Ask Your Doctor: ALZHEIMER’S DISEASE
Alzheimer’s disease affects many individuals in Anguilla, but many relatives and friends have difficulty determining whether some early symptoms are just associated with the process of getting old, or it is the more serious problem like Alzheimer’s disease.
It is estimated that up to one in eight people over the age of sixty five may have symptoms and signs of Alzheimer’s disease, but in the earliest forms of this disease it is difficult for friends and relatives to determine if it is Alzheimer’s disease or if it is just part of being forgetful as one gets older.
Although, typically, people develop Alzheimer’s disease as they grow older, the disease is not a natural result of aging. It is an abnormal condition whose causes continue to be investigated.
Identifying early warning signs of Alzheimer’s disease
It might be difficult to identify the early warning signs but such signs do occur and include the following:
Memory and speech
In early Alzheimer’s, long-term memories usually remain intact while short-term memories become sketchy. Your loved one may forget conversations you had. He or she may repeat questions that were already answered. The disease also disrupts speech, so patients may struggle to remember common words.
Alzheimer’s can cause confusion and behaviour changes. Your loved one may get lost in familiar places. Mood swings and poor judgment are also common, as is poor hygiene. People who once dressed with style may resort to wearing stained clothes and unwashed hair.
Do not ignore the signs
While it is difficult to face the possibility that a loved one could have Alzheimer’s, it is better to consult a doctor sooner rather than later. First, the diagnosis might not be Alzheimer’s after all. The symptoms could be caused by a highly treatable problem such as a thyroid imbalance. If it is Alzheimer’s, today’s treatments work best when they are used early in the course of the disease.
There is no simple test for Alzheimer’s, so the doctor will rely on you to describe the changes in your loved one. A mental status test, sometimes called a “mini-cog,” or other screening tests, can help evaluate the patient’s mental function and short-term memory. In addition, neurological exams and brain scans may be used to rule out other problems such as a stroke or tumour — and they can help provide other information about the brain.
Alzheimer’s and the brain
Alzheimer’s disease leads to nerve cell death and tissue loss throughout the brain. As the disease progresses, brain tissue shrinks and the ventricles (chambers within the brain that contain cerebrospinal fluid) become larger. The damage disrupts communication between brain cells, crippling memory, speech and comprehension.
Alzheimer’s disease takes a different path in every patient. In some people the symptoms worsen quickly, leading to severe memory loss and confusion within a few years. In others, the changes may be more gradual with the disease taking 20 years to run its course. The average length of survival after a diagnosis of Alzheimer’s is three to nine years.
How Alzheimer’s affects daily life
Alzheimer’s affects concentration. Patients may lose the ability to manage ordinary tasks like cooking or paying the bills. A study suggests that difficulty balancing a checkbook is often one of the first effects of Alzheimer’s. As the symptoms worsen, your loved one may not recognize familiar people or places. He or she may get lost easily, or use utensils improperly, such as combing hair with a fork. Incontinence, balance problems, and loss of language are common in the advanced stages.
Alzheimer’s and driving
Poor coordination, memory loss and confusion make for a dangerous combination behind the wheel. If you feel your loved one should not be driving, explain why. If he or she won’t listen, ask the doctor to step in. If the patient still insists on driving, contact the Police. Then make an alternate plan for your loved one’s transportation needs.
Alzheimer’s and exercise
Exercise can help people with Alzheimer’s maintain some muscle strength and coordination. It also improves mood and may reduce anxiety. Check with your loved one’s doctor to learn which types of exercise are appropriate. Repetitive activities, such as walking, weeding, or even folding laundry, may be the most effective at promoting a sense of calm.
There is no cure for Alzheimer’s disease, and no known way to slow the nerve damage within the brain. There are a variety of medications that appear to help maintain mental function and slow the disease progression. If these treatments are given during the early stages of Alzheimer’s, your loved one may be able to remain independent and carry out daily tasks for a longer period of time.
Challenges in caregiving
In the early stages of Alzheimer’s, patients often understand what is happening and may be ashamed or anxious. Watch for signs of depression because this can often be managed with medication. In the more advanced stages, your loved one may become paranoid or violent and could even turn on you. Remember that the disease is responsible for this change. Alert the doctor about violent behaviour promptly.
Some people with Alzheimer’s become distressed when the sun goes down. This agitation tends to last through the evening and sometimes all through the night. The cause is not known, but there are some strategies to ease the tension. Keep the house well lit and close the drapes before sunset. Try distracting your loved one with a favorite activity or TV show. And restrict caffeine after breakfast.
Warning signs of caregiver stress
Caring for someone with Alzheimer’s can be physically and mentally taxing. Signs of caregiver stress include:
• Anger, sadness, and mood swings
• Headaches or back pain
• Difficulty concentrating
• Difficulty sleeping
Taking care of the caregiver
To avoid caregiver burnout, make sure you take at least a few minutes to do something you enjoy everyday. Stay in touch with friends and keep up with hobbies whenever possible. Find a friend or relative to be your support person. You can also join an online or local caregiver support group through the Alzheimer’s Association.
People with advanced Alzheimer’s may lose the ability to walk, talk or respond to others. Eventually, the disease can hinder vital functions, such as the ability to swallow. Patients in this stage may benefit from hospice care which provides pain relief and comfort for the terminally ill.
Helping children cope
Children may feel confused, afraid, or even resentful when a family member is affected by Alzheimer’s. Let the child know these feelings are normal and answer his or her questions about the illness honestly. Help the child celebrate happy memories of the patient — for example, by creating a scrapbook.
Reducing your risk of Alzheimer’s
If you’re caring for a relative with Alzheimer’s, you might be wondering if there’s anything you can do to reduce your own risk. Research in this area is ongoing, but diet and exercise appear key. Studies indicate a lower risk among people who eat a Mediterranean diet rich in vegetables, fish and nuts. Research also suggests that those who are the most physically active are the least likely to get Alzheimer’s.
Alzheimer’s disease is the cause of 60% to 70% of cases of dementia. It is a chronic disease that usually starts slowly and gets worse over time. The cause of Alzheimer’s disease is poorly understood. About 70% of the risk is believed to be genetic. Identifying early warning signs and symptoms and early treatment have been shown to halt the progression of this serious condition. If your loved one has any signs and symptoms suggestive of Alzheimer’s disease take him or her to see a doctor for a full evaluation.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).