This is the first of three articles that will outline the typical progression of Alzheimer’s disease.

Alzheimer’s unfolds over many years, probably decades. The time between current medical detection and death is nearly 10 years. However, there are earlier stages that unfold over the course of at least a decade before diagnosis can be made. There is so much you can do to protect your own future at this stage. The key is that the first change occurs in the ability to learn new things — short-term memory.

At first, the changes in memory cause inconveniences that are hard to distinguish from the changes in memory that result from normal aging. Consider those ubiquitous senior moments. You forget where you park your car. You momentarily can’t think of your phone number. You drive past the turn to your home.

We all have these “slips” in our everyday life. The challenge is to tell the difference between normal instances of forgetting and forgetting that marks a progressive attack on short-term memory and later attacks other brain skills. This first stage is called “forgetfulness.” During this stage you ask your friends about the mental lapses and they say “we’re all doing it.” You ask your doctor, he or she either says you sound fine or they do a screening test (e.g., Folstein Mini-Mental State Exam) and you score perfectly or nearly perfectly and you are told that your memory is fine. But if you are in the forgetfulness stage of Alzheimer’s disease, you may not remain fine.

You may notice that you have to think harder to do challenging tasks. You are not as facile with the computer. You don’t learn new things as quickly. You may have more trouble planning a complex event like throwing a party. The changes seen in forgetfulness are very difficult to tell from the changes in memory that result from aging.

The only way to tell is to have a challenging memory test (I use a test that requires you to learn and remember 16 words). These tests are not done by a physician but rather by a specialist, a neuropsychologist, preferably one who specializes in memory evaluations and dementia. As with cancer screenings (e.g., mammograms, PSA, colonoscopy), you are seeking to determine if you have risk in your future and, if so, take control now.

During the forgetfulness stage, you are in control of your present and future. Don’t wait until you are having difficulties with the memory screenings available today. Even if your memory is working well, act now. Put together legal directives (e.g., Durable Powers of Attorney, Living Wills), if you have not already done so.

Start your brain enrichment programs now. Exercise and eat healthier. Start planning for a better memory and an engaged life. The journey through later stages will be so much easier for you and your loved ones.