Is "nodding off" a sign of Alzheimer's' Disease?

[Peregrine Took]

I had dinner tonight with a friend and she told me her mom has Alzheimer's. She said several years ago she saw an MRI of her moms' brain (she's a nurse) and said it was full of "cotton balls."

This is apparently an image that comes up on an MRI of a person with this condition.

I've never noticed this about her mom and 'wonder if she isn't exaggerating. Her mom is 75.
She claims she (mom) has no "short term memory" (haven't noticed this either) and that she will "nod off" when she is out to dinner or in a social setting.

I think my friend is being overly dramatic and I know she has a very pessimistic attitude about illness and disease. It seems to me that she thinks we would all be better off dead. She is very religious and feels a "faith filled" person would enjoy being deceased and in God's kingdom. She hasn't stated exactly those words but 'has often said things like when people are dx'd with cancer it would be better for them to just die right away - rather than drag it out over 10 or 15 years.

Anyway, is anyone familiar with Alzheimer's - does any of this older ladies' symptoms sound familiar?

[Tangerine LaBamba]

1. Nurses aren't trained to read MRIs, for openers........

Also, Alzheimer's and dementia are two different things. You might not have been in the mother's company long enough to notice whatever the nurse is claiming. Or the nurse might be such a pain in the ass, the mother gets flustered and then forgets stuff. Hell, we've all seen stuff like that happen where senior citizens are concerned.

I had a friend who was in her eighties, and she went to visit her daughter and son-in-law and grandchildren in another city, staying for several days. Her daughter emailed me after the visit, telling me that her mother had nodded off during dinner in a Chinese restaurant. Did I notice anything like that about her mother's behavior? she wanted to know.

What I couldn't tell her was that her mother had already told me that she hadn't wanted to go out to dinner at that particular restaurant, but everyone insisted. She also knew she'd get stuck with the check - and she did. And she said that the conversation was so boring - the daughter and son-in-law and their (grown) kids are sort of assholes, and my friend knew it - she fell asleep.

I also know that my friend - who was sharp and full of life until the day she dropped dead shortly after her 87th birthday - took blood pressure medication that made her drowsy.

Your friend sounds a little bit dangerous. But that's just me.

[Peregrine Took]

Great point plus I know this lady has problems sleeping!

[bettyellen]

2. only the short tem memory loss... the diagnosis cannot be confirmed till autopsy

but there are tell tale signs. both in behaviour and from scans. the quizz to see the type of memory/ confusion that is happening. in the short term for instance they often do not know where they are- even if it;s their home. i would think when theyr scanned her brain they gave her the probable diagnosis though. there are lots of cognitive problems older folks have- i imagine they just eliminated the other possibilities and so have landed on AD.

[emilyg]

3. My Dad had Alzheimers

he didn't drop off after eating. He would doze when he was tired or bored - even with people in the room. I don't agree with your friend.

[Mnemosyne]

4. Does the mother have money? My sisters tried to claim our mom

was "getting really senile" after their father's death.

She wasn't, just grieving.

[Old Codger]

5. Nah

Lot of elderly people "nod off" at strange times,also short term memory loss better not be a sign of it or I am in trouble.. LOL One I heard to best compare that type of thing was "if you forget where you left your car keys, that is not alzhiemers, if you forget what they are for that might be."

[TwilightGardener]

6. Two of my grandparents had it--I don't remember them routinely dozing off

until they were fairly late in their disease progression and thus very disconnected from what was going on around them--but they were also on a number of pills for other conditions, so that might have made them drowsy also.

[PDJane]

7. No, drowsiness isn't a sign of Alzheimer's.

Memory loss can be, but not the kind of 'tip of the tongue' memory loss, difficulty in performing familiar tasks, Problems with language, Disorientation in time and place, poor judgement, difficulty with abstract thinking, misplacing things, changes in mood or behaviour or personality, and loss of initiative.

The trouble is that the signs are so generalized, it can also be signs of overmedication, or distance from the community, or arthritis, or just general distraction.

ETA: I have dealt with Alzheimer's and know others who are doing so, with parents or grandparents. I have had a very nice elderly gentleman have a long conversation with the automated customer service at Bell Canada, I have sent photos of her new grandson to my grandmother, who had no idea who I was or that the child was her grandchild, I have visited a woman who was so organized that it took her children a long time to realize she did have alzheimer's because the organization was such a habit that she never misplaced anything, right to the day she died.

I have a mother, on the other hand, who does misplace her keys and other things, but always in plain sight, and who is getting more liberal in her views every day. She may be disorganized, but she's quite all there. She can't zip some of her jackets, but that's because she has two fingers on each hand so bent with arthritis that she can't use them.

[CoffeeCat]

8. Ummm...ok...just food for thought...

...and I say this delicately and with all due respect.

Your friends sounds a bit high maintenance and opinionated with some very bizarre ideas.

Maybe her mother is nodding off in order to escape from the crazymaking.

Just a thought!

[IntravenousDemilo]

9. No, it's a sign of narcolepsy. n/m

[Fridays Child]

10. Googling cotton balls + brain + MRI...

...I found that description of a brain lesion only with respect to this diagnosis of multiple sclerosis:

"T2 MRI scans are useful for detecting MS lesions in the brain and, to a lesser extent, the spinal cord. These lesions appear as bright areas that resemble white, fluffy cotton balls. Neurologists can calculate the overall volume of the lesions on a T2 MRI to get a measure of the amount of brain tissue is involved in the disease process, says Dr. Coyle."

http://www.squidoo.com/ms_mri

[bertman]

11. Very familiar with it from my mother's experience. During the earlier stages--before the

afflicted individual gets WAAAYYYY out there and is easily recognizable due to a totally inability to function normally--it is very easy to NOT see what's happening. Unless you spend a lot of time with that person.

I don't remember any nodding out at all with my mother.

My mom could carry on a conversation with someone during casual social interaction and the other person would often have no clue that Mom was ill. Our social cues and habits are often strongly enough embedded that we can interact with others on a superficial level for hours. Such was the case with my mom, who was always a gregarious type.

HOWEVER, the clues start when a conversation turns to specific topics requiring detailed explanations. Usually my mom would fall back to her default social cover and begin chatting amiably about whatever SHE was comfortable with. If you did not understand about her illness you would have thought she was just a good-natured ditz. My mom was valedictorian of her high school and an astute businesswoman who could hold her own in serious conversations until the onset of Alzheimer's.

Another clue is repetition of a story line. After my father died (he had been her protector and her shield against the world, including the family) I spent many hours alone and on car rides with Mom. She would tell me the same story fifteen times in a row and never flinch or show any indication that she knew she sounded like she was a human tape recorder.

When we finally took her to a geriatric specialist, he was very polite and cordial with all of us, and of course with Mom too. He asked her her name and a few other mundane questions which she answered perfectly. Then he asked her what time it was. She was wearing a watch-which was accurate-yet it did not even occur to her to look at it and answer his question. She just laughed awkwardly and chit-chatted away about some other topic as if he had not asked her the time. Later, when my sister and I were alone with him he said that the "What time is it?" question was often the giveaway.

Alzheimer's had my mom for 13 years that my siblings and I now recognize. We knew that something was weird with Mom because she was acting so "silly" but my dad was such a wonderful, loving mate that he was able to help her negotiate her way through life without being discovered for at least seven years. After he died and my siblings and I had to be with her all the time we found out how bad off she really was. She was healthy as a horse otherwise and very good-natured until her last two years, when she became very volatile and her health failed very rapidly. It is not a pretty thing to watch or be involved with.

I hope your friend is wrong about her mom. I hope my explanation helps you in some small way.

[SheilaT]

16. I read something recently

that studies have apparently shown some kind of inability to tell time properly is a very early sign, long before any other symptoms, of Alzheimer's. I can't recall the details. Maybe it's someone not being able to correctly draw a clock face. Of course, if that's what it is, the younger generation will need something else, because a lot of them seem unable to tell time on an analog clock.

[bertman]

18. Interesting, SheilaT. The funny thing was that Mom didn't even know to LOOK at her watch.

It was really weird and disturbing.

[bettyellen]

21. my father couldn't figure out how to unlock the bathroom door + was locked in

his was a rare form of parkinsons, but the cognitive symtoms were very similar to AD, which my Mom has.

[tularetom]

12. My dad died 6 years ago. He had everything except Alzheimer's

And one of the things he had was a sleep disorder. He snored so loud that the dog would run no another part of the house and hide. But it wasn't restful sleep. Consequently he would nod off at odd times during the day.

[Celebration]

13. Most people are projecting with things like this

Sounds like she has some slight senility. But Alzheimer's? Uh, I guess you aren't sure when it's really early. I knew my mom had a problem when she played a game of Scrabble PERFECTLY-except, well, it was entirely upside down. Still, I don't think it was Alzheimer's--just a circulatory deal.

In a much younger person in our church, I thought, "This person is a tax specialist? YIKES." We organized the basketball teams one year. I knew something was off. Okay, it is much easier to detect in a younger person. I didn't diagnose it, but I was pretty amazed at this person's behaviour (he was under forty years old).

Paranoia is a big deal, too, with Alzheimer's. Yup, that was my grandma......very, very sad. No, she didn't nod off.

You know, school kids even nod off--not a big deal.

[Buzz Clik]

14. Nodding off can be a simple matter of blood chemistry, hormones, etc.

[Gregorian]

15. Sleep apnea is a very common problem which is seldom diagnosed.

Drowsiness is definitely one symptom of sleep apnea.

[mzteris]

19. i second this -

"nodding off" : sleep apnea. Alzheimers - no nodding off with my dad.

[Fire_Medic_Dave]

22. and can be a source of mental confusion.

[Warpy]

17. The MRIs I've seen from Alzheimer's patients

show enlarged ventricles and generalized shrinkage of the parenchyma (meat?) of the brain. Other than that, the structures are largely normal. Either she has no clue what a normal brain looks like on MRI or she's off in some sort of fantasy land. Cotton balls, my ass.

The drowsiness needs to be checked out, though. That's not normal.

The daughter sounds like she's got some psychiatric problems of her own. I hope someone else is in a position to get Mom to a doctor and get her checked out. Just because the daughter wants us all to die doesn't mean anybody has a duty to, least of all her poor mother.

[LeftishBrit]

20. No

Nodding off occurs in people who are tired, have difficulty in sleeping at night, or take certain medications. In extreme form, it can be a sign of the neurological disorder narcolepsy, but it is not characteristic of Alzheimers. Elderly people in general are more prone to 'nodding off' than younger people, but anyone can do it.

Also: Alzheimers cannot be diagnosed by MRI. The brain changes that are specific to Alzheimers don't show up on an MRI (though some degree of brain atrophy is usually seen, but this can occur in many other conditions, and does not always even indicate dementia). Alzheimers is diagnosed in living people on the basis of symptoms and ruling out other conditions, and can only be conclusively proved by examining the brain post-mortem. So your friend has got things very garbled.