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Forum Name: Psychiatric Topics

Question: My mom may have early signs of Alzheimer's? or Aphasia?


 precious_sweetie_4u - Tue Mar 11, 2008 10:20 pm

My mother has been having trouble (for the past 3 years, with it a LITTLE worse now than when originally started) with her speech/communication and memory. She is 54 years young.

She can UNDERSTAND communication very well, and has no problem. But, when asked to re-tell/paraphrase/summarize a story [like a short story she read from a book], she has trouble placing the events in proper order and telling the story effectively [if one had NOT read the story she was re-telling, they would not understand her version of it].

During regular speech, she often has trouble finding the right word [and will often DESCRIBE the object/word sought after, (like instead of 'popcorn' she will say 'the thing you eat at the movies, the thing you put butter on', etc.). This type of thing happens quite often - and she usually replaces the word with "that thing" [sometimes not even describing it further, because it is evident to us with context clues].

She understands what she reads,but just has a hard time communicating it to others. She watches movies/tv the same way - she understands everything, but when it comes to communicating her understanding to others, she has trouble with words/phrasing/order.

She doesn't have trouble FORMING speech (like she doesn't "babble" or make repetitive noises). She says she KNOWS what she is trying to say [and knows the word] but "it just won't come out".

She doesn't have any trouble dressing or doing day-to-day activities (cooking, cleaning, etc) and does not get lost (like driving home from work, etc.). She does forget small things (like where she put her glasses, etc) sometimes, but she doesn't show any signs of DEMENTIA per-say, only the inability to find words, at times.

She has not had/does not have any known stroke, head trauma, or brain-lesion/tumor.

If you have any idea what might be the problem (or any advice) it would be greatly appreciated. Thank you very much for taking your time to address my concern. I really appreciate your kindness.
 Dr. E. Seigle - Wed Mar 12, 2008 7:58 pm

Precious_sweetied_4_u,

It sounds like you are concerned about your Mom. It does sound like she is having some difficulties that would be described as some mild expressive aphasia. She is rather young for the age onset of Alzheimer's, unless you have a family history of early onset Alzheimer's. The next step would be to rule-out any brain process that might have led to this symptom or predispose to further symptoms in the future. The fact that her symptoms don't seem to be progressing is a good sign. One common cause among many of this kind of aphasia would be a very small, unnoticed mini-stroke, other types of dementia, or medications that she might take. Common factors predisposing to "mini-strokes" are high blood pressure, diabetes, smoking and high cholesterol.

The prudent course of action would be for your Mom to visit her internist, who would want to probably do a complete history and physical (with emphasis on the neurologic exam) and what is called a "Mini-Mental State Exam" (a brief cognitive screening test), check her blood pressure, get blood work (if not recently done) to include cholesterol, B12 and folate levels, thyroid panel and glucose, and to consider a brain MRI. A neurologic consultation might be considered by the internist. If your Mom hasn't had the usual cancer screening tests such as a mammogram, chest x-ray and colonoscopy, Pap smear, these can be considered.

Good job paying close attention to your Mom, and be sure she gets a thorough evaluation if she hasn't had one in a while. A good assessment may take several office visits. Good luck!

-Dr. Seigle
 precious_sweetie_4u - Wed Mar 12, 2008 9:45 pm

Thank you very much for your help, Dr. Seigle.

My mom has had mammogram, chest x-ray and colonoscopy, and pap smear done recently. She has had a physical about 10 months ago which showed her blood work (including cholesterol, B12, folate, thyroid panel, and glucose, levels) were all within range. We don't have a family history of AD, and she has no history of high blood pressure, diabetes, smoking or high cholesterol.

I will schedule a visit with her internist for her. I will request an H&P exam along with emphasis on the neurologic exam, and a "Mini-Mental State Exam". I think a brain MRI and neurologic consultation are very good ideas, and will try to get these done. Thank you very much for your time and advice. It really made me feel a lot better knowing what to get done and what the possible problem could be.

Your help was greatly appreciated.

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