Few ailments are as heartbreaking as Alzheimer’s disease. Initially, the body remains vigorous, while the mind slowly and inexorably wastes away. Then mild disorientation and memory lapses give way to agitation, confusion, and helplessness. Eventually, what we know as the “self” disappears altogether.
What is Alzheimer's disease?
Alzheimer’s is a brain disease that affects memory, thought, language and reasoning. As brain cells are progressively destroyed, Alzheimer's becomes more and more disabling—eventually robbing you of the ability to think or speak coherently. Abnormal plaques and tangles form in the brain. Plaques are clumps of a sticky protein called beta-amyloid, which builds up on neurones (nerve cells). Scientists believe that beta-amyloid releases free radicals, which attack the neurones. Tangles occur when protein threads that normally support the neurones become twisted, damaging the neurones.
Alzheimer’s disease can’t be cured and its symptoms can’t be reversed.
Who is at risk for Alzheimer's disease?
Age and heredity are the major known risk factors. You’re at higher risk if you’re over 65 and your risk rises for each successive decade of life. Your risk is also higher if you have a close relative with Alzheimer’s. More women than men are affected, but this may simply be because women tend to live longer. A recent study showed that people who come from large families (five or more siblings) are at increased risk for Alzheimer's disease. Serious head injury, resulting in loss of consciousness, may also put you at risk, as does low educational level and a habitually low level of physical activity.
Treatment for Alzheimer's disease
Doctors and psychologists can diagnose Alzheimer’s disease with 80% to 90% certainty at an earlier stage, when people are most likely to benefit from drugs, counseling, and a broad range of therapies. While none cure Alzheimer’s, these treatments can delay the disease’s progression. Most patients are advised to start on medication. Benefits may be modest, but drugs can temporarily reverse or stabilize progression of the illness, easing the burden on caregivers. Counseling and other lifestyle therapies can boost mood and enhance daily living skills.
Medications for Alzheimer's disease
The four Alzheimer’s drugs currently available are called cholinesterase inhibitors and slow the breakdown of a memory-enhancing brain chemical called acetylcholine. Medications should be started as soon as possible, because they are most effective in the earlier stages of the illness.
Like all Alzheimer’s drugs, donepezil (Aricept) and rivastigmine (Exelon) have only limited benefits for those with mild to moderate disease, but they may offer some aid for more advanced disease. Exelon may be the drug of choice for those with rapid progression of symptoms. Extracted from daffodil bulbs, galantamine (Reminyl) has effects similar to Aricept and Exelon. One promising study indicates that this drug may have sustained effects that accumulate over time. These newer medications are generally preferred over tacrine (Cognex), the first Alzheimer’s drug to become available. At high doses, tacrine can damage the liver.
Keep a notebook. Include in it important information, like the names and birthdays of grandchildren.
Exercise. A supervised walk several times a day can be calming and reduce the likelihood of wandering. One study showed it may also improve communication.
Limit caffeine. Avoid coffee, tea, colas, and other caffeine-containing products (including some OTC medications). They can cause jitters or sleeplessness.
Related Procedures for Alzheimer's Disease
Psychotherapy can help Alzheimer’s patients come to terms with what they are experiencing and aid them in coping with depression and anxiety. They may also benefit from occupational therapy, which provides tips and cues for remembering daily living skills like getting dressed and staying clean. Physical therapy helps Alzheimer's patients stay mobile, and speech therapy improves communication.
Non-drug treatments include massage, aromatherapy (the use of essential oils to affect mood), music therapy and pet therapy.
Alternative therapies for Alzheimer's disease
Ginkgo biloba, derived from an ancient Chinese tree, may improve memory slightly by boosting blood flow to the brain and has few side effects, but may cause clotting problems and internal bleeding. Like vitamins C and E, the herb may also have antioxidant properties that protect brain cells. Long used in traditional Chinese medicine, the moss extract huperzine A is a cholinesterase inhibitor, similar to prescription drugs, and it appears to be as potent. However, combining this herb with a prescription drug could be risky. A potential drug overdose is possible.
Questions for your doctor
- • Could it be something other than Alzheimer’s? Could prescription medicines be causing these symptoms?
- • Would it help to enter a clinical trial that’s testing new drugs and treatments?
- • Does Alzheimer’s shorten a normal life span?
- • Are there ways to avoid becoming a burden to others?
- • What planning should be done for the later stages of Alzheimer's disease?
Living with Alzheimer's disease
Living with someone who has Alzheimer's Disease can be difficult. Here are a few ways of simplifying things:
• Simplify surroundings. Excessive distractions can be stressful. Create soothing routines. And limit choices, such as what to eat or wear.
• Redirect attention. Don’t argue if an Alzheimer’s patient becomes irrational or upset. Share a chore, like folding napkins, or have a snack.
• Install gates and safety locks. They can prevent wandering and limit hazards.
• Talk. Touch. Watch old home movies. These activities are comforting for many people with Alzheimer’s.
• Communicate clearly. Some people get confused because they don’t recognize emotions. So be calm. Use short statements, and offer visual and verbal clues, varying your tone of voice and expressions.
Adapted from Looking After Your Body: An Owner's Guide to Successful Aging, Reader's Digest; Know Yo