Alzheimer's Part III-Stages And Treatments

As promised in the previous post, here are some things to know about the stages and treatments for Alzheimer's disease.

Like many other conditions, Alzheimer's disease comes in stages. There are seven stages, although many doctors combine them into three:

• Mild/Early Stage. The symptoms aren't usually noticeable-even to a doctor-in the very beginning. As time goes on, the person may become more forgetful of things such as the correct names for things, and will lose things more often than normal. They may have problems with basic arithmetic such as counting forward or backward by 4s, or with organizing and planning. They may withdraw from others. Many of us do these things to a degree; the main indicator is that they are becoming worse and more noticeable by friends and family.
• Moderate/Mid-Stage. The cognitive impairments get in the way of daily life. Forgetting one's own address and phone number is common. They may start to have problems with recognizing family and friends, personal hygiene and dressing themselves properly.
  They may be unaware of their surroundings and wander off or think they are back in another time in their life. For instance, they may think they have to pick their child up from school and not remember that said child is now an adult. They may occasionally have trouble with eating or using the bathroom, and will have major problems with sleep patterns. Incontinence becomes more frequent. Personality changes such as depression, violent anger or paranoia become more pronounced.

          People at this stage start to experience what is called 'sundowning'-the worsening of        

         symptoms toward the end of the day.

• Severe/Late Stage. At this stage, the person will become incontinent and no longer be able to eat or care for themselves in any way. They will not be aware of their surroundings. As the end comes near, the person will no longer be able to speak or sit up on their own.

It can be difficult to tell what stage someone is in because they often overlap. Even so, it's important to know what to expect. It will be much easier to care for the person and for yourself if you know what's coming and not to take it personally. Remember, their behavior is the disease talking, not them.

Unfortunately, it appears that the progression of Alzheimer's cannot be slowed or stopped. Drugs such as Aricept and Exelon may be able to slow it down temporarily (say, for about 6-12 months), but there's no way to completely stop or delay the progression. Some doctors will also opt to treat individual symptoms such as depression.

Some things you can do to make things as good for yourself and the other person as possible are:

• Do things to exercise the brain, such as doing crossword puzzles or sudoku.
• Exercise and eat healthily.
• Keep things free of clutter or anything the person could trip over. You might want to invest in a walker or guard rails for stability. Also, try to limit the number of mirrors in the house because the person may no longer be able to recognize themselves and may become fearful of 'the other person'.
• Make sure the person is comfortable, such as room temperature and hunger or thirst.
• Keep everything as calm and routine as possible, because any major changes can be problematic.
• As time goes on, you may not be able to leave the person unattended for any length of time.

As they say, 'Knowledge is power.' While I'm not entirely sure who 'they' are, learning as much as you can about an illness such as Alzheimer's can only help. If you think you or a loved one may have Alzheimer's, ask your doctor. That's the only way you will know for sure. For more information, check out http://www.alz.org.

Part II-Alzheimer's Signs And Symptoms

As promised in Part 1, here are some of the early warning signs of Alzheimer's disease.

One thing that is very important to remember (no pun intended):

Just because you forget someone's name you just met or lose things doesn't necessarily mean you have Alzheimer's. There are other forms of dementia, and sometimes it's just a case of selective memory. For instance, people with ADD/ADHD might forget certain things or miss smaller details because their brains are working much faster than other people's. It's possible for someone with depression or bipolar disorder to experience dementia that improves or goes away with treatment, and Huntington's and Parkinson's diseases can cause memory impairments. And, well, sometimes we don't remember something because it's really not that important anyway. :) Only your doctor can tell for sure whether any dementia or memory loss is caused by Alzheimer's and not something else.

• Memory loss. When I say 'memory loss', I'm talking about forgetfulness that gets in the way of your daily life. They might be able to remember a speech they gave at their high school graduation, but not remember what their kids' names are or what their address is. This gets worse as the disease progresses.
• Losing things and not being able to retrace your steps. We all misplace our keys every once in a while, but we can usually figure out where we were last time we had them. People with Alzheimer's are unable to do this. They may also accuse someone else of stealing from them or put things in really odd places, like the TV remote in the refrigerator.
• Difficulty with your daily tasks. Most of us will occasionally forget things like how to operate the toaster oven or get lost while driving, but someone with Alzheimer's will forget these things on a regular basis, no matter how many times you tell them. They may also have problems with hygiene or dressing themselves.
• Problems with planning and problem-solving. Related to the above, a person with Alzheimer's may have difficulty working with numbers or following directions. For instance, they may have problems following a recipe they've done many times before or keeping track of their spending.
• Language or communication problems. Anyone can get lost in a complicated conversation or have trouble with finding the right words, but a person with Alzheimer's may constantly repeat themselves or stop talking mid-sentence and forget what they were going to say. They may also forget what common object is called-for instance, calling grape juice 'that purple stuff' or forget how to read.
• Problems with visual or spatial images. Many people may have problems seeing things up close or far away as they get older, but a person with Alzheimer's might not be able to identify colors. Also, they may have a problem with depth perception and judging distances, which causes problems for things like driving and walking up and down stairs.
• Losing track of time or place. A person with Alzheimer's may go somewhere and forget how they got there. This is where wandering off is a problem. They may also lose track of large chunks of time, such as thinking that Ronald Reagan is still the president or that their long-dead spouse is picking up dinner.
• Judgement. We all mess up sometimes, but a person with Alzheimer's will make uncharacteristically bad decisions or forget general rules of caution. This includes things such as sending a lot of money they don't have to a televangelist or taking something out of the oven with their bare hands.
• Uncharacteristic mood swings or withdrawal from people and activities. This one can be very difficult to pin down because these are also symptoms of other conditions such as depression and bipolar disorder. However, it may come up suddenly in people who have no history of these problems. They may get anxious about things that are not happening, such as thinking they're being spied on by the government. They may also get angry and violent for no reason at all or lose interest in their favorite hobbies.

If you have ever seen someone you love go through these changes, you know that it is one of the saddest and most fearful things in the world. While there is no cure for Alzheimer's, there are treatments that can help a person and his/her caregivers get the most out the life they have left. I will discuss these in the next post.

Are You At Risk For Alzheimer's Disease? Part I

Have you or your dad ever had a 'senior moment'? Most of the time, this is just a joke about minor forgetfulness that can come with age. However, having a lot of 'senior moments' that interfere with your daily life can be an indicator of Alzheimer's disease, a form of dementia. But exactly what causes Alzheimer's disease? What are the risk factors, stages and warning signs? Is it always fatal? What can someone who has the disease do to increase their quality of life? How can you tell the difference between Alzheimer's and another form of dementia? In this series of posts, I'll go over some of the facts about it, as well as what can be done to improve a patient's quality of life.

Doctors still aren't entirely sure what causes Alzheimer's disease. They have, however, discovered enough commonalities among patients to determine a set of risk factors. Some of them are:

• Age. As you probably guessed, a person's age plays a huge role in whether they will or will not develop Alzheimer's. While it is possible for someone to develop the disease as early as their 30s, this only accounts for about 5% of cases. It's estimated that one in eight people over 65 suffer from some form of the disease, with the risk nearly doubling every five years after age 65. When it comes to people 85 and older, an estimated 50% will have it.
• Family history. Scientists have discovered that people who have a sibling or parent with Alzheimer's are about twice as likely to develop the disease themselves than someone with no family history. There are still more 'risk genes' being discovered, but having the gene doesn't necessarily mean that a person will develop Alzheimer's; it's just something to for your doctor to keep in mind when determining a diagnosis.
• Heart problems. There is a strong connection between heart health and brain health, most likely because things like high blood pressure and high cholesterol can adversely affect both the cardiovascular and nervous systems. The same things your doctor advises you to do-exercise, eat a healthy diet, avoid smoking and excess alcohol consumption-for your heart can also help your brain.
• Gender and race. For whatever reason, women tend to develop Alzheimer's more often than men. Also, Hispanics are 1 ½ times more likely to develop the disease than whites, and African Americans about twice as likely. The sheer diversity among Asians and Pacific Islanders makes it difficult for scientists to come to any one conclusion regarding their risk.
• Head trauma. While hitting your head playing sports doesn't necessarily mean you're at a higher risk for Alzheimer's (good thing, otherwise I'd be out of luck!), studies have shown a connection between severe brain injuries and Alzheimer's because of the changes in brain chemistry the injuries can cause.

There have also been some studies that show a higher rate of Alzheimer's in people who haven't had much formal education. I'm not really sure why this is. I wonder if the brain chemistry that comes with Alzheimer's affects people early enough to where they wouldn't really be able to handle much beyond high school? I have no idea.

The answer to question number three above is, yes, Alzheimer's is always fatal. The disease kills brain cells and causes such a decline that a person with it is eventually unable to care for themselves in any way.

Now that you have an idea as to who is most at risk for Alzheimer's, I'll go over the symptoms in another post.