New Blood Tests May Help With Early Detection
Among the most exciting news in the Alzheimer’s field is the development of simple blood tests to detect the disease, reducing the need for an expensive brain scan or invasive spinal tap. The new tests also potentially make it possible to detect the changes in the brain before symptoms appear.
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One test, called the PrecivityAD, is already available in most of the U.S. It went on the market in late 2020, after being approved under the federal government’s general rules for commercial labs, but it does not yet have authorization from the Food and Drug Administration . The test detects the presence of beta-amyloid plaques in the brain and is meant to be used by health providers who are evaluating people 60 and older who have cognitive or memory problems.
Several other tests are also close to market, Weiner says. He predicts that a variety of tests to help diagnose Alzheimer’s will be available to patients in the next few years.
Early detection of Alzheimer’s is key because the brain may start changing as early as 20 years before symptoms appear, says Rudolph Tanzi, a neuroscientist at Harvard Medical School and codirector of the McCance Center for Brain Health at Massachusetts General Hospital.
Sleep Problems Or Disturbed Sleep
Getting a good nights rest is essential for protecting the brain as you age, Ellison says. Sleep gives our brain time to learn, store memories and filter out toxic substances. If your sleep-wake cycle is disturbed or you have insomnia, you may experience dementia-like symptoms such as trouble focusing, confusion, mental fatigue and irritability.
Studies have shown that insomnia affects 30 to 48 percent of older people. If you are struggling to get shut-eye, experts recommend limiting or eliminating daytime naps, restricting the use of alcohol and caffeine in the evening, and following a consistent sleep schedule and other good sleep hygiene habits. If those remedies dont work, cognitive behavioral therapy can help. Ellison cautions against the use of sleep medications except in the very short term and under a doctors guidance.
Some older adults also suffer from sleep apnea, a sleep-related breathing problem that can deprive your brain of the oxygen it needs while you slumber, possibly causing long-term damage. Many patients dont realize they have the condition, Ellison says. Inform your doctor if you have signs of apnea, such as loud snoring, waking up gasping or choking, uncontrolled high blood pressure, a morning headache or a dry mouth upon waking.
If you are diagnosed with sleep apnea, using a continuous positive airway pressure machine while you snooze has been shown to be an effective treatment, Ellison says.
Medicare Coverage For Alzheimers
Medicare covers a variety of Alzheimers care services, including inpatient treatments and hospital stays, doctors visits, testing and care planning services. And while Medicare may cover care services for multiple forms of dementia, this blog will focus only on Alzheimers care specifically.
Alzheimers affects each person differently. Because of this, the type of care and assistance needed may change over time, depending on the stage of the disease they are in.
The Alzheimers Association defines three general stages of Alzheimers:
- Early-stage Alzheimers
- Late-stage Alzheimers
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What Problems Could Happen
Change in behavior Your patient may lose interest in things they once enjoyed. They may be irritable and have very high and low moods. They may show sexual behavior that is upsetting to others.,Loss of memory Getting lost in familiar places happens often. So does forgetting common recipes. Your patient may miss meetings or leave the stove on. They may lose their keys or glasses.,Loss of ability to function Your patient may have trouble with bill paying or other household chores. Shopping or other things in a normal daily routine may be unfamiliar.,Loss of ability to communicate They may have problems finding the right word. This may progress to not being able to express needs. The patient may not be able to understand directions or instructions.,Harm towards others and self This is often not planned but may be a problem. It may be a result of changes in balance or depth perception. A decline in skills or how to stay safe can also cause injury.,Injuries and illnesses Lung infections or bedsores may happen because of limited activity or a drop in function.
Additional Resources For Medicare Beneficiaries With Alzheimers
It is common for those suffering from Alzheimers to experience depression, anxiety, and/or frustration, especially as the disease progresses. Its important that your care or care for a loved one is handled properly. It is also important that if you are a caregiver, that you take care of yourself and have access to all the resources you need.
If you need more generalized information and support, the Alzheimers Association is a great place to start. You may also have access to community-level or state-level organizations that may be able to help.
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Signs Of Dementia Where To Find Help
When your loved one is displaying troubling symptoms, a trip to a primary care physician is often the first step. But to get a definitive diagnosis, youll need to see a specialist such as a neurologist, geriatrician or geriatric psychiatrist.
If you cant find one, the National Institute on Aging recommends contacting the neurology department of a nearby medical school. Some hospitals also have clinics that focus on dementia.
Ailments can mimic dementia
Vitamin deficiencies
Specialists will want to know about the patients personal and family medical history. A close relative or relatives having had Alzheimers is a major risk factor.
Recent research suggests that a prevalence among even members of your extended family can increase your dementia risk. Doctors also will conduct physical and neurological exams to rule out other treatable causes for dementia symptoms.
Some of the methods that doctors use to diagnose dementia:
Cognitive and neuropsychological tests assess language and math skills, memory, problem-solving and other types of mental functioning.
Lab tests of blood and other fluids, including checking levels of various chemicals, hormones and vitamins, can help rule out nondementia causes for the symptoms.
Brain scans such as CT, MRI or PET imaging can spot changes in brain structure and function. These tests also can identify strokes, tumors and other problems that can cause dementia.
More on Dementia
I Know What The Letter K Looks Like But I Cant Remember How To Draw It
Courtesy Dan Miller
Daniel Miller, 59, Charleston, West Virginia
For Dan Miller, the first thing to go was his typing. The 59-year-old retired procurement analyst and grandfather of two also had difficulty remembering names.
I also started having trouble putting on my clothes, backwards, the West Virginia resident remembers. He wondered if it was late-onset dyslexia. And I was told there is no such thing.
At first, Millers primary care physician dismissed his symptoms as age-appropriate, maybe arthritis, he says. But that all changed when he brought up his handwriting.
Finally, I told the doctor, You dont understand. I know what the letter K looks like. I know it when I see it. But I cant remember how to draw it,he says.
Thats when his doctor sent him to a specialist who ordered an MRI . Miller says it took over two years, maybe as as three years, just to get a diagnosis. Like Jobes, it was PCA.
My wife has to drive, because the day I got diagnosed they also told me to stop driving, he says. Thats a major part of independence that Ive kind of lost now.
Since his retirement, Miller has focused on his recovery. He believes its important to advocate for yourself to get the best care possible, including access to potential treatments and clinical trials. And to anyone who may be putting off that doctors visit, he says, Be a little assertive, and make sure you explain everything with as much detail as you can.
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I Showed Up At The Wrong Airport
Courtesy Bart Brammer
Bart Brammer, 72, Old Hickory, Tennessee
I was starting to confuse my dates, my hotels, my rental cars, my airplanes, says Bart Brammer, 72, a former corporate trainer who had a 30-year career in automotive manufacturing.
His travel-heavy work schedule had him visiting three locations in a typical week. I showed up at the wrong airport. I showed up at the wrong training site. I showed up a day early, he remembers.
But he didnt go to the doctor. He thought his issues were caused by stress, his busy schedule or working too hard.
It wasnt until he had a stroke at age 70 that things changed. While he was in recovery, managing a stutter and memory loss, his doctor ordered a PET scan. The imaging test revealed that he had early-stage Alzheimers, and dementia was setting in.
Though planning for this quick absence of mind has been difficult, Brammer says, whats even more challenging is not being able to plan for the future. If someone asks what hes doing on July 4th not this year, but next he doesnt have an answer. I cant think that far ahead because of the fear I may not be around. And theres no way of knowing, he says.
Brammer kept his diagnosis a secret for six months, mostly because he was so worried about the stigma. Some people with Alzheimers are living in absolute fear, he says. Theyve just pretty much crawled inside their shell and said, OK, thats all there is. Theres no more. This is how its gonna be.
More on Dementia
Dementia Friendly Baltimore County
More than 110,000 Maryland residents live with dementia and by 2025, this number is expected to increase to 130,000. Dementia is a general term for memory changes that create challenges in daily living, organizing, planning and communication. Alzheimers is the most common disease causing dementia, although there are others.
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Medication Interactions Or Side Effects
If someone complains of memory problems, Hashmi says his first question is always, Did you recently start a new medication?
Older adults are more likely than younger people to develop cognitive impairment as a side effect of a medication, and drug toxicity is the culprit in as many as 12 percent of patients who present with suspected dementia, research shows.
Many types of prescriptions and over-the-counter drugs can affect your cognition, but the most common include those for sleep, urinary incontinence, pain, anxiety and allergies. Taking too many medications can also affect your ability to think clearly and remember things, Hashmi observes. Research from the Lown Institute shows that nearly half of older adults take five or more prescription medications.
Even a prescription youve been on for many years can trigger confusion. The reason why, Hashmi explains, is that your kidneys and liver become less effective at clearing drugs from your body as you get older, so a medication can build up in your system over time and cause problems.
Read The Detailed Findings
Misperceptions and stigma about dementia are hindering efforts to appropriately address brain-healthy behaviors among adults 40 and older, a recent AARP survey found.
The survey, which targeted both healthcare providers and adults age 40 and older in the general population, revealed that fear, confusion, and false information are clouding the truth about dementia. Significant disconnections exist not only in the perceptions of the general public, but also among health care providers.
There is a clear opportunity to inform both providers and the public about the real concerns surrounding dementia and the known lifestyle habits that can help maintain brain function as people age. Reassuring health care providers that patients do not hold as negative a view of dementia as they do was a major theme throughout the findings.
Fact Versus Perception
Numerous discrepancies exist between the realities of dementia and overall feelings about a diagnosis. Among the more startling findings is 48% of adults believe they will likely have dementia far more than will actually develop it. According to a 2007 NIA-funded epidemiological estimate, the prevalence of dementia among individuals age 71 and older was 13.9%.
Cognitive Evaluations Are a Doctors Call
Still, many are hesitant to have regular cognitive evaluations. Most adults 40 and older either do not want an annual examination or dont know if they want one .
Addressing Worry, Stigma
Methodology
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Consumer Information Use And Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.
What Medicare Coverage Options Are Available For People With Alzheimers
While Original Medicare typically cover most Alzheimers care services, other coverage options are also available, including Medicare Advantage and Medicare Part D prescription drug plans.
Medicare Special Needs Plans a special kind of Medicare Advantage plan are uniquely available to individuals with Alzheimers and other forms of dementia. These Special Needs Plans are uniquely designed for individuals with Alzheimers or dementia.
If your medications are not administered by a healthcare professional or prescribed as part of an inpatient hospital treatment, youll need to enroll in Medicare Part D or a Medicare Advantage plan if you would like additional coverage.
Medicaid, the Department of Veterans Affairs, and other state programs may also offer additional coverage options for individuals with Alzheimers or dementia.
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Responsibilities As A Dementia / Alzheimer’s Disease Caregiver
Every situation surrounding Alzheimer’s disease and other dementias is different, as are potential roles as a caregiver for someone with the disease. Some of your responsibilities may include:
- Ensuring their home is safe for them
- Offering encouragement for exercise both physical and mental
- Cooking and cleaning
- Arranging social visits with friends and family
- Planning or helping to plan their medical, legal, and financial affairs
- Examining their driving ability and intervening when no longer safe
- Providing emotional support and company
Learn more about being caregiver for someone with Alzheimer’s disease or dementia from MedLinePlus, a service of the National Library of Medicine, including additional possible responsibilities, helpful services and facilities, related issues, specifics, statistics and research, and more.
How To Understand The Difference And Why It Matters
by Kathleen Fifield, AARP, Updated June 15, 2020
Getty Images
Doctors usually rely on observation and ruling out other factors to diagnose Alzheimer’s.
En español | The terms dementia and Alzheimers have been around for more than a century, which means people have likely been mixing them up for that long, too. But knowing the difference is important. In the simplest terms, one is broader than the other. If the two were nesting dolls, Alzheimers would fit inside dementia, but not the other way around. While Alzheimers disease is the most common form of dementia , there are several other types. The second most common form, vascular dementia, has a very different cause namely, high blood pressure. Other types of dementia include alcohol-related dementia, Parkinsons dementia and frontotemporal dementia each has different causes as well. In addition, certain medical conditions can cause serious memory problems that resemble dementia.
A correct diagnosis means the right medicines, remedies and support. For example, knowing that you have Alzheimers instead of another type of dementia might lead to a prescription for a cognition-enhancing drug instead of an antidepressant. Finally, you may be eligible to participate in a clinical trial for Alzheimers if youve been specifically diagnosed with the disease.
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Aarp Study Shows Stigma Surrounding Dementia Among Healthcare Professionals And General Public
With the numerous efforts currently focused on educating the public about dementia, from clinical programs to research to podcasts , how much is stigma surrounding cognitive decline affecting public understanding?
On todays podcast, Sarah Lock, Senior Vice President for Policy for AARP, discusses just that. This year, the AARP published a report on a survey focused on how the general American population and particular subgroups perceive dementia and dementia diagnoses. The survey found that the general public and health care professionals have many misperceptions about dementia, including overestimations about their likelihood to develop dementia and the shame they might feel about a diagnosis. Describing the contrasting perceptions between clinicians and the public and the impacts of stigma on dementia policy, Lock details the ways this survey will allow the AARP to build on their existing programs about brain health to better educate the public about dementia and the ways it affects a persons life.
Guest: Sarah Lenz Lock, Senior Vice President for Policy, AARP, Executive Director of the Global Council on Brain Health
Episode Topics
1:48 – Can you share what went into making the survey and who completed them?
5:05 – What did the survey find? How do people think about their own risk?
7:14 – Can you speak about those key findings surrounding stigma and dementia?
9:43 – What do you make of the stigma’s connection to the fear of not being able to drive anymore?
Show Notes
Tips For Meeting The Unique Challenges Of Caring For Someone With Dementia Or Alzheimer’s
AARP, Updated September 16, 2021
monkeybusinessimages/Getty Images
En español | Nearly 11.2 million Americans serve as unpaid caregivers for people with Alzheimer’s disease or other forms of dementia, and 57 percent have been doing so for at least four years, according to the Alzheimer’s Association’s 2021 statistical report. These family members and friends face the normal stresses of caregiving plus other, unique challenges.
Most distressing can be having to learn how to interact with a loved one whose cognitive decline results in erratic behavior and personality changes.
In the early stages of the disease, the impairments may be relatively minor. Make the most of that time together, and encourage your loved one to join you in developing a care plan.
These steps and tips can help you adapt to your role as a care partner.
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