Stringing sentences together

concerned_sister

I was googling something that took me to this AARP page.

https://www.aarp.org/health/conditions-treatments/info-2018/difference-between-dementia-alzheimers.html

It was kind of a jolt to see the woman in the video talking in complete, consecutive sentences. Is this "normal" EOAD? My brother seems to not go more than a couple of sentences with out getting hung up and starting to stammer and saying "um, um, um…"

AlzWife2023

I just watched the video. This woman is very brave and intelligent. It seems like her losses are in memory, math, and spelling. I have noticed my husband has memory and language loss but he’s still able to play cards and backgammon and do visual things. I agree that you might not detect her Alzheimer’s from the video, but she was talking very deliberately and her abilities now are likely be much declined from earlier. We’re just not seeing that comparison. Also, it’s a professional video so they’ve planned out what she’s going to say, they take breaks while filming, and the piece is edited together. I’m pretty sure that she would not be able to communicate that clearly if she were speaking extemporaneously.

concerned_sister

Thanks, ALZ wife, I appreciate your take. Maybe it is the editing etc.

harshedbuzz

@concerned_sister

Thanks for sharing this.

None of my PWD were younger onset, but from reading here my take-away is that it is fairly similar, aside from the socioeconomic impact, to that in older adults excepting that progression can be swifter.

A couple of things struck me about this video.

Given what she shared about her aunts, I wonder if she has early-onset familial Alzheimer's. This is rare and represents only 5% of those with the disease.

https://www.alzforum.org/early-onset-familial-ad/overview/what-early-onset-familial-alzheimer-disease-efad

EOAD has a reputation for progressing a bit more quickly than in older adults. That she's this poised and articulate 9 years after noticing changes surprised me. There is an infrequent poster named Crushed who came to mind in watching this. He describes his wife as beautiful and brilliant— a physician researcher, pioneer in AI, loving wife and mother. She, too, has had a progression trajectory that is longer than many.

To answer your question, about language skills it seems like this is one of those things that can be very individualized. I've heard it said that sometimes what's lost is a reflection of the area in the brain that is damaged. What you are describing sounds like aphasia. Unfortunately, the video of PPA is unavailable. I wonder if you can find an example of another site.

https://aphasia.org/stories/different-types-aphasia/

The woman in the video is very poised and polished. She clearly brings significant cognitive reserve to her dementia experience. Perhaps she was cherry picked because she could deliver the message effectively without being overly frightening.

Of the people I know who had an Alzheimer's diagnosis, as opposed to VD, speech remained for quite some time.

My friend's mom was very conversational in the early and early middle stages without hesitation although she became amusingly unfiltered. My friend had a severe concussion when her mom was early-middle stages and she had anomic aphasia for a time during which she was amazed her mom could "out-talk" her. Her mom could talk in sentences well after she no longer recognized her daughter Debbie. It broke her heart when her mom told her all about her wonderful daughter Debbie and how my friend (who she thought was an aide) Debbie should get together and be friends.

My doctor's dad was in the middle stages when he argued conversantly at a hearing to determine guardianship. Doctor's dad was a PhD researcher and his speech remained better than his ability to do his IADLs and ADLs. The son awarded guardianship based on photograph's of dad's home, financial statements and the results of neurocognitive testing but was worried dad would prevail because of his showtiming.

My dad's speech remained conversation until he died of complications of aspiration pneumonia. He did have some word-finding issues but could recover using another word or phrase. Much of what he said was fiction and his codeswitching was odd but he was fluent with appropriate grammar and prosody.

I thought it was very interesting that she was diagnosed initially with ADD/ADHD. I have a bunch of ADHDers in my life. Mom was the one who brought it to the family picnic— mom, the niece I helped raise and my son are all diagnosed. Because of her narcolepsy, mom took Ritalin through much of my childhood into her 50's which masked her symptoms to a great degree; she wasn't officially diagnosed until she was 78 which is her psychiatrist's oldest "catch".

Many of the early-stage Alzheimer's symptoms and behaviors overlap those of ADD/ADHD— loss of focus, inattention, poor executive function, time-blindness, disorganization, impulsiveness/lack of social filter. To my point, my mom's now 86 and can no longer take the stimulants safely which has laid her quirkiness bare for all to see. Mom's bright and creative and most folks think she's adorable, but she has the power to drive me crazy. I took her grocery shopping Tuesday— she never has a list, she shops "by meal" ricocheting around the massive store rather than getting all her fruits and veggies or dairy products at once. This is to say, if my mom developed dementia, it would be hard to tell. Seriously.

HB

concerned_sister

Hello HB,

Yes, aphasia seems to be the symptom I'm describing. I've seen it associated with celeberties who have suffered FTD. It started running through my mind that if that woman (in the video) represented 'normal', then there's something 'more' going on with DB. The neurologist described deterioration of the brain in the area of memory on the MRI. There was a part of me expecting him to say language. I guess as I've read here, everyone presents differently. But when watching that video, I thought if that is "normal", then my brother is very off. After typing this, I'll go check out the links you provided.

I have ADHD folks in my life. For the last year or so I've had my young adult grandson living with me. He has ADHD (and dyslexia). When talking to him about DB diagnosis, he asked me about his testing for the dx. When describing the tasks, including subtracting 7 serially, he quipped, "I probably wouldn't pass that test." Do you ever watch the videos by Mel Robbins? She was diagnosed ADHD when she was the mother of a teen age son. She and a guest (on her video) had some insights that were new to me. She talked about how with an orchestra, generally folks can focus their attention on a particular instrument, where someone with ADHD can't filter and focus, they just hear it all at once. They took that analogy to a busy restaurant where folks can generally focus and tune out other noise and concentrate on the conversation at their table, or the voice of a friend approaching; a person with ADHD can't. That was talked about as a feature of their brain chemistry and how they were wired as opposed to a conscious choice. I guess I need to take what I've learned there and apply it to DB. Thank you for that insight in to your family.

concerned_sister

HB,

I looked at some videos, and there wasn't that sense of recognition as compared to what I see with DB. In my conversations with DB, the defining characteristic isn't so much chosing the wrong word, or resorting to word substitution. The prominent characteristic is the midsentence stop. I imagine a deer in headlights moment where he just can't go on, can't find his words, and a few "uh, uh, uh"'s come out, but it's like he has to wait there hoping the thought will come back.

Hope5757

@concerned_sister,

My MIL does this. I think she loses her train of thought, loses the point she was trying to make or realizes what she was going to say was “wrong” .

When she doesn’t know the right word, she’ll substitute or she’ll use a phrase instead of a word (or two).

concerned_sister

Hope757, thanks for sharing your experience. My feeling when speaking with him is it's likely a mixure of losing his train of thought, or just can't find the words to express it.

On the bright side, he and his wife took the time this afternoon to call to express their thanks for the various tasks I've been helping with. They also wanted to ask me to take them to get their legal forms notorized next week. I've been disappointed in the brother who dropped the ball in helping with this. I appreciate the initative that DB and SIL are showing.

Iris L.

Before I began using Exelon patch, my speech was greatly impaired: I forgot words and couldn't remember my train of thought, and people were noticing. Within a few days of beginning the low dose of Exelon patch, my speech was improved. Now, my speech could pass for a normal adult's speech, although to me, I know that I have declined in my verbiage. I do not have Alzheimer's Disease.

Iris

concerned_sister

Thanks, Iris. I do remember you've mentioned MCI. In the short while I've been here I've been impressed with how kind and helpful you are. The information you share strikes me as well thought out and well communicated. It's all the more impressive with your back story.