Recognizing the warning signs of Alzheimer’s disease
Dear Savvy Senior: My mom, who’s 76, has become more forgetful lately and is worried she may be getting Alzheimer’s disease. What resources can you recommend to help us get a handle on this? — Oldest Daughter
Dear Oldest: Many seniors worry about memory lapses as they get older, fearing it may be the first signs of Alzheimer’s disease or some other type of dementia. To get some insight on the seriousness of your mom’s problem, here are some key warning signs and some resources you can turn to for help.
Warning signs
As we grow older, some memory difficulties — such as trouble remembering names of people or places or forgetting where you put your glasses or car keys — are associated with normal aging. But the symptoms of Alzheimer’s disease are much more than simple memory lapses.
Knowing the early warning signs is a good first step in recognizing the difference between typical age-related memory loss and a more serious problem. Here is a list of common early symptoms:
■ Asking the same questions repeatedly.
■ Getting lost in familiar areas.
■ Failing to recognize familiar people.
■ Having difficulty following directions.
■ Misplaces items in inappropriate places, for example putting her keys in the microwave.
■ Having difficulty completing familiar tasks such as cooking a meal or paying a bill.
■ Having trouble remembering common words when
Transmission risk
Much of the debate centers on two issues: the degree of harm COVID-19 causes children, and the extent to which children are spreading the virus to their friends, teachers and families.
COVID-19’S impact on children represents a tiny fraction of the suffering and death experienced by vulnerable adults. Yet it would qualify as a pretty serious childhood disease, having caused 154 deaths and more than 7,500 hospitalizations as of Dec. 3 among people 19 and younger in the United States. That’s worse than a typical year of influenza, and worse than diseases such as mumps or hepatitis B in children before the vaccination era.
Studies show that 1 percent to 2 percent of children infected with the virus end up requiring intensive care, Dr. Stanley Plotkin, professor emeritus of pediatrics at the University of Pennsylvania, told a federal panel. That’s in line with the percentage who become gravely ill as result of infections such as Haemophilus influenza type B, for which doctors have vaccinated children since the 1980s, he noted.
Campbell, who with colleagues has developed a plan for how to run pediatric COVID-19 vaccine trials, said that “in a universe where COVID mainly affected children the way it’s affecting them now, and we had potential vaccines, people would be clamoring for them.”
The evidence that teens can transmit the disease is pretty clear, and transmission has been docu
mented in children as young as 8. Fear of spread by children has been enough to close schools, and led the American Academy of Pediatrics to demand that children be quickly included in vaccine testing.
“The longer we take to start kids in trials, the longer it will take them to get vaccinated and to break the chains of transmission,” said Dr. Yvonne Maldonado, a professor of pediatrics at Stanford University who chairs the AAP’S infectious-disease committee. “If you want kids to go back to school and not have the teachers union terrified, you have to make sure they aren’t a risk.”
‘A huge burden’
Other pediatricians worry that early pediatric trials could backfire. Dr. Cody Meissner, chief of pediatric infectious diseases at Tufts Medical Center and a member of the FDA’S advisory committee on vaccines, is
worried that whatever causes multisystem inflammatory syndrome in children, a rare but frightening coroanvirus-related disorder, might also be triggered, however rarely, by vaccination.
Meissner abstained from the committee’s vote that supported, by a 17-4 vote, an emergency authorization of the Pfizer vaccine for people 16 and older.
“I have trouble justifying it for children so unlikely to get the disease,” he said during debate on the measure.
But panel member Dr. Ofer Levy, director of the Precision Vaccines Program at Boston Children’s Hospital, said the 16-and-older authorization would speed the vaccine’s testing in and approval for younger children. That is vital for the world’s protection from COVID-19, he said, since in the United States and many other places “most vaccines are delivered early in life.”
While vaccines given to tens of thousands of people so far appear to be safe, the lack of understanding of the inflammatory syndrome means that children in any trials should be followed closely, said
Dr. Emily Erbelding, director of the Division of Microbiology and Infectious Diseases at the National Institute of Allergy and Infectious Diseases.
Vaccine trials geared to tweens or younger children may involve testing half-doses, which would require less vaccine and might cause fewer incidents of sore arms and fevers, Campbell said.
But unless additional studies begin quickly, the window for having an Fda-authorized vaccine available before the next school year “will be closed even for our oldest children,” said Dr. Evan Anderson, a pediatrics professor at Emory University. “Our younger children are almost certainly going into next school year without a vaccine option available for them.”
Campbell said that while a coronavirus infection may not be bad for most children, missed school, absent friends and distanced families have caused them immense suffering.
“It’s a huge burden on a child to have their entire world flipped around,” he said. “If vaccinating could help to flip it back, we should begin testing to see if that’s possible.”