. The second one was in April of 2016, I got the results in June of 2016, and was diagnosed as mentioned above. I had my third one in March of 2021, and received the results in April of 2021. I have taken note of changes over the years as I've learned a lot of what I know from readying on Aging Care, reading the Thirty-six Hour Day. and other resources.

We had an appointment with the Neuropsych Doctor two weeks ago to discuss how he came up with the newest diagnosis. He told us the Test he gave me was based on Critical Thinking Skills, My two previous ones were mostly Intelligence test. He told me he'd never had a patient that scored so low as I did in the lowest 1% of men at my age 62. He also said he'd never spoken with a patient that scored in the range I did that could ever carry on a conversation like I do.

I believe the lapses in memory have their own beginning, it is with the little things, forgetting a doctor's appointment, and over time it continues on at it's own pace. Five years went by before the doctors took a real look at me, so now I see myself as being 10 yrs in to this disease. I'd suggest you have mom checked out for all the other things that you are noticing and get a diagnosis narrowed down. We all progress at different speeds. The husband of former Supreme Court Justice Sandra Day O'Connor's husband suffered with ALZ disease for over 20 yrs before he died and now she is fighting her battle with the disease. We all find ourselves on different paths of progression. I wish you peace of mind and recommend you keep coming back to this site looking for answers to questions you may have, and share the experiences you are having as you walk this road we call Dementia.

God Bless you all,
John

My grandmother called it 'short circuits'. She realized she was forgetting certain things and had trouble recalling names of those she knew quite well. She laughed about it and would say, tell me your name - I have short circuits in my brain.

Dementia can be caused by different mechanisms. Alzheimer's disease is the most common and typically symptom is degradation of judgment and problem-solving. Later symptom is memory loss and not being aware of what is being lost. Another cause of dementia is Parkinson's disease with early symptoms of increasing stiffness and hand tremors. The dementia is later. The type of symptoms you describe are more likely mini-strokes. With stroke, a person loses function of whatever area for the brain the stroke occurs. If the brain cells die from stroke, then that is "lost". So you mom knowing that she has some memory "blanks" are probably the result of mini-strokes.

Most strokes are caused by blood clots. Please have your mom evaluated and treated by a doctor. Most causes of blood clots can be diagnosed and treated.

My Mom is 89 years old and she hasn't been diagnosed with dementia but she probably has it. I think the symptoms are there. She can't remember the day of the week or date. She can't remember if she ate or not and taking her blood pressure medication. She uses a smartphone and can't operate it like she was able to a couple years ago. Although it is a different brand its still an android. She used a laptop everyday for years until last summer and doesn't even touch the Asus VivoBook I bought her on Amazon. She played games like Mahjong and Solitaire that I thought was good to stimulate her brain. I'm ADHD so I don't really have the patience for helping her and she's pretty condescending. I'm pretty much depressed cause I'm alone and I have lived with her for over 15 years in a 2 bedroom apartment and my Dad is a sociopath whom I cut ties with a few years ago finally. He's Cuban and lives in Miami. I have a half Sister that lives in Lotus, Ca and works in Sacramento. I'm waiting for her to move back here so she can handle and take over being a Caregiver for our Mom who is a bear. She takes too many laxatives and I can't stop her since she tells me I'm not her Boss, Doctor, or Nurse. I see I care too much and need to back down. I've gotten upset with her a number of times and we have had our arguments. Not pretty either when my own Dad messed with me. It is less than a desirable position and I get told by her that most or all Sons or Daughters are dealing with this my age of 53. I don't think so.

Everyone is a unique person; and their awareness of their dementia is also unique. When my wife was diagnosed with Alzheimer's 13 years ago in the car coming back from the diagnosis (based on a scan) she began whistling the theme tune for "Bridge over the River Ka(?) which I interpreted as "That's the way life goes." But someone pointed out to me it can also mean, "We're going to build this bridge."

My wife was lucid for many years, even though she had progressive dementia--and all dementia is progressive. She said it was like looking out of a window into the rain. You could still see outside but it was rather blurred. It is like that for many people.

I think it is a good sign when someone with any form of dementia recognizes that they have memory deficits. For those with them the challenge is to understand when and where in their past lives have they brought into the present. Then go beside them. Accept their reality as where you will join them; and chat about their awareness. Almost everyone with dementia is "a time traveller" moving into the past. Sometimes, it is good to just go with them and be with them. Accept their reality as your reality.

Amazingly, my wife is still alive and friendly 13 years into Alzheimers! We have a hard time understanding her, but she still seeks to communicate and often does. You never know how your life journey will work out; and you have to, as the phrase goes, "go with the flow."

Love and Prayers

My mother had Lewy Body Dementia and yes, she knew she wasn’t thinking correctly. She just passed away in Mar, eight years after her diagnosis. I believe she had the onset 2 years prior. Do not let your mother take ANY Alzheimer’s meds until you get a correct diagnosis. Her GP doctor unknowingly gave my mother one of the Alzheimer’s meds and I think it propelled her further into her dementia early on. Starting out, my mother would say the exact thing your mother says. Get an early diagnosis and find a good natureopath doctor and give your mother supplements, not psychoactive drugs.

My gran at 90 was starting to have memory issues intermittently. She described it as everything being clear, then a fog would roll in and she didn't remember most everything. We enjoyed the clarity, embraced the fog. Slowly over time the fog was there full time. She lived on surviving a broken hip exceptionally well but died at 99.

Of course people know they have a problem, Until it gets real bad.

You don't just get it over night.

It's a progressive disease.

Some people just ignore the problem and or don't want to accept it.

Thank you all for your responses. Community helps so much. My sister and I just wondered how TIAs, if happening, might contribute to her dementia. My Mom is 93 and has been in assisted living for about 3 years now. That routine environment, constant eyes, and her willingness to do for non-family members is priceless. It lets us be at our best for her and relieves so much of our stress. I am thankful for this group and the words of wisdom!

My grandmother is in mid to late stage dementia and ( lately ) occasionally she will state that she doesn't know "what is going on with my mind " and I will tell her what is wrong and that she is looked after and loved . It's all I can do and it seems to reassure her and calm her .

I was very startled the first time she did it , I'm not going to lie , as during the early to mid stages she did nothing but react with anger / annoyance / denial . I made a point of informing her early on what was happening to her and how it would progress so I don't know if that's a factor.

She is mostly happily settled in now with the routine we have provided and enjoys watching shows , playing with her dolls or looking at her magazines , chatting ( sometimes what seems to others like nonsensical things with me but it's cute and I speak fluent " mama" ) . She recognizes me very well but no one else and she naps a lot at this point.
Even so , evey week or three this statement comes up so I suppose self awareness may come and go with many dementia and Alzheimer's sufferers.
Even her doctor was startled by this information so that tells you something .

Dad knew he was losing his memory - he often searched for words as he got worse. Dad actually was diagnosed with mixed dementia - AD and vascular. The vascular dementia was due to strokes he was having in the balance center of his brain. The strokes showed no outward signs of stroke - the only evidence was his falling - who knew? The only reason we found out about the vascular was because a retired nurse friend of my parents told dad he did not have AD in no uncertain terms. So i contacted his PCP and had a referral to a neuro whose specialty was dementia.

On the other hand - some people don't know they have a problem. Research dementia and learn about the different types and generally how they present. No one goes though dementia the same way. Everyone has its own experience.

My Grandma would have TIA's - in her 90s you'd be talking to her and she'd just get kind of a fuzzy look in her eyes for a few seconds or might say something a little off.

If you have concerns that your mom may have had a stroke or TIA, contact her PCP and see if she can be referred to a neuro with stroke and dementia expertise.

My dad is classified as "severe" dementia and can barely put a sentence together lately. However, just yesterday he told me he had "no recollection" of falling. He amazes me how a person who can't really talk can often use fairly sophisticated phrases. He has been up and down in terms of communcation and memory,, sometimes within the same day.

There are dozens, not to say hundreds, of different types of dementia. Each of those different types affects any one individual uniquely, and again many people experience more than one type at a time. So it is almost impossible to make meaningful generalisations about what particular areas or types or levels or ages of memory will be lost, what abilities will remain, and what awareness any one person will have of his or her own difficulties.

I dispute that it is "usually" the case that people don't know they have a problem - they're usually only too aware that there is a problem, but often will look for ANY explanation that doesn't involve the D- word! I suppose it is fair to say that it's comparatively unusual for a person to be able to identify the problem as clear-sightedly as your mother does.

Take advantage of it! The better your mother's understanding of what is (or may be) happening within her brain and the impact on memory and other brain functions, the more confidence she will have that those around her are able to supply any deficits and maintain her quality of life.

alz.org has good information on a wide range of topics, which you might find helpful yourself and could also share with your mother.

About TIAs. There is a very widespread muddling of definitions of TIAs, "mini-strokes" and strokes, and the terms get bandied about casually - including by clinicians, who ought to know better but sacrifice accuracy to simplicity.

A Transient Ischaemic Attack:
Transient = passing, i.e. not having a permanent effect, i.e. causing symptoms (e.g. loss of consciousness or muscle tone, speech impairment, visual disturbances, etc.) which last for less than 24 hours
Ischaemic = interrupting blood supply
Attack = episode rather than assault
They can be caused by micro-blood clots or sludge gumming up arteries, among other things, and resolve by themselves.
They are often called "mini-strokes" by medics in a hurry trying to describe them to patients and families. Grr.

Mini-stroke.
In vascular disease, often long before anyone gets round to suspecting dementia, small clots and blood pressure problems will impair the blood supply to the brain. Tiny areas of brain tissue die, so tiny that the brain sorts itself out before anyone has noticed or responded to any problems caused. In my amateur picture, I think of the brain as a bathsponge that lives longest when kept pleasantly and consistently damp. Let it dry out for too long, and eventually little crumbs will form and cracks will appear. It's not as dramatic in the brain, obviously, but it's a similar sort of process. Series of these mini or micro strokes over years lead eventually to diagnosable vascular dementia.

Brain tissue once dead does not regenerate, it's gone forever. BUT the brain is amazing. If one set of neural pathways is interrupted, it builds another - it can't send messages through the dead bit of brain, so it sets about sending them round it, creating new routes. This process is called "plasticity" and is retained to some extent throughout life, although by old age it's nothing like as impressive as it is in babies and young people.

And so to stroke: permanent death of a part of the brain. This can be caused by a clot or a bleed - either way, part of the brain is starved of oxygen and dies. Typical effects are the one-sided symptoms we're all told by public information films to look for - Face, Arms, Speech - but there are as many possibilities as there are functions controlled by the brain (i.e. all of them).

It's not unusual for someone with dementia symptoms to realize there is something wrong with their memory. There are so many different symptoms of dementia. People experience their symptoms in different ways. The inability to recognize family occurs in the mid to late stages of dementia, or may not occur at all. Has dementia actually been diagnosed in your mom? At her age, some forgetfulness isn't unusual. Experiencing TIAs over time can cause permanent damage to the very small blood vessels in the brain, which can result in VaD. A single TIA doesn't cause VaD.

FWIW I think a lot of people DENY they have a problem or actively try to cover it up because they fear loss of autonomy but true anosognosia is not as common.

As for TIA's- We've been sold the idea that they are a warning sign and cause no permanent damage but I think that depends on what you are looking for, very often doctors focus is much too narrow (stroke and/or stroke prevention) and they fail to see the bigger picture. All I know is that not one doctor ever mentioned a possibility of vascular dementia when my mom was being treated as at risk for stroke, this despite being told her MRI "lit up like a Christmas tree".
(research multi infarct dementia)

Dementia is an umbrella term for many diseases affecting memory & other cognitive abilities and behaviour. 

Symptoms, behaviour & awareness can vary hugely.

Alzheimer's being the most common type, which is why even some Doctors use this dx interchangingly (incorrectly) for any type of dementia. I believe Vascular Dementia is the 2nd most common type. This has many causes, multi TIAs being a big one.

Some people have zero idea there is anything wrong. Planning trips to their lake home 7 hrs drive away (sadly, a real post I read yesterday).

Some are aware things are a bit off, may stop socializing to hide it. May get anxious, fearful, defensive to hide their deficits. I have even heard of a suicide, after being diagnosed.

Some actually will tell you, but laugh it off
"Oh my memory is no good anymore, but I can still dance!"

The *blanks* your Mother mention do sound like how people have described TIAs to me. Or a friend's Mother after a bigger stroke. She said she was just blank, no thoughts, for an unknown time. Then she said thoughts returned, then words. Made a full recovery in 2 or 3 days.

It seems blanks are not painful - as long as emotional distress around them can be avoided.

Teepa Snow has an amazing amount of info & videos on Dementia that may be of interest to you.

All the best with your Mother.

My mom, with AD, knows her memory’s worse, I get the feeling that it’s more so than she’ll admit. Generally people will acknowledge that their memory is a little worse, but not something that is affecting their ability to live their life without assistance.
You would have to have testing to pinpoint if her dementia/memory loss is more vascular (strokes, TIA’s) than Alzheimer’s.