Alzheimer's: The straight deal

Alzheimer's is a disease that causes brain damage that gradually gets worse, in which the brain cells degenerate and die, which leads to a steady decline in mental and memory function.  It is also the most common form of dementia, and it has been estimated that 36 million people worldwide suffer from dementia.  There is tons of research going on for medications and treatments to prevent and/or cure Alzheimer's disease, but as of now, it is mainly learning to live with the disease and temporarily improve the symptoms.

What are the symptoms?

Alzheimer's disease can start off with some very subtle symptoms of forgetfulness and mild confusion (honestly, some days I question myself as I search for my cell phone as I am talking on it), so you might not always notice them, an many people are good at covering it up, calling it a "senior moment" or making it into a joke.  But over time it gets worse and more noticeable by friends and family members; the person affected might have no idea that they even have these symptoms.  The memory can be affected by: repeating the same statements over and over, forget conversations/appointments/etc and have no recollection about them, put every day items in strange places and be unable to find them, and forget names/dates/places that are important to them.  They may also start to have problems with thinking/reasoning, knowing where they are, and speaking/writing.  This can lead to personality changes: irritability, depression, anxiety, social withdrawal, and wandering.  It can be a devastating process to watch and be a part of.

What causes it?  Increases my risk?

It is not truly known what "causes" Alzheimer's disease per se, but it is thought to be genetic and effected by lifestyle and the environment.  Since Alzheimer's disease also has brain shrinkage related to it, scientists are looking into the effects of substance abuse and alzheimer's disease, as other lifestyle factors also increase you risk: smoking, lack of exercise, high blood pressure, high cholesterol, and poorly controlled diabetes.  As I discussed yesterday, TBIs (Traumatic Brain Injuries) can lead to a much higher rate of Alzheimer's disease than those without.  Genetically, your risk is higher if someone directly related to you (a sibling or parent) develops the disease, and increased age is the greatest risk factor.  Most people who will develop the disease start to show symptoms in their 40's or 50's. Women have a higher risk than men of developing Alzheimer's disease.

Is there anything that decreases your risk?

Research has shown that people with a higher mental functioning have decreased risks of Alzheimer's disease.  Higher levels of formal education, a stimulating job, frequent social activities, and having mentally challenging leisure activities (like puzzles, crosswords, music, reading, playing games) can decrease your risk of getting the disease.  It is unknown why, but it is assumed that keeping your brain stimulated, creates more cell to cell connections and may prevent the changes of caused by Alzheimer's.

What are medications for treatment?

There are cholinesterase inhibitors that boost cell-to-cell communication within the brain and help to slow the progression of the disease. The cholinesterase inhibitors most commonly used are: donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) and their most common side effects are nausea and diarrhea. Another drug that is used, which is very similar and often used in conjunction with those listed above, is memantine (Namenda), which can cause some dizziness.

Are there any alternative treatments?

There has been research to show that Omega-3 Fatty Acids that are commonly found in fish oil can help prevent the mental decline associated with Alzheimer's disease.  As well, it is thought that Vitamin E can help to slow the physical changes (such as moving slower, inability to perform activities of daily living) but should always be taken under a doctors supervision.  Ginko was presumed to help with Alzheimer's disease but NIH funded studies showed no improvement at all.  Also, Huperzine A  is a chinese herbal supplement from moss that acts similarly to the cholinesterase inhibitors.  All alternative treatments should be discussed with your HCP to ensure there are no reactions of medications and to make sure that they are the best treatment for you/your loved one to take.

What are some of the things I can do to help my loved one?

Encourage regular exercise: not too strenuous, but to keep them active and moving.

Encourage a healthy diet: high calorie, high protein smoothies with lots of fruits, veggies, and vitamins.  Also encourage them to drink (sometimes they can forget), so stock their home with beverages they like to drink.

Keep them mentally stimulated: bring them out to lunch, involve them in small gatherings where they can talk to friends/loved ones, so they can challenge their minds and try to remember things.

Create a safe environment: make sure their are handrails on stairs/in bathrooms, remove excess clutter or rugs that can cause them to trip, make sure there are no slippery areas, decrease the number of mirrors (mirrors can frighten people with Alzheimer's disease).

What else?

You need to make sure that you are taking care of yourself, and getting help for YOU.  Alzheimer's can be more stressful to the caregivers and loved ones than the person actually diagnosed with the disease.

-Try to go to a support group for caregivers of Alzheimer's patients

-Get help from other family members, friends

-Talk to your HCP (or the person with Alzheimer's HCP) and get a week/end off using respite care (like visiting nurses for the short term, your insurance will pay, and it gives you a little break and the ability to do what you need for you).

-Make sure you are eating healthy

-Exercise

-Make time for your friends

-Don't feel guilty for needing "me" time, it is the only way you can stay healthy and care for your loved one in the long-term.

Alzheimer's Disease can be devastating, and while nothing can reverse it (as of now), we can try to prevent it by living a healthy lifestyle, getting in to see an HCP if you notice any changes in your loved ones memory/mental abilities.  As it can be subtle, it is worth talking to their HCP about and not being judgmental, but getting on medications that may slow the progression of the disease early, is the best treatment.  Try to keep your loved ones healthy and safe, but seek help from those around you, and make sure that you are healthy too!  There are tons of supports out there, you just need to ask :)

Yours in Good Health

B