Mild Cognitive Impairment (MCI) is a condition in which people experience more memory or thinking problems than other people their age. MCI often transitions into dementia, but there’s evidence that the progression can sometimes be staved off for an amount of time.
The techniques discussed in the article “Preventing Dementia and Alzheimer’s: 8 Habits to Reduce Your Risk”—often referred to as “best practices”—become even more important once signs of MCI are apparent. So it’s important to recognize these symptoms as early as possible.
Unfortunately, my family missed some of these early indicators. None of us recognized in the moment what was going on with my sister, but in hindsight—and after talking to her friends and co-workers—we were able to get a better sense of what had been happening. It seems that she probably already was experiencing MCI beginning in late 2010 or early 2011, years before she was diagnosed with Alzheimer’s and frontotemporal dementia (FTD) in August of 2018.
How could we not know Alzheimer’s was on the horizon? There are a lot of reasons. First, Peggy was young during those MCI years. In 2010 she was just 51. At the time, I knew nothing about early-onset Alzheimer’s, so it never occurred to me that she might be on the road to developing it. Other family members were in the same boat; we’d never seen it in our family.
Several years after my sister’s diagnosis, I asked some of her friends and co-workers if they’d noticed anything “off” about Peggy during that time. And of course they had, but none of them had pegged any of her behaviors as MCI or Alzheimer’s because she was so young.
Oftentimes people think that because they forget someone’s name or misplace their car keys once in a while that they’re on their way to Alzheimer’s. Nope, that’s not it. Occasional memory slips are typically just normal aging, while the early signs of Alzheimer’s or dementia are a bit different than that; they encompass more than just memory problems. A pattern of symptoms emerges that can include poor judgment, difficulties in planning and problem-solving, difficulties with visual/spatial relationships, and new challenges in completing familiar tasks.
Those are all symptoms that my sister experienced before her diagnosis, most of which we missed entirely because they appeared so many years earlier. In hindsight, however, the pattern emerges and the trajectory of her disease becomes more clear. Here are some examples:
- As far back as 2011, Peggy began to struggle with tasks at work; sometimes she didn’t follow through as she should have (and once did), according to her former manager.
- Peggy took almost a half hour to back out of a parking space, according to one friend who witnessed it. We didn’t know it at the time, but her spatial awareness was already being affected by her Alzheimer’s and FTD. (2014–2015)
- When we went wine tasting together, Peggy could not find her ID; it was not in her wallet. It turns out that she had filed her driver’s license in with her CD collection. Maybe because a CD and a driver’s license are both thin and flat? (2015–2016)
- Her driving became quite erratic. (2016–2017)
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Her spaghetti sauce, a family recipe that she had been making for years, suddenly didn’t taste right. My family is Italian; we know how to make spaghetti sauce. (2017)
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She forgot how to make meatballs entirely. See above. (2017)
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Peggy forgot to remove her contact lenses; they remained in her eyes for months. (2018)
The biggest red flag occurred in February 2018, about six months before her diagnosis.
Peggy came to visit me and my partner Jon in San Francisco—and she missed the exit for our apartment entirely. This was especially eye-opening because we’d lived in the same place for about twenty years, and she’d been to see us many, many times.
For this visit, instead of our driveway, she wound up parking in a lot downtown. And that was just the beginning of a series of bona fide, scary red flags that day. I met up with her at the bank, where we needed to get a form notarized, and she couldn’t sign her name. Then, after we left the meeting, she couldn’t find her car. It took us literally hours to figure out where she had left it.
That day was the impetus behind us finally urging Peggy to see a doctor. Looking back, I think we certainly had plenty of opportunities to notice the problem earlier. Would it have made a difference? I can’t say. What I’m sure of is that it can take a long time to get diagnosed, so we were lucky we didn’t wait any longer to start making a concerted effort to look into her symptoms!
