A local tabloid headlined in Tagalog ‘Lolo Sinaksak Si Lola Dahil Sa Matinding Selos’ and would be roughly translated as ‘ Grandpa Stabs Grandma Because of Extreme Jealousy’.
Poring over the banner story, I found out that the seventy something husband stabbed (thankfully not fatal enough to kill her) his sixty something wife on suspicions that his wife was pregnant courtesy of another man. While the report did not mention any mental illness from the husband, at seventy and with the distorted belief that a sixty something can still get pregnant (surrogate pregnancy is not allowed in the Philippines), there can only be one plausible explanation. The man could have been suffering from Alzheimer’s Disease. I wish I had been given the chance to do a neuropsychological test on him.
Paranoid behavior is common in Alzheimer’s Disease and delusions about or accusations of infidelity is among the most common. This would have been an easy enough a behavioral problem to handle but not when it is potentially life threatening to either party, in this case the wife.
While the thought of a sixty something wife being pregnant seems hilarious despite its improbability, at the end of the day, this is no laughing matter at all.
If you have a family member with Alzheimer’s Disease with aggressive behavior, consult your doctor (and I said your doctor, it does not have to be me) about it. Don’t wait before they become, God forbid, another tabloid headline or a banner story.
1. You are having trouble remembering simple words like… uh…(‘what’s that fruit that what’s her name ate in what’s this place?)
2. You are smiling all the time because you can’t hear a word they’re saying.
3. You are very good at telling stories over and over and over and over and that that other people’s grandchildren are not as bright as your own
4.You always look for the bathroom first wherever you go.
5. You know you are getting older when you walk into a rest room, unbutton your vest, pull out your tie and wet your pants.
1.) Which of the following is not an indicator of Alzheimer’s?
- Getting lost in familiar places
- Forgetting the names of casual acquaintances
- Having trouble balancing a checkbook
- Coping poorly with unexpected events
- Head injury
- History of depression
- Low level of education
- All of the above
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3)No other age-related problem results in dementia.
4)Which of the following has been connected to Alzheimer’s disease?
- High blood pressure
- Low blood pressure
5)Family history plays no role in your risk of developing Alzheimer’s.
6)A simple blood test can confirm an Alzheimer’s diagnosis.
7)Besides Alzheimer’s, which of the following also can cause memory loss and confusion?
- Thyroid problems
- Drug intoxication
- All of the above
8)Though a definite diagnosis of Alzheimer’s disease is possible only by autopsy, doctors can usually identify the disease by ruling out other causes of dementia.
9)Early diagnosis provides no benefit in Alzheimer’s disease.
10) And how did you do in the test?
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One of the neuropsychological tests doctors conduct for screening (N.B. Screening not Diagnosing) dementia is Folstein’s Mini Mental State Exam (MMSE) which uses the three objects for immediate and delayed recall.
This is how it normally goes:
Doctor: I’m going to say three words. After I say them, say them back to me
Mango Paper Table
Patient: Mango Paper Table
Doctor: I’d like you to remember these three words because later I am going to ask for them again
(After a brief distraction which may be the Serial Sevens, the doctor again asks the patient those three words)
Doctor: Do you remember the three words I asked you to remember.
It would be that the number of words a patient remembers or the speed with which they remember them depends on the magnitude or degree of the impairment.
One particular patient has been having a hard time remembering any of the words and she appeared to be painfully sluggish. So that even if she would not be getting a point for this, I tried to give her a cue.
Doctor: Ma’am, do you remember any of the three words?
Patient: I don’t remember.
Doctor: OK, I’ll give you a clue. One of them is a fruit.
To this the patient seemed jolted from a trance and exclaimed ‘Did you just say fruit?’
Doctor: Yes Ma’am. A fruit.
Patient: (This time laughing) ‘Ha ha ha. Ha ha ha ha. No, way. No way. No way will I remember that because I never liked fruits!’
1. His arthritis makes causes him either constant or intermittent pain (but makes him unlikely to lose his wedding ring, which makes the missus happy)
2. He loses his hair (but saves on shampoo)
3. He has too much room in the house (but not enough in the medicine cabinet)
4. His knees buckle but his belt won’t.
5. His wife can become the poster girl of a cornerstone of science – The Law of Gravity (Girls, did you take your calcium today?