In this episode of the Truth, Lies Alzheimer's Show, host Lisa Skinner educates caregivers about physical manifestations of dementia that often go unnoticed alongside cognitive symptoms. She begins by distinguishing normal age‑related forgetfulness from dementia, citing prevalence statistics (7 million Americans, projected to triple by 2050) and the clinical threshold where cognitive decline impairs daily function, quoting geriatrician Dr. Stephanie Nothell. Skinner then outlines six key physical signs: (1) difficulty walking and maintaining balance, explained as a cognitively demanding task; (2) posture changes and shuffling gait, especially linked to Lewy body dementia and Parkinson’s disease per Dr. Jory Fleischer; (3) altered taste and smell, an early cue for Lewy body dementia; (4) swallowing problems leading to aspiration pneumonia, illustrated with a personal story about her mother’s end‑of‑life experience; (5) bladder control issues and new‑onset constipation, reflecting nerve degeneration; and (6) sleep disturbances such as REM behavior disorder, which can precede Parkinson’s or Lewy body dementia. Skinner emphasizes that early diagnosis—through biomarkers in blood or spinal fluid—enables timely treatment, care planning, and financial decisions, though current therapies are not curative. She concludes with preventive recommendations endorsed by the experts: adhering to the MIND diet, regular exercise, social engagement, and managing chronic conditions like diabetes and sleep apnea. Listeners are directed to show notes for citations and invited to join a caregiver support community.
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Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.
Welcome back, everybody, to the Truth, Lies Alzheimer's Show. I'm Lisa Skinner, your host, and I bet that a lot of you out there are not even aware that there are common physical Signs of dementia. So this is what I'm sharing with you today because I want you to be aware that there are physical signs of dementia in addition to cognitive symptoms, signs, behaviors, etc., etc. So I thought this would be a really fun thing to share because I know a lot of people are not aware that Sometimes people suffer from physical impairities as well as cognitive impairities. So this comes from an article written in Huffington Post Life. Getting older comes with many changes. We all know that, right? Unfortunately. Not the least of which are occasional memory lapses, which tend to worry many people in the moment. This is true. These cognitive changes can be totally normal, so there is no need to panic if you occasionally forget that your sunglasses are on top of your head or you forget the name of your son's former teacher. We call this normal aging forgetfulness, and we've done episodes on that before. But there is a clear difference between age-related cognitive changes and full-blown dementia. Now, if you remember, roughly 7 million people in America are living with Alzheimer's disease and related dementia, and it's expected that the number is going to nearly triple by the year 2050. And if we do the math on that, that's only 24 short years away. And that's according to the World Health Organization and the Alzheimer's Association. Experts are telling us that cognitive impairment becomes something more severe at a certain point. The magic line that transitions someone from mild cognitive impairment to dementia is when one of their cognitive impairments is impairing their function ability. So it's impacting their day-to-day lives. For me, that is one of the key parts of defining when someone has transitioned to dementia. And that's a quote by Dr. Stephanie Nothell, who's a geriatrician and an associate professor at Johns Hopkins School of Medicine in Baltimore, Maryland. This could mean no longer being able to use a car, for example, getting lost while driving a familiar route, or not being able to do one's taxes after decades of doing them. And this is another quote by, uh, Dr. Nobel: if cognitive changes make it tough to get through a normal day, she says, that's a red flag. Just to kind of reiterate Dementia is used as an umbrella term that describes multiple forms of cognitive impairment, including Alzheimer's disease, which is the most common form of dementia. There are over 100 known brain diseases that cause similar symptoms that we put in the category of dementia, like vascular dementia and Parkinson's disease. The exact manifestations of the disease depend on the actual diagnosis, and while cognitive impairment is a common thread, there are also some physical symptoms that tend to be associated with dementia. So here's what they are. The first one is if you notice trouble walking and balancing. And Dr. Nafel tells us that she finds that a lot of the more physical manifestations happen later in the course of dementia. But there is a physical issue that occurs earlier on and gets worse throughout the course of the disease, and that's somebody's ability to walk and maintain their balance. She continues, the ability to maintain your balance and walk smoothly, actually, it requires a lot of brain power. I find this really fascinating. It requires a lot of brain power because you have to process a lot of different inputs. You have to process sensations from your feet. You have to process what your eyes are seeing in the environment around you and more. You have to quickly react to these things. And so it's a very strong cognitive task to be able to walk. Because of all this, trouble walking, trouble balancing, and falling frequently is a sign of dementia. But note that these issues aren't only a sign of the disease. They can be due to having arthritis or even your own clumsiness. Number 2 is posture changes and feet shuffling. That actually is a very common sign of dementia. The second most common form of dementia is Lewy body dementia. And this is according to Dr. Jory Fleischer, who's an associate professor of neurological sciences at Rush University in Chicago. This describes a few types of dementia, including Parkinson's disease. We see this a lot. In people living with Parkinson's disease is that shuffling effect. In this manifestation, you may notice posture changes, also feet shuffling, or that someone is walking slower than they used to, Dr. Fleischer said. While it's easier to chalk these issues up to getting older, not paying attention, having arthritis. And if we're seeing a pattern of that, we want to pay attention to it, she added. Number 3 is having changes in your sense of taste and smell. I have read some updated information, oh, probably in the last few months, and I shared this with you all on one of the episodes that It's coming out that a lot of people who have been diagnosed with Alzheimer's/dementia, one of the early symptoms that they noticed that they didn't think about at the time was a change in their sense of taste and smell. Well, here it is. A change in your sense of taste or smell can be attributed to many issues, such as a COVID-19 infection, or a history of sinus problems, but outside of known factors, unexplained changes in these senses can also be related to dementia. Dr. Fleischer explains, sometimes the person doesn't notice it themselves, but their loved one is going, hey, something on the stove was burning and you didn't smell that. That's an example. This is a symptom that should push someone to see their physician. While it may not be a sign of all forms of dementia, it is definitely associated with Lewy body dementia, according to Dr. Fleischer. Number 4 is having problems swallowing. People with dementia may also experience trouble swallowing food and drinks. So what Dr. Nafel tells us is that people can be eating or drinking and things will have a tendency to accidentally go down the wrong pipe. In other words, the food actually ends up going into our lungs versus going into our stomachs, and that is not supposed to happen. Now saliva helps us swallow food and drinks, and our mouths are full of bacteria, she said. While some of the bacteria is good bacteria, some of it is not so good, um, like bacteria that comes from cavities in our mouth and gum disease. And if that bad bacteria ends up in your lungs with your food, it can set you up or infection. We call that aspiration pneumonia. And that is the very reason why pneumonia is relatively common in the latter part of dementia, says Dr. Nafel. And I can tell you from personal experience that it is also one of the most common means of end of life for people living with dementia. I want to tell you that my mother passed away from aspiration pneumonia. She kept— she had a feeding tube. She couldn't swallow at all. And even though she had a feeding tube and we fed her formula through that feeding tube that was attached directly to her stomach, just from her swallowing her own saliva, It went into her lungs and the bacteria became infected. And the doctor told us that the more she developed aspiration pneumonia, the more resistant it would come— become to antibiotics. And eventually the antibiotics would become 100% resistant to the bacterial infection. That developed in the lungs and there would be, you know, no recourse. And sadly, that's exactly what happened. The last time she developed aspiration pneumonia, that was it. So, but, you know, it's funny, she did not have dementia. She was like perfectly sound. What she had had was multiple, multiple strokes. And that was the reason why she no longer was able to swallow anything. So number 5 is having bladder control issues or incontinence, which it's also known as, and unfortunately can be a symptom of dementia. Now, the explanation for that is that a lot of nerves are required for bladder control, and those nerves degenerate as dementia progresses. Similarly, folks may experience new constipation later in life, according to Dr. Fleischer, which can also be a sign of Parkinson's and other related conditions and often precedes the other symptoms by years. And number 6 is sleep changes. So according to Dr. Fleischer, sleep changes are also important to look out for in people living with dementia. The person experiencing sleep changes may not notice, but if you live with someone and find they're moving around a lot at night, punching at things, shouting, or talking in their sleep, it's very important to let their healthcare team know. That may be something called REM behavior disorder, which often can come years before a person has Parkinson's or Lewy body dementia, she adds. And I'm going to continue with an early diagnosis can be a powerful way to prepare for the future. It can certainly be hard to admit to any health problems or changes, especially when it comes to cognition. But it's important that we do so. We are living in a time of innovation when it comes to dementia treatments, and this is something that Dr. Fleischer is emphasizing to all of us. There's lots of different research going on right now to try to find treatments and pharmaceutical options for people. Doctors can check biomarkers in blood and/or spinal fluid to determine what kind of dementia someone has and then be able to make treatment recommendations and decisions based on that. So no matter what, it's best to start treatments or interventions the earlier as possible, as early as possible on the course of these diseases. Now, that is something that both Dr. Nathal and Dr. Fleischer want everybody to be clear about. The treatments now are not a cure. But we know now that they can help with disease management, and early diagnosis can also help families and individuals best prepare for the progression of this lung disease. They say finding out early on can be really helpful for a lot of different reasons, including planning, and just having a say in a person's future. If you find out early, you often can still make some decisions, whether that's your care, whether you'll live where— I'm sorry, where you'll live, and also on your financial choices. And this all makes it important to pay attention to any signs of dementia, either in yourself or noticing it in a loved one. And then reach out to a physician if you notice concerning changes. It is starting to impact your daily living habits. So as scary as we know that this is, a diagnosis and knowledge and early detection gives you power, according to Dr. Fleischer, and I agree with that statement 100%. So whether you have any of the symptoms above or not, there are things you can do to reduce your dementia risk or slow down the disease prevention. These include all of the things that go into a healthy lifestyle. Both experts recommend that to lower your chance of dementia, it's helpful to follow a nutritious diet. Both these doctors recommend the MIND diet. That's M-I-N-D. To exercise, to socialize with loved ones, and manage chronic conditions like diabetes and sleep apnea. Experts predict that 42% of Americans over 55 will develop dementia in their lifetime. But there are things we now know you can do to prepare for the disease if you get a diagnosis, and things you can do to help minimize and even lower your risk. So that is the episode today for the Truth, Lies Alzheimer's Show. I'm Lisa Skinner, your host. As always, I will be back next week with a brand new episode for you. And the citation for the information I presented to you today will be in the show notes for you if you want to refer to it. And as always, I Hope you all have a fantastic rest of your week, that you stay happy and healthy, and until then, au revoir for now.
Thank you for listening to Truth, Lies Alzheimer's. We hope you found something in today's episode that helps. We understand that caring for a loved one with dementia can be the challenge of a lifetime, but you don't have to do it If you're ready for exclusive access to even more great content and resources, head on over to Facebook and join Lisa Skinner's Minding Dementia support group. We're a community of like-minded caregivers, and we're here to help.
