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Memory disorders are brain-based conditions that affect retention and recollection of memories. Everyone experiences some lapse of memory periodically, and some decline in memory is normal as we age. However, with memory disorders, people have more significant memory loss that may interfere with their work, social activities, personality, behavior, and ability to perform daily tasks. Impairments in memory may be due to many conditions, Alzheimer's disease, vascular dementia caused by small strokes in the brain, diabetes or high blood pressure, normal pressure hydrocephalus (NPH), or even depression.
Alzheimer's disease (AD) is a specific type of dementia and the most common form. It is a progressive, degenerative disease that causes slow decline of nerve cells in the brain. Individuals with AD experience progressive and irreversible loss in thinking abilities, including language and memory. Changes are also witnessed in mood, personality, sleep-wake cycles, and behavior. In AD, nerve cells involved in learning and short-term memory are affected early which is the reason memory loss is one of the first symptoms of Alzheimer's disease.
Many different conditions and diseases cause dementia. The term "dementia" is used loosely to describe severe memory loss and impairment in other thinking (or "cognitive") abilities that interfere with the individual's daily life and social interactions.
Dementia refers to a category of disorders that involve memory loss while Alzheimer's disease is a specific disease. Alzheimer's disease causes dementia, however, several other diseases or conditions, such as stroke, Parkinson's disease, head injury, and vitamin deficiency can also cause dementia.
Alzheimer's disease has three stages: early (mild), middle (moderate), and late (severe).
A person in the early stage of Alzheimer’s may:
Importantly, the first changes present within the brain may begin 20 or more years before diagnosis.
Those in the middle stage of Alzheimer’s exhibit:
The mild to moderate stage may last between 2 and 10 years.
In the late stage, people:
Severe Alzheimer’s may last between 1 and 5 years.
While Alzheimer’s disease is the most common type of dementia, the second most common type of dementia is vascular dementia. Vascular dementia is associated with problems in the circulation of blood to the brain (cerebrovascular disease). Risk factors for this type of dementia include:
An individual with mild cognitive impairment, or MCI, is able to take care of themselves and go about their normal daily activities, but they have subtle problems with memory and thinking. Some signs of MCI are losing things often, forgetting appointments, and having trouble finding the right words to say. MCI can be an early sign of Alzheimer’s disease—but not everyone with MCI will develop Alzheimer’s.
Everyone experiences memory lapses and forgetfulness from time to time and some decline in memory ability is a normal part of aging. For example, as an individual approaches middle age, his or her ability to recall newly learned information, such as recalling people’s names or specific words, may begin to slip. These memory problems do not get worse over short periods of time and do not interfere much with the ability to do daily activities. People may compensate for these normal memory changes by repeatedly going over things to be remembered, linking them in their mind with something already well known, or keeping lists of things to do. In contrast, the memory loss in Alzheimer's disease is much greater than expected for age. The memory lapses are more frequent and severe and interfere with the ability to manage daily activities.
Yes. See below.
It is normal to occasionally forget appointments or phone numbers. However, a person with Alzheimer's disease may forget things more often and not remember them later. The disease prevents the person from making new memories. Memories of things from long ago often remain after the ability to learn new information is lost.
Busy people can be so distracted from time to time that they may forget what they are doing. For example, one may forget to serve the vegetables during dinner, but will remember to serve them at the end of the meal. A person with Alzheimer's disease may be unable to prepare any part of a meal or forget they ate it.
Everyone has trouble finding the right words sometimes, but a person with Alzheimer's disease may forget simple words or substitute the wrong words, making his or her sentences difficult to understand. The conversation of a person with Alzheimer's disease may wander excessively.
It is normal to forget the day of the week or your destination-for a moment. But a person with Alzheimer's disease can have persistent problems remembering the date, day of the week, or time. They may have more trouble finding their way while driving and may occasionally get lost.
People may sometimes put off going to the doctor if they have an infection but eventually will seek medical attention. A person with Alzheimer's disease may not recognize the need for a doctor at all. Another example of poor judgment is that a person with Alzheimer's disease may dress inappropriately, wearing heavy clothing on a hot day, or two shirts. People with Alzheimer's disease may become distracted and unsafe while doing routine activities such as cooking or driving.
Trouble balancing a checkbook may be an early warning of a more serious problem.
We all misplace things from time to time. Frequently misplacing items may indicate an underlying memory disorder. Later in the illness, a person with Alzheimer's disease may put things in inappropriate places: an iron in the freezer or a watch in the sugar bowl and forget that they put them there. They may also accuse others of stealing when they are unable to find things they need.
Everyone becomes sad or moody from time to time. Depression may be the first sign of an underlying memory disorder in an older person. Someone with Alzheimer's disease can exhibit a wide range of mood or behavioral changes. For example, they may display rapid mood swings - from calm to tears to anger - for no apparent reason, or become abnormally irritable, depressed, or agitated. They may have changes in their eating, sleeping, and hygiene and may engage in repetitive purposeless behaviors such as rummaging through closets and drawers.
People's personalities can change somewhat with age. But a person with Alzheimer's disease can change dramatically, becoming, suspicious or withdrawn. Changes may also include apathy or indifference, fearfulness or anxiety, or acting inappropriately.
It is normal to lose interest and motivation in housework, business activities, or social obligations, but most people regain their initiative. A person with Alzheimer's disease may become very passive and require cues and prompting to become involved in daily activities. The symptoms of apathy are sometimes not distressing to the patient but can be very disturbing for the caregiver and family.
Jody Hiltz has been Clinical Administrative Assistant for Dr. Marks since 2017. She received her Associate of Science Degree from Quincy College. Your can find her smiling face greeting you when you enter our office.
Liz has been working for the practice for over 3 years. Prior to that she worked in skilled nursing facilities as a Life Enrichment Director/Dementia Practitioner. She loves supporting patients and their caregivers. Our practice offers expert level care in a community setting. Because of our association with an international research corporation we are also in a unique position to extend opportunities for treatments not otherwise available. She believes that it’s a pleasure to be a part of staff here who works as a team to provide education, support and as much as possible, a bit of amusement. Her goal is to help our patients maintain their independence and quality of life for as long as possible.
Years ago her grandfather was diagnosed with Alzheimer’s Disease then after taking care of her father her mother was diagnosed. She has worked in the medical field for over four decades as a Medical Biller but finds herself so fortunate to be working for this neurology practice as a Clinical Administrative Assistant in more of a “face to face” capacity with our patients. The years of experience supporting her mother through the disease was an education in what it takes to be a caregiver. She feels she developed more insight into what we can provide here to aid our patients and their support group. She feels she is especially blessed to be in an environment locally that can offer research trials that would not otherwise be accessible. She loves that the team here works to provide smiles every day to the ‘family’ that walks through our doors.
Morgan Tromblee has been working in Alzheimer’s disease research as a sub-investigator with Dr. Donald Marks since 2022. She also works clinically in the outpatient neurology setting, primarily seeing patients with Alzheimer’s and Parkinson’s disease. She received her master’s at the MGH Institute of Health Professions Physician Assistant Program, and her bachelor’s in biology at the University of Vermont.
Elizabeth Simpson has been working in Alzheimer’s disease research as a sub-investigator with Dr. Donald Marks since 2021. She also works clinically in the outpatient neurology setting, primarily seeing patients with Alzheimer’s and Parkinson’s disease. Lizzy received her master’s degree in medical science at the Tufts University Physician Assistant Program, and her bachelor’s degrees at Providence College.
Dr. Hreib obtained his MD, Ph.D. and M.B.A. From Boston University and was trained in medicine and Neurology at Boston University Medical Center and Boston City Hospital. His professional life as a neurologist began at Lahey Clinic in Burlington, MA, where he was the director of Vascular Neurology for over twenty years, after which he became the chief of Neurology at Mount Auburn Hospital in Cambridge, MA before becoming the Chief Medical Officer for Baystate Health North. Dr. Hreib continued to see patients as a neurologist while the chief medical executive and later decided to join Donald Marks clinic on neurodegenerative disease in Plymouth.
For over 30 years, Dr. Marks has focused on the treatment of neurodegenerative diseases, specifically in the areas of Alzheimer’s and Parkinson’s disease. Dr. Marks has been the Principal Investigator (PI) in over 40 clinical trials with numerous pharmaceutical and imaging companies as well as with the National Institutes of Health (NIH). Dr. Marks is a member of the medical staff at the Beth Israel Lahey Health Hospital (BILH) Plymouth and the Nantucket Cottage Hospital. He is the founding Medical Director for the Division of Neurology at the BILH Plymouth.