What Is Alzheimer’s Disease
Alzheimer’s disease damages the brain. It causes a steady loss of memory and of how well you can speak, think, and do your daily activities.
Alzheimer’s disease gets worse over time, but how quickly this happens varies. Some people lose the ability to do daily activities in the first few years. Others may do fairly well until much later in the disease.
Mild memory loss is common in people older than 60. It may not mean that you have Alzheimer’s disease. But if your memory is getting worse, see your doctor. If it is Alzheimer’s, treatment may help.
Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
Play To Their Strengths
Sometimes memory loss is so devastating that we all forget that there is a person still in there somewhere. Family members can be distraught by what’s missing and forget that there’s still a lot there within the person, and that they have strengths.
They still have long-term memory, so its up to the caregiver and/or family member to find them. It’s interesting that, medically, doctors do tests on other conditions but when it comes to memory loss, it’s often looked at like a switch: Either they got it, or they don’t. Just like everything else, there’s a progression of memory loss, and its up to the caregiver and/or family member to find out where the patient and/or loved one is, and bolster that.
Strength #1: Long-term memory & stories
Everyone has a short-term memory drawer and long-term memory drawer, and we put information in each. People with dementia and/or Alzheimers have a short-term memory drawer that has no bottom. He/she puts things in, and then they get lost. The long-term memory drawer, however, has a solid bottom. Lots of stories that are retrievable await . Encourage your patients and/or loved ones to tell you stories. You can even use photos to encourage stories. Photos are wonderful long-term memory reminders.
Strength #2: Humor & music
Strength #3: Spirituality
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Medication Management And Untreated Medical Conditions
It is possible early in the disease to manage medications with just a weekly pillbox that a family member fills and checks regularly. Another method often employed is daily calls with medication reminders. Eventually, it will be necessary for medications to be administered directly by a family member or other caregiver. Your parents health, too, needs to be monitored, as they are at risk of not following up with physicians, or being unaware of new symptoms needing medical attention.
How Do People Know They Have It
The first sign of Alzheimer disease is an ongoing pattern of forgetting things. This starts to affect a person’s daily life. He or she may forget where the grocery store is or the names of family and friends. This stage may last for some time or get worse quickly, causing more severe memory loss and forgetfulness.
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Symptoms Of Alzheimer’s Disease
In the early stages the symptoms of Alzheimer’s disease can be very subtle. However, it often begins with lapses in memory and difficulty in finding the right words for everyday objects.
Other symptoms may include:
- Persistent and frequent memory difficulties, especially of recent events
- Vagueness in everyday conversation
- Apparent loss of enthusiasm for previously enjoyed activities
- Taking longer to do routine tasks
- Forgetting well-known people or places
- Inability to process questions and instructions
- Deterioration of social skills
- Emotional unpredictability
Symptoms vary and the disease progresses at a different pace according to the individual and the areas of the brain affected. A person’s abilities may fluctuate from day to day, or even within the one day, becoming worse in times of stress, fatigue or ill-health.
Do Make Sure That The Dementia Patient Gets Enough Rest Food And Water
Fatigue, hunger and thirst may cause combativeness. Ensure that the person with dementia is well fed, hydrates enough, and gets adequate sleep and rest. In line with this, they should also have enough bathroom breaks. Research also shows that it may help to reduce loud noises as well as clutter in the space where the patient spends most of his/her time, as both loud noises and clutter tend to over-stimulate people with dementia.
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Why Does Dementia Affect Sleep
Problems with sleep are very common for people with dementia. They can include:
- sleeping during the day and being awake and restless during the night
- becoming disorientated in the dark if they wake up to use the toilet
- waking up more often and staying awake longer during the night
- getting up in the early hours and thinking its day time or time to go to work
- not being able to tell the difference between night and day.
Nobody completely understands why dementia affects sleeping patterns. For some people, it may be that their internal biological clock, which judges what time it is, becomes damaged so the person starts to feel sleepy at the wrong time of day.
There are also other parts of the brain which control whether or not we stay awake, and these may also not work properly if they become damaged.
Sometimes a person with dementia might completely reverse their normal sleep pattern, staying up all night and then sleeping all day.
It’s common for people with dementia, especially in the later stages, to spend a lot of their time sleeping
Imaging And Other Tests
- Brain imaging tests, such as a CT head scan or an MRI of the head.
- A lumbar puncture to test for certain proteins in the spinal fluid.
- An electroencephalogram, or EEG.
- Brain imaging studies, such as positron emission tomography or single photon emission tomography .
In some cases, examining the brain after death is done if the family wants to confirm that the person had Alzheimer’s disease.
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Tips For Communicating With A Person Who Has Alzheimers Disease
Have you ever tried to communicate with someone with Alzheimers disease and ended feeling awkward and frustrated? Did you get stuck without having anything to talk about? Was this a once conversant and articulate person you now have difficulty engaging?
Communicating with someone who has Alzheimers disease, though challenging, is achievable. But because the disease affects the brain in ways that make communication difficult, we need to keep in mind some guidelines to facilitate the best possible communication. Below I will address communication when you are visiting someone with dementia, and then I will address non-visit communication, such as by phone or video chat.
Social And Economic Impact
Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be US$ 818 billion, equivalent to 1.1% of global gross domestic product . The total cost as a proportion of GDP varied from 0.2% in low- and middle-income countries to 1.4% in high-income countries.
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Medicines For Memory Problems
- Cholinesterase inhibitors treat symptoms of mental decline in people who have mild to moderate Alzheimer’s disease. They include donepezil, galantamine, and rivastigmine. Donepezil can be used to help those who have severe Alzheimer’s disease.
- Memantine treats more severe symptoms of confusion and memory loss from Alzheimer’s disease.
Because these medicines work differently, they are sometimes used together .
These medicines may temporarily help improve memory and daily functioning in some people who have Alzheimer’s disease. The improvement varies from person to person. These medicines don’t prevent the disease from getting worse. But they may slow down symptoms of mental decline.
The main decision about using these usually isn’t whether to try a medicine but when to begin and stop treatment. Treatment can be started as soon as Alzheimer’s disease is diagnosed. If the medicines are effective, they are continued until the side effects outweigh the benefits or until the person no longer responds to the medicines.
Dont Ask A Person With Short
A patient and/or loved one can construe even the simplest of conversation starters as a real question, but they honestly dont know the answer to it. This can be embarrassing and can send them back into a fogthey try their best to give an answer that makes sense to them and often produce immediate physical concerns: I’m having a lot of pain, for example. A caregiver and/or family member might ask, What did you have for breakfast? and the person with memory loss doesn’t remember at all. They might say earnestly, I haven’t had anything to eat for weeks, . So these are questions to avoid because it causes fear for the person, that they have failed. But there things you can talk about
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How To Ease A Person With Dementias Stresses And Frustrations
At times the person living with dementia may display a stress or distressed reaction, which can be equally distressing for the person caring for them. There are many factors that can cause someone with dementia to become stressed, such as a particular environment, person or people, TV show, lighting, mirrors, patterns on items, a picture or even a word that may have been misunderstood.
When a person with dementia becomes frustrated, you can offer support by acknowledging what they are trying to say, as to them this is very real. Rather than trying to bring them back to our reality, enter their reality. The person may be unable to recall their short term memories from the past few years and may believe they are now back living at a time where they were much younger.
Try to establish what it is they may be trying to say and help them to say it. You can use phrases such as what do you think and how do you feel, as asking direct questions which require facts may exacerbate any stress that they are feeling.
There may be times when the best course of action is to find a distraction. You could reminisce about past good times and perhaps pull out a photo book.
How Is Alzheimers Disease Treated
Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.
Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.
Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.
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Dont Answer Questions Of Patient/loved Ones Regarding Bad Memories
People with Alzheimer’s often ask difficult questions, mostly about people who have passed away years ago. Its not helpful to remind the patient and/or loved one that a person theyre asking about has passed away. Rather than avoid the subject, you can say, He/shes not here right now, but tell me about him/her. Often the person with memory loss is looking for the sensation and security that they would have if their loved one was around.
Caregivers and/or family members should be helping patients and/or loved ones comfortable, safe, and protected. Elderly women, for example, who have had children commonly ask, Where are my babies? This question will often come up at meal time, when feeding the children was an important part of motherhood. Find a way to soothe their concern. You could say, The babies are sleeping.
As stated earlier, trying to bring a person with Alzheimer’s the present-day reality is not effective. Caregivers and/or family members should adapt to the patient and/or loved ones reality. Its ok to go anywhere in any time period in order to communicate.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 6070% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Key Biological Processes In The Brain
Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.
- The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cells activities.
- Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
- The axon is a cable-like structure at the end of the cell body opposite the dendrites and transmits messages to other neurons.
The function and survival of neurons depend on several key biological processes:
Neurons are a major player in the central nervous system, but other cell types are also key to healthy brain function. In fact, glial cells are by far the most numerous cells in the brain, outnumbering neurons by about 10 to 1. These cells, which come in various formssuch as microglia, astrocytes, and oligodendrocytessurround and support the function and healthy of neurons. For example, microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. To carry out these functions, glial cells often collaborate with blood vessels in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best.
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How Is Alzheimer’s Disease Diagnosed
Your doctor will ask about your past health and do a physical examination. He or she may ask you to do some simple things that test your memory and other mental skills. Your doctor may also check how well you can do daily tasks.
The examination usually includes blood tests to look for another cause of your problems. You may have tests such as CT scans and MRI scans, which look at your brain. By themselves, these tests can’t show for sure whether you have Alzheimer’s.
What Causes Alzheimers
The causes of Alzheimers disease are not yet fully understood, but probably include a combination of:
- Age-related changes in the brain, like shrinking, inflammation, blood vessel damage, and breakdown of energy within cells, which may harm neurons and affect other brain cells.
- Changes or differences in genes, which may be passed down by a family member. Both types of Alzheimer’s the very rare early-onset type occurring between age 30 and mid-60s, and the most common late-onset type occurring after a persons mid-60s can be related to a persons genes in some way. Many people with Down syndrome, a genetic condition, will develop Alzheimers as they age and may begin to show symptoms in their 40s.
- Health, environmental, and lifestyle factors that may play a role, such as exposure to pollutants, heart disease, stroke, high blood pressure, diabetes, and obesity.
Watch this video to see how Alzheimers disease changes the brain.
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What To Think About
An important part of treatment is finding and treating other medical problems the person may have.
- Depression occurs in nearly half of people with Alzheimer’s disease, especially those in the early stage of the disease. Helping them get treatment for depression can help them to do better with the abilities they still have.
- Hearing and vision loss, thyroid problems, kidney problems, and other conditions are common in older adults and may make Alzheimer’s worse. Treating these problems can improve quality of life and ease the burden on the caregiver.
Health Environmental And Lifestyle Factors
Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimers. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as conditions such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimers.
A nutritious diet, physical activity, social engagement, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimers. Researchers are testing some of these possibilities in clinical trials.
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