An Overview of Alzheimer's Disease

Alzheimer's (pronounced Alzhimerz) is a disease of the brain that causes a steady decline in memory. This results in dementia-loss of intellectual functions (thinking, remembering, andreasoning) servere enough to interfere with everyday life.

When German physician Alois Alzheimer first described the disease in 1907, it was considered rare. Today, Alzheimer's disease is the most common cause of dementia, affecting 10% of people 65 years old, and nearly 50% of those age 85 or older. An estimated 4.5 million Americans have Alzheimer's.

Alzheimer's disease(AD) usually begins gradually, causing a person to forget recent events and to have diffucuilty performing familiar tasks. How rapidly the disease advances varies from person to person, causing confusion, personality and behavior changes, and impaired judgement. Communcation becomes difficult as the person with Alzheimer's struggles to find words, finish thoughts, or follow directions. Eventually, people with Alzheimer's will become totally unable to care forthemselves.

What causes Alzheimer's disease?

Scientists are still not certain what causes the disease. Age and family histroy with Alzheimer's disease are identifiable risks factors for the disease. Scientists are exploring the role of genetics in the development of Alzheimer's, focusing on chromosome 19. (Rarer forms of the disease, which strike people in their 30s and 40s, often run within familiesandappear to be related to chromosome 1, chromosome 14, and chromosome 21.) Many researchers and phyiscians are coming to believe that Alzheimer's is a complex disease, probably caused by a variety of influences.

Does Alzheimer's disease run in families?

The evidence is not clear. Cases where several members of a single family hae had autopsy-confirmed diagnoses of AD are rare. Much more common is the sitution where a single family member is diagnosed as having probable Alzheimer's (meaning that physicians are 80% to 90% certain that is AD). A person's risk of developing the disease seems to be slightly higher if a first-degree relative (brother, sister,parent) has the disease. This situation is called "familial," which means there could be a genetic factor involved, or perhaps family members were exposed to something in the environment that caused the disease.

Does Alzheimer's disease occur in younger adults?

Yes. The disease can occur in people in their 30s, 40s and 50s, however, most people diagnosed with AD are older than age 65. This is called "early-onset" and represents less than 10% of Alzheimer cases. When a younger adult has AD, the issues related to care, financial planning, work, family, children, ect., can be very different than with older adults with the disease.

Isn't memory loss a natural part of aging?

Yes and no. Everyone has forgotten where they parked the car or the name of an acquaintance at one time or another. And many healthy individuals are less able to remember certain kinds of information as they get older. The symptoms of Alzheimer's are much more severe than such simple memory lapses. Alzheimer symptoms affect communication, learning,thinking, reasoning, and can have an impact on a person's work and social life.

What are diseases act like Alzheimer's?

Many conditions can cause dementia. Dementia related to depression, drug interaction, thyroid and other problems might reversible if detected early. It is important to identify the actual cause in order to receive proper care. AD is the leading cause of dementia.Some other diseases that cause dementia are: Creutzfeldt-Jakob disease(CJD), multi-infarct dementia (MID), normal pressure hydrocephalus (NPH), Pick's disease, Parkinson's disease, Lewy body disease, Huntington's disease, and depression.

How is Alzheimer's disease diagnosed?

There is no single diagnostic test. Instead, AD is diagnosed through process of elimination to rule out other diseases and conditions that can also cause dementia. Whether conducted by a family physician or a team ofspecialists, theprocess usually involves the following:

A through medical history of the person with symptoms of Alzheimer's as well as family members.

An assessment of the person's mental status.

A through physical exam

A neurological.

A series of lab tests.

Psychological and other exams.

A diagnosis of Alzheimer'sdisease obtained through this evaluation is considered 80% to 90% accurate. The only way to be absolutely certain the person has Alzheimer's disease is through an autopsy.

What treatment is available?

There is no medical treatment at this time to cure or stop the progression of AD. Four drugs approved by the FDA- tacrine(also known as Cognex), donepezil hydrochloride (also known as Aricept), and galantamine hydrobromide (also known as Reminyl)- may temporarily improve symptoms related to the disease. In addition, many promising new drugs are now being studied to find out whether they can slow the progression of the disease or improve memory. To learn more about current clinical drug trails, contact the Alzheimer's Association at (800) 888-6671. Medications are also available toreduce some of the behavioral symptoms associated with Alzheimer's, such as depression, sleeplessness and agitation.

What else can be done?

Learn how the Alzheimer's Assoication can help. The Alzheimer's Association has a national network of chapters, providing programs and services within their communities that assist persons with Alzheimer's disease, their families and carfegivers. These programs and services include support groups, telephone helplines, educational seminars, and a variety of publications on the disease, on current research, caregiving approaches and more. The Alzheimer's Assoication is the only health organiztion dedicated to conquering Alzheimer's disease through research, and to providing education, support and advocacy for people with AD,their families and caregivers.

What additional resources are available?

Contact your local chapter of the Alzheimer's Assoication for a list of materials availabe.

The above information was obtained from the Alzheimer's Assoication of Western Carolina Chapter.

for futher information on this subject go to:

Alzheimer's Association

Ten Warning Signs of Alzheimer’s Disease

Some change in memory is normal as we grow older, but the symptoms of Alzheimer’s disease are more than simple lapses in memory. People with Alzheimer’s experience difficulties communicating, learning, thinking, and reasoning — problems severe enough to have an impact on an individual's work, social activities, and family life.

The Alzheimer’s Association believes that it is critical for people with dementia and their families to receive information, care, and support as early as possible. To help family members and health care professionals recognize warning signs of Alzheimer’s disease, the Association has developed a checklist of common symptoms.

1. Memory loss. One of the most common early signs of dementia is forgetting recently learned information. While it’s normal to forget appointments, names, or telephone numbers, those with dementia will forget such things more often and not remember them later.

2. Difficulty performing familiar tasks. People with dementia often find it hard to complete everyday tasks that are so familiar we usually do not think about how to do them. A person with Alzheimer’s may not know the steps for preparing a meal, using a household appliance, or participating in a lifelong hobby.

3. Problems with language. Everyone has trouble finding the right word sometimes, but a person with Alzheimer’s disease often forgets simple words or substitutes unusual words, making his or her speech or writing hard to understand. If a person with Alzheimer’s is unable to find his or her toothbrush, for example, the individual may ask for “that thing for my mouth.”

4. Disorientation to time and place. It’s normal to forget the day of the week or where you’re going. But people with Alzheimer’s disease can become lost on their own street, forget where they are and how they got there, and not know how to get back home.

5. Poor or decreased judgment. No one has perfect judgment all of the time. Those with Alzheimer’s may dress without regard to the weather, wearing several shirts or blouses on a warm day or very little clothing in cold weather. Individuals with dementia often show poor judgment about money, giving away large amounts of money to telemarketers or paying for home repairs or products they don’t need.

6. Problems with abstract thinking. Balancing a checkbook may be hard when the task is more complicated than usual. Someone with Alzheimer’s disease could forget completely what the numbers are and what needs to be done with them.

7. Misplacing things. Anyone can temporarily misplace a wallet or key. A person with Alzheimer’s disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl.

8. Changes in mood or behavior. Everyone can become sad or moody from time to time. Someone with Alzheimer’s disease can show rapid mood swings—from calm to tears to anger—for no apparent reason.

9. Changes in personality. People’s personalities ordinarily change somewhat with age. But a person with Alzheimer’s disease can change a lot, becoming extremely confused, suspicious, fearful, or dependent on a family member.

10. Loss of initiative. It’s normal to tire of housework, business activities, or social obligations at times. The person with Alzheimer’s disease may become very passive, sitting in front of the television for hours, sleeping more than usual, or not wanting to do usual activities.

If you recognize any warning signs in yourself or a loved one, the Alzheimer’s Association recommends consulting a physician. Early diagnosis of Alzheimer’s disease or other disorders causing dementia is an important step in getting appropriate treatment, care, and support services.

Communicating with persons with Alzheimer’s Disease or related disorders

Always approach the person from the front, or within his/her line of vision – no surprise appearance.

Speak in a normal tone of voice and greet the person as you would anyone else.

Minimize hand movements that approach the other person; Avoid a setting with a lot of sensory stimulation, like a big room where many people may be sitting or talking, a high-traffic area or a very noisy place.

Maintain eye contact and smile. A frown will convey negative feeling s to a person.

Be respectful of the person’s personal space and observant of his/her reaction as you move closer. Maintain a distance of one to one and a half feet initially.

If a person is a pacer, walk with him/her, in step with him/her while you talk.

Use distraction if a situation looks like it may get out of hand. A couple of examples are: if the person is about to hit someone of if he/she is trying to leave the home/facility.

se a low-pitched, slow speaking voice which older adults hear best; Ask only one question at a time. More than one question will increase confusion.

Repeat key words if the person does not understand the first time around.

Nod and smile only if what the person said is understood.

References

Alzheimer's - Finding the Words: A Communication Guide for Those Who Care by Harriet Hodgson

Alzheimer's Disease: A Handbook for Caregivers by Ronald C. Hamdy St. Louis, MO: Mosby-Year Book, Inc., 1990. Contains information about the effects of Alzheimer's disease on the patient's day-to-day life. Offers a detailed description of the stages of the disease, options for treatment, and effects of other mental and physical characteristics on expression of Alzheimer's disease. Also, suggestions for approaching nutrition, sleep habits and therapy.

Nursing Homes: The Family's Journey by Peter S. Silin, MSW, RSW

Nursing Homes: The Family's Journey, starts where you do, with talking to your loved one about care. It helps you through the whole process, discussing how to make decisions as a family, how to find care, what good care is, how nursing homes function, how to prepare yourself and your loved one, admission day, adjustment, grief, loss, care issues, how to obtain the best possible care, communicating with the system, problem solving, visiting, and death and dying. It is a complete guide for family members facing the practical and emotional issues that arise in seeking nursing home care and who are learning to be "the family member" of someone in a nursing home or senior's housing.