Alzheimers! My Father! Part 3.
Jul 30 '01 (Updated Aug 13 '01)
The Bottom Line When it strikes, there is a lot to know and a lot to do and a lot to prepare for.
Speaking with my parents over the weekend I have discovered that my mother is not as strong as she would like me to think that she is. Neither is my father. So I wanted to try and find all I could find on Dementia and Alzheimer’s disease to try and help them and myself deal with this situation we have found ourselves in.
So I started reading what ever I can find. I am going to mail this information to my parents in hopes that it will help them be able to deal with things better. Reading this has helped me as well and I hope that it may help those of you out there who are facing this disease within your family. It is long but very educational. I hope that you find yourself reading and not being able to stop until the end, as I did.
what is Alzheimer’s?
"Alzheimer's disease is named after German neurologist Dr. Alois Alzheimer. In 1906 he autopsied the brain of a woman who had died after years of progressive dementia. Her brain tissue showed abnormal clumps and irregular knots of brain cells. Today, these clumps (now called plaques) and knots (now called tangles) are considered hallmarks of Alzheimer's disease."
"Alzheimer's disease is the most common form of dementia. Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. It occurs in people with Alzheimer's disease because for reasons unclear healthy brain tissue degenerates, causing a steady decline in memory and mental abilities. More than 4 million Americans have Alzheimer's, a disease that usually develops in those age 65 or older. However the disease can strike people in there 30’s and 40’s."
Although there's no cure or real way to prevent Alzheimer's, researchers have made progress in the last 5 or years. Treatments are available that help improve the quality of life for people with Alzheimer's. More drugs are being studied, and scientists have discovered several genes associated with Alzheimer’s, which may lead to new treatments to block progression of this disease.
Signs and Symptoms
We all have occasional lapses in memory. It's even quite normal to forget the names of people whom you rarely see. But it's not a normal part of aging to forget the names of familiar people and objects or places. Alzheimer's disease is a progressive or degenerative brain disease that goes beyond simple forgetfulness. It may start with slight memory loss and confusion, but it eventually leads to severe, irreversible mental impairment that destroys a person's ability to remember, reason, learn and imagine.
Most people with Alzheimer’s do share certain sign of the disease: 1.)Increasing and persistent forgetfulness. At its onset, Alzheimer's disease is marked by periods of forgetfulness, especially of recent events or simple directions. But what begins as mild forgetfulness persists and increases. People with Alzheimer's may repeat things and forget conversations or appointments. They routinely misplace things, often putting them in illogical locations. They frequently forget names, and, eventually, they may forget the names of family members and everyday objects such as a comb or a watch. 2.)Difficulties with abstract thinking. People with Alzheimer's may initially have trouble balancing their checkbook, a problem that progresses to trouble understanding and recognizing numbers. 3.)Difficulty finding the right word. It may be a challenge for those with Alzheimer's to find the right words to express thoughts or even follow conversations. Eventually, reading and writing are also affected. 4.)Disorientation. People with Alzheimer's may lose a sense of time and dates. They may find themselves lost in familiar surroundings. Eventually, they may even wander from home.
5.)Loss of judgment. Solving everyday problems, such as knowing what to do if food on the stove is burning, becomes increasingly impossible. Alzheimer's is characterized by greater difficulty in doing things that require planning, decision-making and judgment. 6.)Difficulty performing familiar tasks. Once-routine tasks that require sequential steps, such as cooking, become a struggle as the disease progresses. Eventually, people with Alzheimer's may forget how to do the most basic things, like brushing their teeth.
Personality changes.
People with Alzheimer's may exhibit mood swings. They may express distrust in others, show increased stubbornness and withdraw socially. Early on, this may be a response to the frustration they feel as they notice uncontrollable changes in their memory. Depression often coexists with Alzheimer's disease. Restlessness is also a common sign. As the disease progresses, people with Alzheimer's may become anxious or aggressive and behave inappropriately.
The course the disease takes and how rapidly changes occur vary from person to person. Loved ones will notice a gradual but not a sudden change in there loved ones daily routines. As the disease progresses, symptoms become more serious and more noticeable. Enough to cause the family members to seek medical help. Many people with Alzheimer's disease realize that something is happening to their memory, which can be frightening for them. As I know it to be with my father.
Alzheimer's generally progresses from mild to moderate to severe. People with mild Alzheimer's can usually live alone and function fairly well. Persons with moderate Alzheimer's may have greater difficulty coping without supervision. People with advanced Alzheimer's generally can no longer care for themselves. Researchers have recently identified a state of memory loss called Mild Cognitive Impairment, that could potentially be known as a pre-Alzheimer's period. This memory loss falls somewhere between what's associated with normal aging and what's common in Alzheimer's disease. People with mild cognitive impairment may experience forgetfulness beyond what's typical for their age, yet they don't have the dementia of Alzheimer's. Identification of this category of memory loss can help the physicians more accurately diagnose and advise patients and family members. It can also alert patients to a greater risk of developing Alzheimer's disease.
Causes
"In people with Alzheimer's, neurons in the brain slowly die. As they die, lower levels of neurotransmitters are produced, creating signaling problems in the brain. A healthy brain has about 140 billion nerve cells called neurons. Neurons generate electrical and chemical signals that are relayed from neuron to neuron to help you think, remember and feel. Chemicals called neurotransmitters help these signals flow seamlessly between neurons.
Plaques are made up of a normally harmless protein called amyloid-beta. It's believed plaque deposits form between neurons early on in the disease process, before neurons begin to die and symptoms develop. Although the ultimate cause of neuron death in Alzheimer's isn't known, mounting evidence suggests that a form of amyloid-beta protein may be the culprit. Tangles, the internal support structure for brain neurons depends on the normal functioning of a protein called tau. In people with Alzheimer's, threads of tau protein undergo alterations that cause them to become twisted. Many researchers believe this may seriously damage neurons, causing them to die. Researchers are also studying the role genetics play in Alzheimer's. The presence of certain defective genes is known to increase a person's risk of developing Alzheimer's. Some scientists believe that a slow-developing viral infection that causes brain inflammation may also be involved in Alzheimer's."
Risk Factors
1.) "Age, Alzheimer's usually affects people older than age 65, but can, rarely, affect those younger than age 40. The average age at diagnosis is about 80. Only one to two people in 100 have Alzheimer's at age 65, but that risk increases to about one in five by age 80. By age 90 half of all people have some symptoms. Women are more likely than men to develop the disease, in part because they live longer. 2.) Heredity, your risk of developing Alzheimer's appears to be slightly higher if a first-degree relative (parent, sister or brother) has the disease. Although the genetic mechanisms of Alzheimer's among families remain largely unexplained, researchers have identified a few genetic mutations that greatly increase risk in some families. 3.) Environment, researchers are studying environmental factors to discover both possible causes and prevention of Alzheimer's. For instance, some people with Alzheimer's have deposits of aluminum in their brain. Scientists who have studied environmental sources of aluminum, everything from antiperspirants to drinking water hasn’t found a link between aluminum and Alzheimer's."
Screening and Diagnosis I read that small, undetected strokes, for example, can cause dementia by temporarily interrupting blood flow to the brain. People with Parkinson's disease, a degenerative nerve disease, also can develop dementia. Depression can sometimes cause lapses in memory. In addition, many older people are on multiple medications that may impair their ability to think clearly. However there is no known test to diagnosis Alzheimer’s. It is rather a process of elimination. Doctors look at the medical history of the patient, blood and urine tests and even spinal tests. They also look at mental status and brain scans. Doctors can accurately diagnosis up to 90% of Alzheimer’s patients doing the above.
Complications
Contrary to popular belief people do not die from Alzheimer’s disease, but from complications caused by pneumonia, infections and in some cases falls. Because Alzheimer’s patients can become disoriented they lose their way and fall, sometimes causing severe damage to the brain and other areas of the body.
Treatment
There is no treatment for Alzheimer’s disease. However there are medications that can be taken to possibly slow down the disease. Such as; 1.) "Tacrine, which can improve the mental abilities up to 30% in mild cases of known Alzheimer’s disease patients but have caused liver problems. 2.) Donepezil (Aricept). This medication also decreases mild to moderate symptoms of Alzheimer's by improving levels of neurotransmitters in the brain. Its side effects, which include nausea, diarrhea and fatigue, are usually mild and don't last long. 3.) Rivastigamine (Exelon). Like tacrine and donepezil, rivastigamine blocks the breakdown of neurotransmitters in the brain, lessening symptoms. Side effects may include nausea and vomiting. Doctors can sometimes prescribe drugs to improve behavioral symptoms that often accompany Alzheimer's, including sleeplessness, wandering, anxiety, agitation and depression."
There are several types of prevention medicines to use. 1.) "Nonsteroidal anti-inflammatory drugs, which can reduce the risk of Alzheimer's by 30 percent to 60 percent. Doctors believe brain inflammation occurs as one part in the development of Alzheimer's. Yet they were uncertain why aspirin, which is also an anti-inflammatory drug, and acetaminophen (Tylenol), which is not, had no effect. The study reinforced an earlier one that compared NSAID use in twins. That study found that a twin who used these regularly, usually for arthritis, was 10 times less likely to develop Alzheimer's than the twin who wasn't taking any. But doctors don't recommend taking them, which can cause gastrointestinal bleeding, solely to prevent Alzheimer's until more research confirms these results. 2.) Vitamin E may hold a possible protective effect against the progression of Alzheimer's. Which may help prevent brain cell damage by destroying toxic free radicals; which are byproducts of normal cell function. 3.) Estrogen in older women may be related to estrogen deficiency. Estrogen helps keep the brain healthy by boosting production of a key neurotransmitter helping prevent plaque deposits and improving blood flow to the brain. Studies show that hormone replacement therapy after menopause can reduce a woman's risk of developing Alzheimer's by 30 percent to 40 percent and 4.) Mental fitness."
Care Giving
Always try to encourage an Alzheimer’s patient to do for him or herself, and help them to remember without making them feel bad. Lots of hugs and love are the greatest assets to give the patient. You have to also be patient yourself. Use memory aides, provide structure, monitor wandering, establish nighttime rituals, communicate better, create a safe environment and encourage exercise.
Coping
Coping is one step at a time and one day at a time. There are programs out there that offer assistance with Alzheimer’s patients and their families. You need to check your phone book for places near you. There are also web sites that can help. But check them out before joining and be sure they are the right ones for you.
I hope that this review has help in some way. It certainly helped me to find out what I could about this disease and how to help my parents as well.
Until next time.
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