Impairment in the early stages is subtle and can be difficult to recognise. Mild ARBI in particular is best identified by a neuropsychological assessment.

When Is ARBI Most Likely To Be Apparent?

The frontal lobe functions of the brain and the ability to learn new information are essential to coping with and adapting to change effectively. The person with ARBI may attempt to compensate by avoiding change, or may become distressed by it. Change may be as minor as disruption to the daily routine, or may involve starting a new job. Other examples of times where ARBI may become apparent follow:

• Changes in workers, carers or staff members
• Changes in duties or responsibilities at work
• Retirement
• Relationship break-up or problems
• Moving house
• Changes in banking procedures
• Moving the furniture
• Loss of a family member or friend
• Disruptions to the daily routine like cancelled appointments
• Last-minute changes to plans
• An unexpected bill
• Closing down of the local milk bar
• A new room-mate

Indicators of ARBI

Clues about ARBI can be gathered by observing the person's mood, behaviour, daily functioning and coping skills. Here are some examples of common indicators:

• Mood changes - anxiety, agitation or depression
• Behavioural changes - difficult behaviour, acting out, suspicious or paranoid behaviour, withdrawal, inappropriate behaviour
• Confusion and disorientation
• Talking excessively about, and living in, the past
• Problems carrying through with plans and getting around to chores
• Disconnection of gas, electricity or the phone
• Missed appointments
• Repetitious conversation
• Problems staying focused in conversation
• Resistance to change
• Confabulation
• Irrational reasoning
• Inability to change even when the person desires to