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How can I know for sure if my mother-in-law has Alzheimer’s?

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The question

I think my mother-in-law is in the beginning stages of Alzheimer's. She sometimes looks at me funny – like she doesn't recognize me – but then will snap out of it and remember who I am (but sometimes not my name). There have been other incidents that involve misplacing significant items, like her car. Is there a way to test if she is indeed in the beginning stages of the disease?

The answer

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It is concerning to hear that your mother-in-law is experiencing changes in her memory and is having difficulty recognizing and finding previously known people and objects.

Symptoms such as forgetfulness can be intermittent and seem mild but they can also be signs of early dementia or Alzheimer's disease. The problem with diagnosing dementia is that symptoms may not be recognized until they become more serious because too often they are written off as signs of "normal aging." For this reason, it's good that you're concerned, as early recognition is important to get to the bottom of why these changes are happening.

Alzheimer's disease is the most common type of dementia and can cause a decline in cognitive functions, such as memory loss, change in language skills and a decreased ability to carry out daily routine activities. In the early stages of the disease, these changes can occur insidiously and may not be noticed, but over time, they can result in significant changes to personality and behaviour. What's worse is that Alzheimer's is a chronic, progressive disease that is irreversible. While there are medications that treat dementia, unfortunately, they have a limited effect on slowing progression or reversing this disease.

The other reason why Alzheimer's is such a disheartening disease is that it's so personal in nature and thus requires a great deal of sensitivity. Try talking to your mother-in-law about your concerns. She may be aware that something is changing. But remember that this may be a very confusing and potentially scary time for her.

Don't be alarmed if there is some resistance to discussing these concerns. This happens but what's critical is that she continue to receive support from her family. Gently introduce the idea of getting help as a way for her to understand what may be happening.

If she is willing, a visit to her family doctor is the next step. There is a possibility that a family member may be able to accompany her to the appointment, if she gives her permission. This can be helpful when it comes to sharing details of any concerning incidents.

Her doctor will likely do a physical examination, routine blood tests and other investigations to see if these changes may be due to an underlying medical, nutritional or hormonal cause. It would be important to also review her emotional health, since depression can mimic dementia and cause memory loss and difficulties with concentration.

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There are specific cognitive tests that can be done to assess her memory, spatial abilities, reasoning skills and judgment. This may be done with her family doctor or by a specialist with training in cognition.

By taking these steps, you can support your mother-in-law understand what may be causing these changes. Based on her doctor's findings, you can work together as a family for her well-being.

Send family doctor Sheila Wijayasinghe your questions at She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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