Syphilis

Early Signs Of Alzheimer's

Are you worried about your mental sharpness? Or that of a loved one?

Mild forgetfulness can be a normal part of aging. If you have trouble remembering someone's name but it comes to you later, that's not a serious memory problem.

But if memory problems are seriously affecting your daily life, they could be early signs of Alzheimer's disease. While the number of early signs you have and how strong they are vary, it's important to identify Alzheimer's warning signs. You need to ask yourself some tough questions.

Memory loss

This is the most common early sign. Do you easily forget information you just learned? Do you lose track of important dates, names, and events? Do you forget that big things even happened? Do you ask for the same information over and over? Do you rely heavily on memory aids like Post-it notes or reminders on your smartphone?

Trouble planning and problem-solving

Do you have trouble making plans and sticking to them? Is it tricky to follow a recipe, even one you've used many times? Is it hard to concentrate on detailed tasks, especially if they involve numbers? For example, can you keep track of your bills and balance your checkbook?

Daily tasks are a challenge

Even familiar things can become hard. Do you have trouble driving to a location you go to often? Can you complete an ordinary task at work? Do you forget the rules of your favorite game?

Times and places are confusing

Can you fully grasp something that's not happening right now? Are you disoriented? Do you get lost easily? Do you forget where you are? Do you remember how you got there?

Changes in vision

Is it harder to read the words on the page? Do you have trouble judging distance? Can you tell colors apart? This is important because it can affect your driving.

Words and conversations are frustrating

Vocabulary becomes hard. Can you find the right word you're looking for? Or do you call things by the wrong name?

Conversations can be a struggle. Do you avoid joining in? Are you able to follow along? Do you suddenly stop in the middle of a discussion because you don't know what to say? Do you keep repeating yourself?

You lose things

Everyone misplaces things from time to time, but can you retrace your steps to find them again? Do you put things in unusual places, like your watch in the refrigerator? Do you accuse people of taking things?

Lapses in judgment

Have you made poor decisions lately? Do you make mistakes with money, like giving it away when you normally wouldn't?

Are you showering as often? Do you take less care of yourself? Do you dress for the wrong weather?

Social withdrawal

Are you scaling back on projects at work? Are you less involved with your favorite hobbies? Do you lack motivation? Do you find yourself watching television or sleeping more than usual?

Mood changes

Do you get upset more easily? Do you feel depressed, scared, or anxious? Are you suspicious of people?

Alzheimer's makes the brain work less well over time, and that will change how you act. In addition to mood changes that result from brain issues, Alzheimer's symptoms can be frustrating and scary. It's common for people living with the disease to feel sad, stressed, and confused.

Alzheimer's also causes some physical symptoms that can affect mood, such as trouble sleeping, pain, constipation, and trouble seeing or hearing. 

Researchers have discovered that the retina – the area at the back of your eye that sends visual information to the brain – can show signs of Alzheimer's. 

When you have Alzheimer's, a protein called amyloid builds up in the brain and forms plaques. Studies show that this same protein builds up in the retina when you have Alzheimer's, and the amount of buildup typically aligns with the amount of amyloid buildup in the brain.

These amyloid protein deposits are related to changes to specific parts of the brain called the entorhinal and temporal cortices, which are important for memory, navigation, and the perception of time. 

Experts hope this can help create new tools for early diagnosis and monitoring of the disease.

As Alzheimer's develops, words may be harder to recall. You might come up with alternative phrases for things you can't remember (like calling a watch a "hand-clock"). 

Or you may start to forget the meaning of certain words, and pause during speaking to try to remember words or your train of thought. 

Recent research on speech and mild cognitive impairment showed that people in early stages of dementia speak less. More specifically, they use fewer nouns when they speak, and they keep them very general and abstract. 

If you notice these signs, talk with your doctor. They will evaluate your physical and mental health. They will look over your medical history and do a mental status test, which looks at your memory, ability to solve simple problems, and thinking skills. They may also do blood or brain imaging tests.

They may then refer you to someone who specializes in Alzheimer's, like a neurologist (a doctor who specializes in treating the brain and nervous system), psychiatrist, psychologist, or geriatrician (a doctor who specializes in treating older people).

You can also find a specialist through your local Alzheimer's Association or Alzheimer's Disease Research Centers.

The sooner you know, the better. Starting treatment may help relieve symptoms and keep you independent longer.

It also helps you plan better. You can work out living arrangements, make financial and legal decisions, and build up your support network.

It can be hard to know if troubles with memory and other thinking skills are a normal part of aging or a warning sign of Alzheimer's. Certain behaviors are more concerning than others: Memory problems that get worse over time, confusion, trouble completing daily tasks, vision changes, behavior changes, and lapses in judgment are common.

Your doctor can examine your symptoms and talk you through your concerns so you can decide next steps. 

At what age does Alzheimer's start?

Most people with Alzheimer's have symptoms after age 65. A small set of people can get the disease in their 30s or 40s. This is early-onset Alzheimer's.

What triggers early-onset Alzheimer's?

Researchers aren't sure why some people get Alzheimer's earlier than others. Your risk may be raised slightly if you have a family member who had early-onset Alzheimer's, but that's not a guarantee you'll get it too. 

Rarely, some people with Alzheimer's have mutations in specific genes. If you inherit at least one copy of a mutated gene, you're likely to develop Alzheimer's before age 65.

How does your body warn you that dementia is starting?

Some common early warning signs of dementia include getting lost in familiar places, forgetting words or recent events often, trouble making simple decisions, and changes in mood.

Women, Families And HIV/AIDS

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Panel Issues First Guidelines To Prevent Anal Cancer In People With HIV

Results from a national study led by UC San Francisco informed the first guidelines at the federal level in the U.S. To detect and treat anal cancer precursor lesions in people with HIV to reduce the risk of developing anal cancer.

The guidelines were published on July 9 by a panel of experts in HIV care, utilizing findings from the Anal Cancer/HSIL Outcomes Research (ANCHOR) trial led by Joel M. Palefsky, MD, a professor of medicine in the UCSF Infectious Disease Division. The ANCHOR study was funded by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and conducted by the AIDS Malignancy Consortium.

The ANCHOR trial, conducted at 25 clinical sites around the country and published in the New England Journal of Medicine in 2022, found that routine screening for and removal of precancerous anal lesions could significantly reduce the risk of anal cancer, in much the way that cervical cancer is prevented in women.

"Anal cancer is a very bad disease, and we now have the tools to significantly reduce the risk," said Palefsky, a globally recognized expert on anal cancer. "With this new recommendation, we hope that screening for anal cancer becomes a routine procedure in the care of people with HIV."

While anal cancer is rare within the general population, cases have been rising, and among people living with HIV, it is the fourth most common cancer.

I strongly encourage people with HIV to discuss anal cancer screening with their primary care providers."

Joel M. Palefsky, MD

For people with human papillomavirus (HPV), a common sexually transmitted virus, coinfection with HIV can increase the risk of developing anal cancer. "Men with HIV who have sex with men and transgender women with HIV are the groups at the highest risk of anal cancer," note the new guidelines.

Anal cancer may have no symptoms in its early stages, and patients may mistake it for hemorrhoids. By the time it's diagnosed, it may have spread.

Under the new guidelines, if high-resolution anoscopy is available, certain adults with HIV – starting at age 35 for men, and transgender women, who have sex with men; and starting at 45 for women and men who do not have sex with men – should undergo screening for anal cancer precursor lesions with laboratory testing of an anal swab sample, and a digital anorectal examination to feel for changes that might indicate the presence of a cancer.

"The screening procedure is quite simple," Palefsky said. "If the screening test is positive, the next step of the evaluation is HRA. If an anal cancer precursor lesion is found at HRA, it is then treated to reduce the risk of progressing to cancer."

Vasean Patel, a UCSF Nurse Practitioner with ANCRE (Anal Neoplasia Clinic Research and Education), performs a high-resolution anascopy (HRA) exam using an anoscope and colposcope to screen for anal HPV-related disease. Image provided by Vasean Patel

If HRA is not available, people with HIV who are of screening age should still have an annual rectal exam and be referred for standard anoscopy if the screen is positive. Those who have pain, bleeding or masses, or who show signs of anal cancer should undergo standard anoscopy. Palefsky added that symptomatic people under 35 with HIV should also undergo standard anoscopy.

"I strongly encourage people with HIV to discuss anal cancer screening with their primary care providers," he said.

In 1991, Palefsky established the world's first clinic focused on prevention of anal cancer, the UCSF Anal Neoplasia Clinic Research and Education Center.

The recommendations were developed by the U.S. Department of Health and Human Services' Panel on the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV, which is composed of experts in HIV care. The panel is a working group of the NIH Office of AIDS Research Advisory Council, in collaboration with the Centers for Disease Control and Prevention, the HIV Medicine Association and the Infectious Diseases Society of America.

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