Alzheimer’s Disease
This week we’re going to dive into a topic that is pervasive throughout elder care and aging - Alzheimer’s Disease (AD). Dementia or cognitive impairment is often thought to be synonymous with AD, but dementia is an umbrella term which includes many types of cognitive processing problems of which AD is the most common. Read more about the general idea of dementia here.
AD is a progressive, terminal disease that affects memory, planning, reasoning, and finally our ability to function and live. There are many contributors to the development of AD, but the actual underlying cause at this time is unknown. Some brain related changes have been observed, including the formation of “plaques and tangles,” which disrupt our brain cell function, along with abnormal brain cell degradation are involved in the development, but the most critical factor is our age. As our age increases so does our chance of developing the brain changes and symptoms consistent with AD. There are some genetic factors that increase the risk of developing AD too, and the disease manifests much earlier than it typically would if a person has these genetic changes, usually between 30s and early 60s.
Alzheimer’s usually first shows signs through memory loss, and it is typically mild. Short term memory is affected, so having trouble at check-out lines, forgetting to pay bills, and getting lost are all common issues early on. The important thing that distinguishes dementia from normal changes of aging is that it affects our day to day life in ways that normal aging changes do not. For example, if a person was able to stay on top of their bills their whole life, or do their own grocery shopping and then starts having trouble with these activities is when the concern for dementia is raised. On the other hand, if a person never was responsible for household bills, and then all of a sudden a spouse or partner dies and that person is now in charge of these activities but is having trouble - that is not in line with dementia. As AD progresses so does the memory loss along with other cognitive processes. Hallucinations and delusions may become apparent. Apathy sets in. Finally a person becomes bedbound and stops eating and drinking which leads to death.
There is no cure for AD, but there are a few treatments, the most important being remaining physically, cognitively, and socially active. There is a medication that may slow progression, but it has not been studied long term, only over the course of six months after diagnosis with mild AD. Important actions to take, even if a person hasn’t been diagnosed with AD, are to appoint a power of attorney and make advance care plans. These steps help a person explore what is important in their life and adds to the quality of life experienced. I usually recommend routine based exercise (physical activity) like Tai Chi or Yoga because these activities are usually group oriented (social activity), require the use of many different brain functions (cognitive activity), and result in the release of endorphins which just make a person feel good!
Key Points:
Alzheimer’s Disease (AD) is the leading cause of dementia and is progressive and fatal
There is no cure, but treatments include medication, physical/social/cognitive activity
Make advance care plans and communicate What Matters in your life
