Follow this Alzheimer’s checklist for early detection

Certain behavior changes may be a harbinger of Alzheimer’s disease, and researchers say they’ve developed a symptom “checklist” that might aid earlier diagnosis.

Experts have long focused on so-called mild cognitive impairment as an early warning sign of Alzheimer’s disease. That refers to problems with memory and thinking that may or may not progress to full-blown dementia.

But now some researchers are zeroing in on a new concept they call “mild behavioral impairment.”

The term is meant to describe persistent changes in an older person’s normal behavior. The changes include problems like social withdrawal, angry outbursts, anxiety and obsessiveness.

“We’re not talking about a blip in someone’s behavior,” said Dr. Zahinoor Ismail, of the University of Calgary’s Hotchkiss Brain Institute, in Canada. “It’s a sustained change from their former ways of functioning.”

And, he said, “that out-of-character behavior can be the first sign of something going wrong in the brain.”

So Ismail and his colleagues have developed a symptom checklist that doctors could potentially use to assess older patients for mild behavioral problems. The tool still needs to be studied further, but the hope is that it will help spot people in the early stages of Alzheimer’s.

Ismail was to present the work Sunday at the Alzheimer’s Association International Conference, in Toronto. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

“People often think [Alzheimer’s] is all about memory loss,” Ismail said. “But it’s not.”

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Many patients with dementia, he explained, also have neuropsychiatric symptoms — an umbrella term for problems with behavior, mood and perception.

But the concept of “mild behavioral impairment” as a precursor to dementia is new, according to Ismail.

“Until now, there hasn’t been a good way to measure it,” said Keith Fargo, director of scientific programs and outreach for the Alzheimer’s Association.

Fargo, who was not involved in the developing the new checklist, said it still has to be tested in studies. Researchers will need to see whether patients’ results really predict how they will ultimately fare.

For now, Fargo said, it’s important for doctors and families to be aware that sustained behavior changes can be a red flag.

The checklist breaks symptoms of mild behavioral impairment into five groups.

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