If there is a bogeyman of aging, it might be Alzheimer’s disease because it is an irreversible, progressive brain disorder that causes patients to lose both short-term and, eventually, long-term memories. For many people, the fear of developing Alzheimer’s disease keeps them up at night and shadows their progression to advanced age. Fear also may keep them from seeking medical advice, which is essential to having the best care if Alzheimer’s disease is present.
What is Alzheimer’s disease?
A common misperception is that Alzheimer’s disease and dementia are the same. Dementia is an umbrella term under which a number of memory loss conditions sit, including Alzheimer’s disease.
According to Courtney Martin, director of memory care and life enrichment at Masonic Homes Kentucky, 60 percent of dementia cases are Alzheimer’s disease. But not all forms of Alzheimer’s disease are the same; there are actually three subtypes, according to recent research, that impact both the progression and severity of the disease. While the exact cause of Alzheimer’s disease is unknown, researchers think that genetics, environment, and lifestyle may all play a role.
While Alzheimer’s disease is a complicated illness, what happens in the brain can be fairly easy to understand: nerve cells (neurons) begin to die as a result of plaques and tangles. Plaques are remnants of proteins (beta-amyloids) that begin to build up between neurons. You might imagine clumps of goo between neurons that prevent them from sending signals between each other.
Tangles happen inside the neurons themselves. Within a neuron, there are membranes that carry nutrients and information to different parts of the cell. A tangle is when the membrane either falls apart or twists abnormally, making it impossible for the nutrients and information to get where they need to go. Think of these membranes like a railroad track that is long and straight; a tangle would be if someone took a segment of train ties away, meaning the train wasn’t able to continue moving forward but had to stop.
While symptoms of Alzheimer’s disease can vary from person-to-person, Martin says patients may begin to have problems with word retrieval, judgment and decision-making, and spatial awareness. As the disease progresses, patients may experience a loss of details in older memories, the development of anxiety or depression, and an inability to retain new memories.
The Importance of Seeing the Doctor
Martin says most people do not see a doctor soon enough, which can be difficult for the patient, the family, and the physician. “People are reluctant to go to the doctor and tell the full scope of what they’re experiencing,” she says, “but doctors can only work with the information they are given. They need comprehensive information.”
Memory loss doesn’t automatically mean a diagnosis of Alzheimer’s disease. Martin says there are many possible causes of memory issues including vitamin deficiency, hormone levels, sleep apnea, medication side effects, and even infections. For example, urinary tract infections (UTIs) are notorious for causing memory loss and confusion in older people.
Martin says there are five popular medications right now for the management of Alzheimer’s disease: Razadyne, Aricept, Exelon, Namenda, and Namzaric. Some of these are for early- to mid-stage Alzheimer’s disease, while others are for later stages of the illness.
There are also non-pharmacological treatments for Alzheimer’s, such as validation therapy, physical exercise, and sensory stimulation, and Martin says it is best when both forms of treatment are used together.
Validation therapy is a form of communication in which caregivers do not try to bring the Alzheimer’s patient to reality. Caregivers accept the reality that the patient is experiencing. Sensory stimulation offers patients a range of auditory, visual, gustatory, and olfactory experiences to help them reconnect with the world and cope. For example, if an Alzheimer’s patient touches sand or shells, this may reconnect him/her with positive feelings associated with past beach or vacation memories.
Auditory experiences are generally a big part of therapy for Alzheimer’s patients because “music is the last memory to go,” Martin says. When Alzheimer’s patients hear music from their childhood or early adult years, it can help them make connections to memories that have been difficult to find.
Help for Caregivers
Alzheimer’s disease is a terrifying illness because it means a lack of control over the brain, which causes tremendous stress to patients. Unfortunately, Martin says patients’ families can often make the stress worse for their loved ones by asking “Do you remember this person?” or “Do you know who I am?” While it is understandable that families want their loved ones to remember, being questioned and unable to recall faces and names is profoundly upsetting to Alzheimer’s disease patients.
Martin encourages families to have “more experiences, fewer conversations” with their loved ones who have Alzheimer’s disease. This can mean taking a walk, working a puzzle together, listening to music, or eating dessert together.
BY CARRIE VITTITOE