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Physical therapist Hailey Damrow works on balance with Kim Schiefelbein at Hastings Physical Therapy Monday.

Although most people associate Alzheimer’s disease solely with memory loss, its earliest symptoms often are difficult to recognize because they don’t appear to have anything to do with forgetfulness.

Hailey Damrow, a recent addition to staff at Hastings Physical Therapy Spine, Sport, and Extremity Center, is a physical therapist who specializes in working with patients with traumatic brain injury (TBI), including patients with neurological conditions including Alzheimer’s. Damrow said that while memory deficit obviously is the biggest qualifier for diagnosing Alzheimer’s disease, it is more likely to see a patient exhibit abnormal movements as an early symptom of the disease rather than anything typically associated with memory loss.

“Actually, the very first symptom to look for is that they have abnormal movement patterns,” she said. “Going up and down stairs, they may think there’s another stair there, but there is not. Or stepping over a line on the carpet that’s not there because of depth perception (issues). Or they may go for a cup of coffee and overshoot it and tip it over, or grab at it and it’s not there yet.”

Another common symptom of brain injury is the loss of sense of smell. This occurrence is commonplace among those interviewed, Damrow said.

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Physical therapist Hailey Damrow smiles Monday while working with a patient at Hastings Physical Therapy.

“Almost everyone says they’d eat but that the food didn’t smell like it used to,” she said. “Then a couple years later they notice the memory loss.”

While Alzheimer’s is described as a progressive disease that destroys memory and other important mental functions, traumatic brain injury occurs as the result of a blow to the head that disrupts normal brain function.

Certain types of traumatic brain injury may increase the risk of developing Alzheimer’s or another type of dementia years after the injury takes place.

A key study cited on the Alzheimer’s Association homepage indicates that older adults with a history of moderate traumatic brain injury are 2.3 times more likely to develop Alzheimer’s than seniors with no history of head injury, and that those with a history of severe traumatic brain injury had a 4.5 times greater risk.

And while there is no evidence that a single mild traumatic brain injury increases dementia risk, emerging evidence suggests that repeated mild traumatic brain injuries, such as those that occur in sports like football, boxing, hockey, and soccer, may be linked to a greater risk of chronic traumatic encephalopathy (CTE), a form of dementia.

In states where snow and ice are present, slip and fall injuries are among the more common causes of TBI, Damrow said.

A large percentage of cases she sees involve patients who have fallen in the shower, on stairs, or on ice. Falls from putting up Christmas lights and other holiday decorations tend to make winter an especially vulnerable time for injury, especially among the senior population.

At HPTSSEC, brain injury patients already are vamping up for the winter months by working on balance issues that will challenge them as extreme winter temperatures turn sidewalks into ice rinks. By using foam or uneven surfaces to simulate conditions that will arise, patients are better prepared to tackle potential fall risks and avoid them.

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Physical therapist Hailey Damrow works with Kim Schiefelbein at Hastings Physical Therapy Monday.

“Some things we work on addressing are uptraining other balance systems,” Damrow said. “Vision is the No. 1 thing that helps you keep your balance, so when it’s dark out, training inner ear and muscle strength can help them react faster if they do lose their balance.”

An estimated 775,000 seniors are living with TBI, according to statistics released by the Centers for Disease Control and Prevention.

Each year, 56,000 seniors are hospitalized as a result of head injuries sustained in falls. About 8,000 will succumb to their injuries, while many others will suffer long-term cognitive changes, including the reduced ability to function and changes in emotional health.

Suggested measures to reduce the risk of falls include: Using a walker to compensate for mobility problems, muscle weakness or poor balance. Other useful remedies suggested by Damrow include use of a cane, grab bars, ice cleats, and in extreme cases, wheelchair.

Strategies for helping those dealing with brain injury memory issues include having them write down appointments on a cell phone or specific place consistently, and placing items such as keys and shoes, in the same place each time to strengthen the memory.

Soliciting outside services from groups such as Meals on Wheels, church groups, and public transportation outlets can be of benefit by creating a safer environment for a patient, Damrow said.

Incorporating memory exercises into treatment plans can enable patients to stay sharper longer, she said.

“We try to incorporate memory and getting them to not only uptrain their balance and muscles but also their brain,” she said. “We may ask them to recall five things they would like to do, what they had for breakfast, where they were born...

“With Alzheimer’s, it’s a degenerative disease and it’s going to keep getting worse. You just want to start compensating with different memory strategies that can be really hopeful in early stages.”

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