Alzheimer's hidden signs

By Sheryl Theessen

Delving into the issue of mild behavioural impairment (MBI), which is a newly recommended status in the early detection of Alzheimer’s disease, is going to be tricky. 

Tricky for a number of reasons.

Looking back on the situation with my husband, Chuck, I now see I did not recognize the signs that indicated major and sudden behavioural changes had developed. 

There were a number of variables that came in to play in my not recognizing these changes.

Alzheimer’s disease was not close to being on my radar because my husband was in his early 50s. To me, 15 years ago, Alzheimer’s was an old-person ailment. 

Next, there was no information circulating in mainstream media that behavioural changes may be a precursor of cognitive impairment possibly leading to Alzheimer’s, even if it had been a subject I had an interest in. 

Then, there was another variable that I assigned his behavioural changes to. 

In 1999, after spending most of our lives in northern B.C., we moved to Kelowna. 

We came because research showed that relocating to a new community in the later years of life made adapting to new surroundings more challenging. 

Relocating when my husband was 50 years old seemed to be the right time for this major disruption to our well-established lives.   

Yet, we found it was not easy for us to establish routines and interests in our new community to replace the ones left behind. 

My husband commuted for work — one week here and one week there. Even making time for a social life was compromised by this weekly commuting.

Then, when behavioural changes did become apparent, I spent a lot of energy reminding myself that the changes I saw in him were because I had insisted we move. 

  • I wanted to be where the winters were shorter
  • I wanted to be where our girls were now living
  • I wanted to be close to our grandchildren when they arrived  
  • I wanted this move. 

And it was not that he was unhappy here, but he would have preferred to have stayed where we were, with the life he had made there.

So I wrote off the behavioural changes as him not adapting well to moving.

I wrongly assumed his unexpected selfish and uncharacteristic reaction to having my breast implants removed  was his inability to find his place in our new life in Kelowna.

Now, with the latest research and the power of hindsight, I clearly see that 15 years ago my husband was exhibiting the earliest signs of the disease that has overtaken our lives.

Still, even with mild behavioural impairment now making its way in to the public’s awareness, it may not be easy for a spouse or family members to recognize these signs in their loved ones. 

There are uncountable variables that may mask the recognition of such behaviour, such as a relocation like we undertook.  

There may always be what seems a logical explanation for a change in behaviour, a change that goes unrecognized for what it could be — the beginning of the downward spiral that is Alzheimer’s.

I hope the new awareness will prompt people to consider what may initially not be obvious, that behavioural issues may not have a logical explanation. 

It will take alertness on the part of a spouse or family member to recognize that MBI may be what they are witnessing. 

And, for now, the status of Mild Behavioural Impairment and the accompanying checklist, developed by the International Society to Advance Alzheimer’s Research and Treatment, is a proposal only and has not been adopted by physicians.

This may complicate the issue further for those who witness significant behavioural changes in their loved ones, making it, indeed, a tricky matter.

Sheryl Theessen was the primary caregiver to her husband, an early onset Alzheimer’s patient, until his move in to a care facility earlier this year. She can be reached at [email protected]

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