The First Signs of Alzheimer’s: Spatial Navigation

first signs of Alzheimer's

One of the first signs of Alzheimer’s may be problems with spatial navigation according to researchers at Washington University in St. Louis. Understanding the first signs of Alzheimer’s is important for not only treating the disease but also giving a family time to make plans for what the future may portend.

Alzheimer’s is one of the most devastating conditions that elderly people (and their loved ones) face today. Although getting older frequently brings challenges with it—such as a decrease in mobility, a greater aptitude for injury or illness, and the loss of one’s independence—Alzheimer’s can be particularly pernicious, rendering its victims and their family members helpless to prevent its continual progression towards ending life. Family members are searching for information on the first signs of Alzheimer’s and so research has followed this same path in hopes to stop or slow the progression.  Along the way, it can inflict a serious amount of suffering, as it strips its victims of their memory and even, eventually, their ability to speak clearly and care for themselves.

Knowing how destructive Alzheimer’s can be, it makes sense for family members to watch their elderly loved ones closely for signs of this disease. While it progresses at a different pace in different people, there are some early warning indicators that are common among those it strikes. Researchers have identified some of the first signs of Alzheimer’s, including one that may present itself before all the rest.

By keeping a close eye on your elderly loved one, and by remaining informed as to what some of the first signs of Alzheimer’s are, you can help be prepared—emotionally and otherwise—for the emergence of this disease. Although there is not a cure for Alzheimer’s disease, there are things that can be done in order to ease the trauma for all involved. In this sense, it is important to be vigilant as your loved one ages, so that you can help him or her through this time of his or her life.

To begin with, let’s look at the intermediate stages of Alzheimer’s as they are the symptoms that we most associate with the illness.  These intermediate signs may begin to appear early and may not be recognized as symptoms of Alzheimer’s but should be tracked for progression as they may become more conclusive of an Alzheimer’s diagnosis. We later discuss the first signs of Alzheimer’s and the study that has been done at Washington University in St. Louis.

Intermediate Stage Signs of Alzheimer’s Disease

Scientists do not yet completely understand Alzheimer’s. In fact, a diagnosis of the disease can only be made by looking at the symptoms that someone displays and ruling out other causes; it is not until after a victim’s death that a diagnosis can be conclusively made (this is done through an autopsy to examine the tissue in the brain).

Because it is such a puzzling disease, it stands to reason that the early signs may not all be present in all of those who suffer from it. Some people may exhibit one or two of the signs; others may exhibit different signs, and still, others may exhibit all of them. Thus, the signs noted below are only some of the signs of Alzheimer’s, and if you suspect that your elderly loved one may be developing the disease, you should have him or her examined by a healthcare professional.
1. Losing items and not remembering where you have been. Everyone loses things from time to time. This is especially true if you are multitasking—for example, talking on the phone while you put away dishes. As such, simply misplacing something is not, by itself, much of a cause for alarm. However, if your elderly loved one misplaces something and then cannot even remember having it last (or where he or she was when he or she recently had the item), this may be a cause for concern. Sometimes, your elderly loved one might begin to suspect you, or someone else, of stealing the item because he or she has no recollection of even handling it.

2. Shifting dispositions and mood swings. First, let’s be clear: simply having mood swings is not, by itself, a sign of Alzheimer’s. Many people become slightly more temperamental as they age, developing a very strict routine and then becoming upset if something throws them out of the routine. However, if the overall disposition of your elderly loved one is beginning to change, that may be a sign of Alzheimer’s. This is especially true if the change seems to be more than a mere shift in mood.

3. A difficulty with numbers or problem-solving. Some people simply are not good at math. Likewise, some people just aren’t the creative, “think outside the box” type of people. However, if a person has traditionally been strong with manipulating numbers or creative thinking, and begins to notice a difficulty engaging in these types of activities, it could be an early warning sign that Alzheimer’s is coming.

4. Memory loss that becomes disruptive. It’s somewhat normal to begin forgetting names and dates as you age. This is especially true if you have a very full plate—you just aren’t able to dedicate the cognitive resources to storing and recalling such information. However, if you or an elderly loved one notice a pattern of forgetting—and the forgetting is severe enough to cause disruptions—it may be a sign of Alzheimer’s. Things like forgetting important dates, asking for the same information repeatedly, and an increasing reliance on mental “crutches” such as making notes as reminders (or using pocket electronic devices) should be a clue that something could be wrong.

It is important to note that this type of forgetting is something more than temporarily forgetting someone’s name, or forgetting a date, and then remembering it down the road. That type of forgetting is quite common and probably nothing to be alarmed over.

5. Difficulty remembering the day or noting how time has progressed. While many people who are in the beginning stages of Alzheimer’s function just fine in the present, they (or their loved ones) might notice an increasing difficulty being aware of the date, the time of year, or even the time of day. To put it succinctly, they struggle to apprehend the passage of time. Their short-term memory is beginning to degrade, and this is one way it is manifested. In some cases, people in this situation may even forget where they are, or how they got there.

This is different from occasionally getting confused as to what day of the week it is, and then figuring it out later. Everyone experiences mental glitches like that from time to time; when you should begin to consider consulting a doctor is when these experiences become more than a mere glitch and it begins to require more effort to keep things straight.

6. Struggles in processing images and determining spatial relationships. One way that we judge how far away something is from our current viewpoint is by using a portion of our brain to process the spatial relationship between two items. We use this ability (albeit subconsciously) when we engage in activities such as driving. If someone begins to display a tendency for driving dangerously, part of the issue might be an inability to accurately judge how far away a given item is. This could be a sign that his or her brain is not working accurately in the area where spatial relationships are processed.

Of course, everyone likes to joke about elderly drivers. And, to an extent, our ability to drive does degrade as we age. Our reaction time slows; our reflexes become dulled. What’s more, declining eyesight can play a role. As such, a decreased ability to drive is not, by itself, cause to suspect Alzheimer’s. However, it should be enough to prompt a visit to the doctor for more testing.

7. Language comprehension issues. It’s common to momentarily forget a word. When something is on the tip of your tongue and you can’t quite remember it, it’s not a cause for concern. However, serious issues in communication can be an indication that Alzheimer’s or dementia is beginning to affect the part of the brain used in processing language and forming sentences.

If you notice an elderly loved one who begins stopping in the middle of conversations, or who begins to frequently repeat things he or she just said, you should suggest a visit to the doctor. Likewise, sometimes people who are in the beginning stages of Alzheimer’s will begin to forget words and call something by an incorrect name (such as calling an “airplane” a “sky car”).

The First Signs of Alzheimer’s: Difficulty Navigating

A study was done at Washington University in St. Louis which indicates that, of all the warning signs that suggest Alzheimer’s may be developing, the earliest one is probably a difficulty in navigation. This is because the area of the brain that is used to help you move from one place to the next seems to be affected by the disease earlier than other areas. To understand why this is one of the first signs of Alzheimer’s, you must understand how it is that we are able to find our way around when we are in a new setting. This study on the was published in April 2016 in the Journal of Alzheimer’s Disease.

There are two ways that most people navigate. The first way, called “egocentric navigation,” is a method in which the person uses information from past experiences in order to move along a known route. This is the type of navigation you use when you are traveling a known route that you have used before. Typically, you will move from one landmark to the next—whether the landmark is a certain exit sign, a tree at a certain intersection, or something else—taking predetermined acts at each landmark and progressing from landmark to landmark sequentially.

The second method of navigation, called “allocentric navigation,” requires people to have a “big-picture” view of their surroundings, which they then populate with known landmarks. Using allocentric navigation, people can take new routes—for example, looking for a new shortcut—from one known landmark to another known landmark.

Egocentric navigation tends to rely on the brain’s ability to recall past journeys. In contrast, allocentric navigation uses the brain’s ability to create a cognitive map of the person’s surroundings.

In the study led by Denise Head, associate professor of Psychological and Brain Sciences in Arts & Sciences, researchers placed subjects in a virtual maze populated with different landmarks. Using a joystick, the subjects were able to navigate the maze, either to travel through it along a pre-specified path or to spend time exploring the maze and learning where various landmarks were.

The study results showed that people who had Alzheimer’s had little difficulty using egocentric navigation—following a pre-determined route that is already known to the person. However, when they attempted to use allocentric navigation, the subjects with Alzheimer’s displayed much more difficulty learning where certain objects in the maze were located in relation to others. This suggests that the part of the brain used for building a cognitive map may be one of the first sections to be affected by Alzheimer’s. This inability to use allocentric navigation can show up much earlier than other warning signs of Alzheimer’s.

This conclusion also seems to fit with another already-known sign of Alzheimer’s: short-term memory loss. Many people who are suffering from Alzheimer’s or dementia have no problems recalling things that happened years or even decades earlier; however, they display significant difficulty when asked to recall things that happened within the last few days or weeks. This may be because the same part of the brain that processes short-term memory is involved with creating and updating a cognitive map of one’s surroundings. Whatever the specific reason, the results of the study suggest that someone suffering from Alzheimer’s will display considerably more difficulty navigating in a new environment than someone without the disease.

A Caveat: Mere Difficulty Navigating May Not be Conclusive Evidence of Alzheimer’s

Of course, some people simply have more trouble using allocentric navigation than others do. Many people seem to have an internal compass and can never get lost even when in unfamiliar settings; others can get lost the moment they leave their familiar, tried-and-true routes. As such, difficulty navigating in new surroundings does not, by itself, mean that someone has Alzheimer’s.  A further disclaimer is necessary: the study only involved 71 subjects, which means that the sample size was small enough that it could have been easily skewed by only a few outliers. Further research is necessary, and scientists will need to perform long-term studies with many more subjects before a definitive conclusion can be reached.

However, if someone who previously was able to use allocentric navigation without difficulty suddenly displays an inability to do so, it may be a warning sign as one of the first signs of Alzheimer’s. If you—or your elderly loved one—notice something like this beginning to take place, it is definitely worth taking a trip to the doctor for a discussion on the matter. It could be that you are witnessing the very initial stages of the onset of Alzheimer’s disease.

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