The Not-So-Obvious Symptoms of Alzheimer's

When we think about Alzheimer's symptoms, we often go straight to memory loss or cognitive issues. While these are hallmark features of Alzheimer's, there can be other, not-so-obvious issues that arise when living with the condition.

Signs to watch

The results of our 2019 Alzheimer's Disease In America survey reveal more about life with Alzheimer's, including some of its other, less talked about symptoms. Some of the most commonly reported issues are shared below.

Visual-spatial issues

Balance and vision issues often go hand-in-hand. Together, these can be called visual-spatial issues. This means that our brain is having a hard time processing what we are seeing and how we are associating things with one another.

For example, our depth perception might be off, and our body may think something is closer when it is farther away. This can potentially lead to balance issues and falls if we bump into something or cannot perceive things around us correctly.^1-4

Other common vision issues include trouble reading, impairment in color vision, reduced visual field, an overall decrease in the clarity of vision, and more.^1-4

Coping with balance and vision issues

With Alzheimer's, vision and balance issues can begin early on and worsen over time. These issues may be due to damage in the areas that help interpret our vision or control our posture or muscles. Further, balance issues, including dizziness, maybe a side effect of certain medications.

A doctor can help determine if vision or balance issues may be related to any meds you're taking; however, there are no specific treatments for these issues. The best way to cope with these issues is through lifestyle changes, including the following:^1-4

• Keeping walkways around you as clear and wide as possible
• Moving objects with sharp corners out of pathways
• Making sure the area around you is as well-lit as possible
• Using large print labels or getting books, magazines, or newspapers with large print (or increasing the size of the font on your phone, tablet, or computer)
• Using a walking device or adding handrails to areas that you might need extra support in, such as near the toilet or in the shower
• Asking for assistance if you are unable to safely walk from one area to another or can't find something you're looking for
• Using contrasting colors to help you find objects you need, such as placing white or light-colored objects in front of a darker background so that they might stand out
• Participating in regular physical activity (within your means) in order to strengthen muscles and improve balance
• Regularly checking-in with your eye doctor

Sleep troubles

Sleep difficulties may vary throughout the progression of Alzheimer's. Early on, some people may be excessively sleepy during the day, and then experience restlessness at night as the condition progresses.

Later during Alzheimer's progression, sleep-wake cycles may become completely disrupted. Experts are not completely sure why these changes in sleep happen; however, they may be related to mental or physical exhaustion, disorientation, anxiety, depression, sleep apnea, or changes in our internal body clock.^5-7

Coping with sleep troubles

Some medications can be used to treat sleep-related issues. However, these medications have side effects that may harm people with Alzheimer's (such as an increased risk of falls, excessive drowsiness, stroke, or further cognition issues). A doctor can help determine if sleep meds are right for you.

Outside of medications, there are other changes that can be made to improve sleep, including:^5-7

• Avoiding alcohol, nicotine, and caffeine
• Participating in regular exercise (but no later than 4 hours before bed)
• Maintaining a regular schedule, including regular meal times, bed times, and wake-up times
• Avoiding turning on the television if you wake up in the middle of the night
• Maintaining a comfortable bedroom temperature
• Talking with your doctor about the medications you're on to see if any may be causing restlessness
• Surrounding yourself with bright light shortly after waking up

Loss of interest in activities

After receiving a life-changing diagnosis like Alzheimer's, it is normal to experience feelings of grief and to need time to process the news. Some may withdraw from friends, family, and hobbies after diagnosis, and may experience overwhelming feelings. While this is normal at first, these feelings may persist or worsen to the point where they impact daily life.

Loss of interest in activities may be due to depression, memory issues, language difficulties, vision issues, or fatigue. These issues can emotionally impact someone with Alzheimer's and lower their desire to want to participate. Also, these issues can physically prevent someone from being able to participate in activities they once enjoyed, such as reading, chatting with friends, or doing puzzles.

Depression or loss of interest may be caused by the loss of neurons in certain brain areas. For example, our brain's frontal lobe plays a role in our motivation and ability to plan and stay focused. If this area is damaged, it could lead to depression and a lack of interest.^8-10

Coping with loss of interest in activities

Losing interest in activities or experiencing feelings of depression can happen at any time with Alzheimer's. While some fear or grief is normal, if these feelings start impacting your daily life and ability to function, it may be time to seek additional support.

Seeing a counselor or other mental health professional may help you navigate feelings of depression, anxiety, loss of interest, or mood swings. Additionally, joining a support group (either online or in-person) may help provide extra support.

In some cases, medications, such as antidepressants, may be helpful. However, these come with side effects. A doctor can help determine if antidepressants are right for you. Eating well, exercising regularly, and getting restful sleep can also help improve mental health.^8-10

Fatigue

Fatigue can be a challenging symptom to describe and recognize. For many, it is an overwhelming feeling of constant tiredness or weariness.

Fatigue can occur on its own due to mental or physical exhaustion. However, it can also be related to any (or all) of the other issues listed. Mood issues, including depression, can lead to fatigue. Additionally, sleep disturbances or vision/balance difficulties can also lead to feelings of exhaustion. Many of these issues can combine and feed off of one another.

Coping with fatigue

Many common ways to combat fatigue have been outlined above. If you're able, it is essential to determine where your fatigue is coming from.

Are you not sleeping through the night? Is your vision becoming blurry and causing your eyes and mind to strain all day? Are you feeling down, sad, stressed, or depressed? Asking yourself, your caregiver, or your doctor about the causes of fatigue in your life may help you isolate what's contributing to your weariness and take steps to improve your energy levels.

In some cases, the exact cause of fatigue may not be identified, and general energy-boosting steps may be helpful, such as eating a balanced diet, working toward better sleep, and getting regular exercise.