My DH is in early stages and has some clearer days than others. However, everytime we are driving anywhere he makes the same comment, " Doesn't everthing look so different." When I ask how he says it just looks blah. He is taking anti depressants and doesn't seem depressed at this time. Is the thought that land and buildings look different typical for early alzheimer?
I suspect this is very common. Very early on, my husband seemed to have lost his bearings right in the neighborhood where we had lived for over 20 years. For some reason I didn't think it was all due to memory, but rather, that things didn't look the same to him. (However, he never verbalized it as your husband did.) I wonder if it could be part of the agnosia that sets it, eventually not recognizing their home and even us.
I also wonder weather this could be a variation of "everything looks the same," or the experience we have where Jeff frequently believes he's been places or seen things "before" or "all the time" that he's probably never seen before.
Perhaps the disease is attacking the part of the brain that handles vision. Though I have never had anyone talk about loosing hearing or vision , taste or touch this disease. That seems really odd. I know that it attacks the motor skills and speech which are related and it attacks memory. Not all brain function but a partial list of brain functions are attacked.
My DH sometimes asks where we are going, when we are in a very familiar area. He can't recognize landmarks anymore. This may be the reason people with AD get lost. When I get DH to walk with me in the neighborhood, he gets uncomfortable if we get too far from home.
During the first year after Dx we used the GoBus to go to his Dr. appoinntments while adjusting meds. In 10 trips he couldn't recognize where we were until we were about 1/2 way home at least 7-8 times, using the same route. That was in 2007. Now, when ever and where ever we go he watches the passing landscape vigilantly. He's stored his hearing aid away for at least 3 years an d his 2 year old glasses live in a dresser drawer (have done sosince he got them) except for rare visits for use. He has a hearing loss, but I have to use TV Ears so I don't disturb him. His eyes checked out fine for those glasses---but they don't work (sometimes). IMHO, these are all related to his VaD. It just depends on where the damage is attacking as to what becomes impaired. We all know that eventually major body operations will be affected--movement, swallowing, etc. We shouldn't be surprised at these sensory losses.
Ever have the feeling that when you drive someplace at night, a place you drive often but not at night, that sometimes it looks different to us too? Or how about when driving at night on the freeway you could be going say 65 and it feels like 85? Maybe that is what this feels like to our LOs. That is the only way I can even begin to understand what they feel.
moorsb--I would think all early stage patients (whether EOAD or not) may have sensory issues. My husband's loss of sense of smell was the earliest symptom (even before short-term memory loss was evident). As I recall, there is an area in the brain called the olfactory bulb which is responsible for smell, and it is right near the hippocampus, that controls short-term memory. This area of the brain is usually the first to be impacted by AD. He used to say he couldn't taste his food, but since taste and smell are linked, that's what I think it was. As his other senses diminished, his sense of hearing seems to have become sharper, in that loud noises/talking bothers him a lot. His neuro says this is a common cause of overstimulation in EOAD patients; they have good vision and hearing combined with a damaged brain. He said that, believe it or not, older patients who have worse vision and hearing are actually somewhat at an advantage, because their brains have a built-in "filter". Maybe this is one of the reasons younger dementia patients can be more challenging to handle, behaviorally speaking.
As far as vision loss, what I was describing above is agnosia, which is not recognizing things because of a brain problem. It has nothing really to do with the eyes, so I would not call it vision loss.
Mimi--I like that comparison to driving at night. I am always trying to "get inside" my husband's head and figure out what things must seem like to him. Confusing and scary is what I have come up with.
Loss of the sense of smell was one of my husband's first symptoms also. He also can't taste things that aren't very spicy. As Marilyn did, I've assumed the loss of taste was related to the loss of the sense of smell.
Talking about driving at night - we don’t do much night driving, but when we do I’ve noticed that it upsets him. Usually we are going home from wherever we have been & after about 10 minutes he will say, (in an agitated voice) “Where are we going?” When I tell him that we are going home he then says something like, “This isn’t the way home,” or “it doesn’t look like we are going home.” I think he gets upset because even though he wouldn’t remember the way home in the daylight, when it is dark out he can’t see the landscape & I think it frustrates him.
When I first learned about my DH having dementia I read about a man who took his grandchild (must have been very young) to the park that was just across the street from their apartment building. Two days later he showed up at the door. At the time I couldn't figure out how that could've happened because they were just across the street but now I am thinking that nothing looked the same to him and he kept walking and of course the longer he kept walking the further lost he got. The article didn't give any details it basicly just said(for affect I am sure) two days later he showed up at his door. From what your DH said, srsteen, I can now see how that might have happened. It hasn't happened to my DH yet although he does say the same things when he gets in the car and we go to the same places every week.
A few years ago when I drove to Ohio (12hours) for the first time my DH kept saying he didn't remember any of it. I put it down to him just not recognising anything because he always did the driving and that is what I told him. I know he thought I was going the wrong way. After reading the comments on this thread I am thinking it was agnosia.
Sometimes when we are out, my hb asks if I know how to get where we are going, or if I know how to get home. What that tells me is that he doesn't recognize where we are, even if we're right on our street.
We've been talking about pattern recognition and continuity recognition mostly. Those would likely be there to various degrees depending. Pattern would include spatial relationships and the depth of recognition of a thing or the degree of not being able to remain focused on the issue about the scene before them they are noticing.
There are a variety of mechanisms we take for granted that more or less are affecting our spouses at each particular moment for example within the first hour of taking a med or later in the cycle of that same med but before the next dose.
When we see things such as when we go for a drive, every single instant not only floods us with the sensory input of the scene itself - but causes us to literally zoom through many different reactions, ancilliory thoughts, and associations. For instance a certain house might trigger us to think what we might buy with a lottery win, the hamburger joint makes us consider eating, the car pulling in front makes us consider manners, we flit back and forth on the thing on our mind, the pretty girl/handsome boy jogging, on and on second after second.
When a spouse says everything looks different and it's blah - they might not be witnessing anything different. Their eyes might be precisely what they were. But the mind is not rich with association. Or all things lead to the fear or are seen through the scariness, or the associations are not in tune or being stimulated by what is seen.
It is the mind that is changing. Not the retinas. Or at least not cause and effect. The well oiled mind that remembers that Walgreen's price is 1.89 and you'll be back there thursday anyways so - you know what?, I'm here and then I can use it tonight so I'll pay the 1.99 and get it now and you have $22 in your wallet and won't be going anywhere tomorrow so you'll pay cash.
That mind. Not having that rich orchestra of thoughts that all are germain to your existence. That changing in them might make seeing the same things more blah. Point things out here and there. Or better than trying to get them to look at something tell a story. "We used to go to places like this" and remind them. Don't use the word 'remember'. If I had AD that's the last thing I would want to keep hearing. NO I DON"T! Just include them in the moment by mentioning things out loud. "Wow there are a lot of cows out in the fields." "It's a nice warm day." "Well will you look at that sunset outside." In some ways I am my wife's thoughts. Her eye's are perfect with the glasses. She can spot a rabbit or a cardinal from way off. She just can't deal with it. So I say "I see him. It's the cardinal."
I'm not advocating being mother teresa. Living in the moment like that when we're up to it feels almost like sharing the moment. In the same way you might share the moment with the furniture. You're both there but it only has meaning for one of you. I know everyone does this more or less and I'm stating the obvious but perhaps not to some. Or do what I do. Put a paperbag over her head and tell her it's night time.
(That's a joke. I would never do that. Except that one time.)
My husband has EOAD and he is a former pilot. He was always good with directions and always aware of his surroundings. When he was in the early moderate stages, he wouldn't recognize where we were. He said things looked different or would ask where we were. Lighting changes seemed to cause more confusion with him. Shortly after this occurred, he would get nervous walking. He would walk around water on the ground, oil spills on the black top,etc, he wasn't able to judge what he was seeing.
DianeT--you brought up a good example with the walking around water on the ground, etc. I have read that if you put a dark rug in front of a door it will keep them from stepping on it, that they perceive it as a hole in the floor. I'm trying this by our front door--I put a small black bathroom rug on top of the larger Persian rug that is there hoping to keep my husband from opening the front door--so far it has worked. Their depth perception also changes, when my hb started hesitating going down dark wood stairs, I switched him to white athletic shoes rather than his brown or black regular shoes. The contrast seems to help.
I am wondering if the senses are not as good because the CPU is not able to process as well or if the connection to the brain is being attacked. I am wondering if there are parts of the brain, the the senses and how they are connected that are less prone to the disease and if so why.
The image that hits the retina (upside down due to lense fraction) is sent to the brain for each of processing and storage and association and association storage (4 tasks).
So, I see an old chum. My mind is receiving all the data from the retinas, is processing that, is storing that, and is associating that. My mind twigs that I have a pattern recognition signal sounding off. I recognize that face. My mind has not only signalled recognition but has also sent it to a higher concious level suggesting to my concious self that I have something I might want to deal with. Even though my chum in now older and looks a little different, my mind did comparatives and decided this person in front of me might be relevant to me.
We both recognize each other and walk up and shake hands exclaiming suprise. He is with his wife and their children standing in front of the market I sometimes go to. My mind captures all this and associates it and stores it.
My memory of him is now updated because the brain literally created physical synaptic connections between the old images of him and the new ones I'm capturing now.
My memory of him is now updating in association with his children whom I look at and store and with the market which I have many other associations and memories of.
Two weeks from now I'll be back at that market and as I approach it my mind may well bring up that this is where I saw my chum. It will bring that up because it was a suprise and had an effect on me - so by that the mind understood it was important or of consequence. So when I think about or arrive at the market again my mind is bringing things up that might be relevant. Like that I want the Rosemarie Garlic spread, this is where Rosemarie Garlic spread is sold, and this is where my old chum is.
My understanding of reality which is my concious thoughts are also feeding my processor and storage. Without really being aware of it, I sort that data to 'this is NOT where my old chum is' because my old chum lives 40 miles down the road I found out two weeks ago when we bumped into each other and chatted - updating those particular files. Now I'm updating another one. This association between the market and chum are coincidence. The next time I go to the market I am unlikely to think of my chum again but I might. I physically built more synapses in my brain (literally) reinforcing the association of where he now lives, defusing the association of the importance of him with the market, and updating my concious feelings now about meeting him here then.
Some of whether I do or not will have to do with other associations I also have or created. I never liked him. So I glance around because I don't actually want him to be here. Or I do like him and might do exactly the same glance for the opposite reason (evasion versus hunting).
I really like him and hope to see him again. When we talked I noticed the smell of waffles was in the air and there was a waffle stand. I look around for it because I might want a waffle. My mind associated waffles with happiness at seeing him and suprise and his wife and children etc.
Much later in life an AD patient reacts to the smell of waffles and looks around for his friend. That synapse has not been broken by the build up of tau protein plaque and the mind accesses all things 'waffles'.
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Two months later I meet another chum. My mind throws up this meeting because it has associated 'chum' and 'news'. I decide to tell the story. My brain accesses the memory and fires up the mouth. (I may want to speak but only my brain can direct my lips, throat, and tongue to start making those strange shapes while blowing air so that this other chum can find out I bumped into that other chum a month ago. (Talking is a skill not a right. Just like driving. You think you're driving but you're not. Your brain is operating your hands.
So what are you in all this? You're George Bush. You are the decider. When your brain doesn't do what you decide you notice. Like quitting smoking. It's gets complicated. Basically the human is in control not the brain - but they're connected in many redundant system ways and here's the important part about this.
The person is only conciously aware. I have access to what I have access to. The brain has access to everything which it has to and it never sleeps. The caregiver sleeping is instantly awake when a new noise is heard. The person was sleeping - the brain was not 'off'.
All of this the brain does by creating new physical synapses which close enough are electric 'wires' that it not only lays down in not-yet used areas of the brain - but also connects to many other previous 'wires' and the hubs of where that electric wire map connects to other connector hubs.
The hub in your brain called 'spouse' is huge. There are tens of thousands of electric pathways connected to that identity. How your spouse smells. The map of their body. Each thing on that map (eg: moles), what they like to eat, how they sound compared to how they usually do.
You can lose thousands of connections because plaque has destroyed them - but there are still thousands left on this one hub called 'spouse'
In addition the main processor of the mind is a physical thing (cerebral cortex mainly). That too gets attacked by the plaque build up.
In summary: The retina still works great. The mind may not be functioning as well anymore in laying down the new information. It may not be functioning as well in associating (random damage). It may not have access anymore to past associations (random damage), it may not have access to base date (both the chance meeting of the chum and/or some of the long past memories of that chum or high school or the concept of memory or the main processor that usually works all that stuff). At every stage within the brain there is random increasing damage which is unpredictable in it's consequence.
The eye in simple terms is an opening with a lens like a camera and receptors that now that we have digital works in almost exactly the same way. There are millions of individual photo receptors on the retina (like number of pixels). Each one has an individual direct line into the brain. The aggregate of that is formed into a whole in the mind (not 1.4 gigabytes of pixels - a flower).
If the plaque builds up on the brain end of that then that one pixel receptor is 'dead'. The retina still sends. The line still works. The brain end of it is broken. Not a big issue when you have millions of lines coming in. Up to a point individual missing pixels are 'filled in' (that is ignored) by the brain.
Sound is similar. The data here is discrete frequencies chopped up into thousands. The ear works, the eustation tube works, the data gets to the brain. At 1.42833462 hertz precisely that reception in the brain is plaqued over to the point of not working.
Smell and taste are similar again. This is all simplistic but it's close enough. Each part of the mouth has taste receptors. Each individual receptor is one to one connected to the brain. If the brain end of those randomly gets plaqued over then the brain can no longer receive much 'salt' or 'sweet' etc.
Touch is different. The skin is an organ like the liver or heart. It does have similar mechanisms this time by nerve cells each of which is one to one mapped into the brain. (So it knows where to scratch or which finger on which hand to take off the hot thing).
The five senses are independent systems of the brain although they are each very finely mapped into the brain so that we get as much information that is as usuable as possible (good idea really).
Each of these input systems works in a different part of the brain and then is gathered and worked with by the brain as I went through in the last post. There is also a great deal of redundancy in how God/nature designed this wonderful machine. Senses can compensate, they have duplicated input devices (two eyes, two ears, two nostrils, redunant overlap in taste cells, cross connections in nerve cells etc all at the input device).
That creates increased redundancies. The input designs themselves have multiple redundancies (backups, duplication, overlaps etc) and then the brain also has multiple redundancies (left/right hemisphere, multiple location, multiple function with backup capabalities).
So in final summary. The senses are less prone because of these multiple redundancy designs.
If the plaque buldup concentrates by random growth in one or several areas, those areas will experience many times more damage in function than others to the point they may not be useable and every step in between perfect function and completely broken is affected simultaneously wherever the plaque is building up.
The complexity of the systems and the randomness of plaque buildup is why everybody has different experiences but generally there is a mapping of progression.
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You can prove some of this to yourself. Listen to music. Concentrate on only the drums. Concentrate on only the base guitar. Concentrate on only the string section, the organ, the oboe, or the triangle. Seperate the four singer's voice.
You can do all that. Most people don't. All musicians do. The point is that the data is there because the data comes in that discretely. If 'the decider' decides to focus in - the decider focuses in. Unless of course the Rosemarie Garlic spread crosses your mind instead.
Which means doing that really is not a priority and the concious mind decided the brain should present to the concious person a different priority. A normal brain is always ready with hundreds of graduated priorities. The truth though is you didn't want to. AD patients lose that ability too.
It's so odd, My DH was having cookies this afteroon, when he came home from day care.... he couldn't see them in the package. not unless i took one out and handed it to him, otherwise, he thought they were all gone. This comes to mind now, only because it happened today, other things have happened over and over in the past. If his nose is running, and the tissue box is right next to him, he won't see it, the food on the plate, really strange how this occurs. I recall one woman saying, the only thing that was affected was her husbands sight, but i'm sure his memory was affected also. Just the sight thing is so noticeable when it occurs. Wolf, you are amazing. rosemary Garlic spread sounds delicious!
chris r--the medical term for what you are describing is agnosia. I will have to read Wolf's post when I am more alert--looks like a lot of good info. there!
Not only does Wolf give us a lot of great information, but his humor is uplifting too. I was reading the article so seriously and then when I got to the "paper bag over the head" I cracked up. We all need a little humor!! Thanks, Wolf