Subtle changes in gait and sleeping patterns in older people may be linked to Alzheimer's disease, according to research out today at the Alzheimer's Association International Conference 2012 in Vancouver, Canada. USA TODAY talked to Bill Thies, chief scientific and medical officer for the Alzheimer's Association, about these changes and other warning signs of the disease. Alzheimer's affects 5.4 million people in the USA, numbers that are expected to soar to 16 million by 2050 as Baby Boomers age. The disease is the second most feared, behind cancer.
Q: What are some of the characteristics of how gait might change?
A: Walking becomes slower or more variable. The research presented at the meeting is robust. These links have been suggested before, but this is the first science to support it. In several of the studies, gait changes were noted before cognition changes. One of the studies showed there was no link between walking and memory, but there is a link between walking pace and variability and executive function (a set of mental processes).
Q: If the changes are linked to Alzheimer's disease, what is occurring in the brain to cause the problem?
A: Walking relies on the perfect integration of several areas of the brain. The disease interferes with the communication between different regions of the brain.
Q: How do you know if changes aren't caused by another disease such as Parkinson's or arthritis?
A: That isn't an easy answer, but the current studies ruled out those diseases or found that people who had early stages of Alzheimer's might also have arthritis in a hip or knee as well, or other problems. The important message is to seek a professional's advice if you notice a change in gait. There are a lot of things that are early signs that aren't always diagnostic of Alzheimer's disease but should encourage you to want to get a complete evaluation from a professional.
Q: Can an untrained family member see the changes in gait or is a specialist required to detect it?
A: The changes might be very hard for a loved one to pick up, but even if you suspect a change, then find out what the underlying cause is by going to a specialist.
Q: What effect does sleep have on changes in the brain associated with Alzheimer's?
A: Researchers reported on Monday that cognitive health declines over the long term in some people with sleep problems. A large study done at Brigham and Women's Hospital in Boston, of 15,000 participants ages 70 and older, reported important findings. Sleep duration shorter or longer than the recommended seven hours might have an effect on cognition in older individuals. It's still not clear if sleep change is one of the risk factors or an early sign.
Q: What else did the study note about sleep and cognition problems?
A: Participants who slept five hours or less had lower average cognition than those who slept seven hours a day. Those who slept nine hours a day or more had lower average cognition than those who slept seven hours per day. And too little or too much sleep was cognitively equivalent to aging two years.
Q: What is one of the most common early warning signs of Alzheimer's disease?
A: Loss of interest is an early sign of the disease. I hear it over and over. People will say their husband or wife did something all the time and then over the period of a few months they didn't do it anymore. There could be a number of reasons why they stop doing something they love. But that change in interest and personality should move you toward getting a diagnosis.
Q: If a loved one stops doing something he or she loves, does that mean they have Alzheimer's?
A: Not necessarily. Depression could be another reason, but it is important to find out why they've stopped doing something and take the necessary steps to get them tested. This can happen years before they become demented.
Q: Can you be more specific about some of the things people will stop doing?
A: Very often, there's one person in the household who pays the bills. If you see them struggling to manage the finances, it is time to get a diagnosis. Following recipes and cooking might also be difficult for someone in the early stages of the disease.
Q: How do I find a doctor that can diagnose Alzheimer's?
A: The more practice a doctor has with Alzheimer's, the better he is going to be at diagnosing. Ask the doctor if he is comfortable making a diagnosis. And if he's not, ask him to recommend someone who can do it. It pays to have an early diagnosis.
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