Complaints & connections · borters.ch
Not forgetfulness in general but the new that does not stick — and first the short list of treatable causes belongs checked.
Also known as: Alzheimer’s disease
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The commonest form of dementia. Proteins accumulate in the brain over decades, and the nerve cells first lose their connections and then themselves — starting where new memories are formed. That is why the first sign is not forgetfulness in general but a very particular kind: the new does not stick, while the old is well preserved. Someone who tells childhood stories vividly but asks the same question from this morning three times is describing exactly that pattern. Equally typical is that the memory does not come back with help: a prompt does not work, because nothing was filed. Before anything else happens, though, a short list belongs checked, because several causes look just the same and are treatable — an underactive thyroid, a vitamin B12 deficiency, depression, sleep apnoea, too many sedating medicines, and a hearing loss that pushes people out of the conversation. For the condition itself there are treatments that soften the course but no cure. What carries daily life most is therefore something else: structure, hearing and sight, movement, company — and an environment arranged early, while the person can still take part in the decisions.
The Alzheimer form is the commonest, but not the only one. The vascular, the Lewy body and the frontotemporal forms begin differently — and before any assignment come the treatable imitators and the distinction from delirium.
Thyroid, B12 and folate, mood, sleep, hearing, sight and the medication list. That single pass regularly finds something that can be put right.
An untreated hearing loss takes away conversation, company and stimulation — and it measurably speeds the mental decline. Of all the measures this is one of the most effective.
Sleeping tablets and sedatives, certain bladder drugs, old allergy medicines and some stomach drugs cloud thinking. What is taken away sometimes brings more than anything added.
Regular movement, a steady daily rhythm, morning daylight and people around. That is not occupation but the part that carries daily life the longest.
A power of attorney, an advance directive, authorisations, the housing question and driving. It is the one thing that can only be settled early — and it relieves everyone later.
A carer falls ill in turn if nobody looks after them. Knowing and using respite services early is part of the treatment and not a weakness.
The new antibodies against amyloid clear the deposits measurably on imaging. What they achieve in people is a slowing of decline by about a quarter to a third over eighteen months — they do not stop it and reverse nothing. They come into question only at an early stage with documented amyloid, require regular MRI checks because of swelling and small bleeds, and are given by infusion every two to four weeks.
The deposits in the brain begin fifteen to twenty years before the first signs — which is why the new antibodies work only at an early stage. They slow the decline by about a quarter to a third over eighteen months. About two in three dementias are Alzheimer’s. Among the modifiable factors, uncorrected hearing loss in midlife comes first in numbers; the large reviews attribute about forty per cent to the whole bundle of factors.
The same question several times a day, appointments that never land, conversations from yesterday that never happened — while youth is told vividly.
With ordinary forgetfulness a hint brings it back. Not here — because it was never filed. That is the most useful difference there is.
Bills pile up, cooking gets simpler, a familiar route becomes uncertain, the phone suddenly unusable. Not the memory question but the doing shows it.
Depression, an underactive thyroid, B12 deficiency, sleep apnoea, sedating medicines, an untreated hearing loss — all treatable, all regularly missed.
Alzheimer’s begins gradually over months to years. Confusion arising within hours or days is an acute event — infection, medication, dehydration — and an emergency.
An underactive thyroid slows thinking and lowers mood — and it is entirely treatable. It therefore stands at the top of the list.
A deficiency can hit memory, gait and mood at once. Common in older age, more so on acid blockers and metformin.
Low levels are the rule with little daylight. They do not explain dementia but belong to basic care and to preventing falls.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Associated with slower decline.
The best-studied single factor for prevention. In cohorts regular movement is linked with a later onset; with established disease it improves everyday abilities and mood but does not halt the course.
Much studied with mixed results: some studies at 240 mg a day found small improvements, the large GEM prevention trial found no protection. With blood thinners it belongs discussed.
Low levels are linked with more frequent dementia in cohorts. Whether supplementing protects has not been shown — the link may also be because those affected go outdoors less.
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