Alzheimer's Disease

Alzheimers is a progressive disease that results in the degeneration of neurons in the brain. It is a form of dementia, a term that includes a variety of illnesses or conditions that cause dysfunctions in the brain. It can begin with what appears to be simple forgetfulness that can normally happen to any individual.

However, with someone suffering from Alzheimers it will eventually progress to the point where they lose all of their memories and abilities. It is estimated to affect somewhere between 5 to 15 percent of people 65 years and older.

This disease was first discovered in 1906 by Dr. Alois Alzheimer after performing an autopsy on a middle aged woman who suffered for several years with declining mental health. The exact cause of the disease remains unknown.

However, the characteristics of this condition include the accumulation of excess proteins in the brain that result in amyloid plaques in abnormal clusters and neurofibrillary tangles which are basically tangled bundles of fibers.

It is thought that these accumulating obstructions cause interruptions in the normal flow of chemical reactions between the brain's nerve cells. Over time, the areas that are cut off and isolated cease to function properly.

The disease generally follows the pattern of first affecting the area of the brain that deals with how new information and memories are processed. Resulting in such difficulties as some memory loss, confusion, restlessness, mood swings and trouble making decisions. As it gets worse, higher abilities such as language will be affected. Familiar faces or locations are not recognizable. Eventually the most basic functions of how to care for oneself are lost. This may be to the point that the individual may forget how to even chew and swallow their food.

Alzheimers is a difficult disease to diagnose. The family doctor will be the first one to consult. Typically the doctor will endeavor to eliminate any other of a number of conditions that may be the actual cause of an individual's dementia or symptoms thereof. Some disorders such as diabetes, thyroid disorders and anemia can be behind some of the same symptoms. These disorders would then be treated.

Additionally, some forms of dementia are the result of an illness, an injury or possibly a stroke. In many of these cases there are treatments to alleviate the illness and thus the symptoms of dementia.

The doctor may also decide to bring in a specialist consultant. Together they will continue to work to narrow down the possible causes of the patient's form of dementia.

After other possibilities have been eliminated the doctor may give a diagnosis of Alzheimer's disease. However, it is only after a person has died and an autopsy performed can there be a certainty.

Although there is at present no known cure for Alzheimers there are treatments designed to help slow its progress down, to help alleviate some of the symptoms, to help the patient cope with the challenges of the disease, and to help achieve the best quality of life as possible.

There are also a number of organizations that seek to help and give comfort to those with Alzheimers and those that are caregivers.

Doctor's Diagnosis

It is not unusual for any individual to experience absentmindedness or moments of confusion due to stress or temporary illness. If however these symptoms persist and worsen it would be well to consult a physician to discuss your concerns.

To determine if a patient has Alzheimers a doctor will first try to eliminate other possible causes of any symptoms of dementia.

Dementia is not considered a disease but is a word used to describe conditions suffered by someone that indicates a progressive problem with brain function. These symptoms can be the result of a stressful illness such as diabetes or Parkinson's. They could come about due to an accident or brain tumor. Certain medications can also produce similar side affects.

These symptoms may include such things as: an inability to concentrate and follow simple directions, chronic forgetfulness, neglecting proper hygiene, getting easily disoriented, asking the same things over and over again, and getting lost in what should be familiar surroundings.

Although a physician may readily be able to diagnose that a patient is suffering from dementia it is more difficult to pinpoint the cause.

To begin with, the physician will want to know as much as possible about when the symptoms began, how often they occur and if they have progressively worsened.

He will conduct a series of simple tests involving memory, cognitive ability and the capacity to follow a set of directions. These tests are specifically designed to test everyday skills and are not meant to be difficult.

He will also be concerned with the overall state of health of the patient. Are they aware of the problem themselves? Are they disinterested, having trouble paying attention or perhaps unusually moody?

Another area of concern will be the family medical history. This is to find out if others connected genetically to the patient have had either Alzheimers or a similar condition.

An overall physical exam will be conducted to either discover or eliminate the possibility of another disease or disorder that can cause similar symptoms. Included in this is a neurological examination that tests such aspects as reflexes, speech, balance, coordination, and eye movement.

Advancement in technology with the use of MRI's also allow the doctor to investigate more thoroughly the structure of the brain with regard to the shape and volume of brain tissue, and the function of the brain as to how active it is in using oxygen and sugar.

Though there is no current standard for clearly defining what a brain affected by Alzheimers will look like, these aspects help eliminate other problems such as tumors. Since some researchers believe that evidence of brain shrinkage and reduced brain activity in certain areas may indicate the presence of Alzheimers the results of MRI's may be valuable in a diagnosis.

However, there is yet no standard value that could be applied to each unique individual that would be conclusive as to the presence of Alzheimers. So the goal of the doctor in making a diagnosis is to start by eliminating as many other options as possible.

Who May Be At Risk for the Disease?

Since 1906 when Alzheimers was first discovered and named, researchers and scientists have tried to come to an understanding of what might be the exact cause of the disease.

As with any disease, knowing the cause enables doctors to act preventively to help those who may be at higher risk. Although the direct cause of Alzheimers is not yet understood by researchers it can be stated that the disease involves the progressive failure of brain cells.

Further studies have been made to analyze any similarities in Alzheimer patients to determine if there were factors that may have played a role in making them more vulnerable to developing the disease.

Some risk factors may be within our ability to control while others may not.

  • Old age is accepted as the greatest risk factor. Most people who acquire the disease are 65 years and older.

  • Genetics play an important role. If a person has a parent or sibling with the disease their chances of getting it will increase threefold. The identified gene that plays a role in Alzheimers is labeled 'apoliprotein E-e4'. This gene is a blueprint for one of the proteins that transmit cholesterol in the blood. Researchers believe that other genes yet to be identified may be involved. Although, this gene indicates a risk factor the number of actual cases linked to it are very few in number compared to the actual number of Alzheimers patients. The conclusion has been reached therefore, that Alzheimers most often results from a combination of non-genetic and genetic risk factors.

  • Severe head injuries are another common link found in Alzheimers patients.

  • Health problems that may affect a healthy blood flow to the brain make another serious risk factor. The brain is nourished with an extensive network of blood vessels. It will use nearly a quarter of the blood that is pumped by the heart. Heart diseases, diabetes, high cholesterol or blood pressure are among some the issues that can contribute to the risk of Alzheimers.

  • Excessive alcohol drinking and smoking combined with poor nutrition can deteriorate overall health and therefore contribute to a breakdown in brain activity and health.

  • Lack of proper physical exercise to keep blood and oxygen flow healthy can be a risk factor.

  • Lack of sufficient mental and social activity that normally works to stimulate the brain cells and the neuron connections and thus encourage atrophy.

The evidence to date shows that though genetics may place a person at higher risk, the way a person lives plays a pivotal role. This gives hope that there is a great deal within one's control. With care and effort in living a healthy lifestyle one may be able to avoid succumbing to this disease.

Aluminum: Is It involved?

Another question that has been raised with regard to factors that may play a role in causing Alzheimers is the possible absorption of excessive amounts of aluminum into the body.

The issue began as scientists in the early l960's observed that the brains of rabbits exposed to aluminum exhibited a pathology similar to that of Alzheimers disease. It was also noted that some patients that had to undergo long term dialysis developed a build up of aluminum in their blood that caused a type of dementia. The concern continued to grow as more and more aluminum found its way into everyday items in the form of cooking utensils, antiperspirant, antacids and drinking cans to name a few.

Throughout the years there have been studies that seem to make a link between Alzheimers and aluminum as well as studies that work to disprove any substantial connection at all.

These studies show on the one hand that while some people with Alzheimers have shown increased levels of aluminum in their system others have not.

It is accepted that aluminum is a toxic substance that is harmful to the body's nervous system. However, because aluminum is one of the most common elements found on earth it makes linking it specifically to this disease more difficult. Added to this is the fact that the type of dementia that has been linked to increased levels of aluminum differs in its pathology to that of Alzheimers.

In view of the fact that a direct correlation between aluminum and Alzheimers has yet to be established in laboratory studies some major health organizations have taken the stance that based on current knowledge, the type of natural exposure that the average person may experience in daily life will play no significant role in developing Alzheimers.

Though research continues in this field, scientists have broadened their approach in the search for what, if anything, may be an environmental cause of this disease. While it may not yet be known if there is any direct link, common sense teaches us to be watchful nonetheless. Ultimately, it still remains with each individual to focus on areas that have proven to have a positive impact on their health. These areas include as always such important aspects as:

  • Avoiding negative things as smoking and excessive alcohol
  • The pursuit of good nutrition and healthy exercise
  • The need to stay active intellectually
  • To have good social and emotional interaction with others
  • In the war against Alzheimers, taking a long term proactive stance is vital in our defense.

    Recognizing Some of the Signs

    As people get older it is natural to expect that some of their abilities will change. However, each individual's abilities and health are different. Instead of simply accepting that matters must decline rapidly with age, medical researchers encourage people to try and cultivate and maintain a positive outlook. With thoughtful effort the quality of one's life even in older age can be enjoyable.

    Nonetheless, if it becomes apparent that there is a change that is beginning to affect the quality of life how can an individual know if it is something that is just a normal tendency of aging or a sign of a serious illness such as Alzheimers?

    Some of the defining aspects are as follows:

    • Memory loss that goes beyond the forgetfulness of someone's name that they may not see regularly or the recalling of some minor event, or missing an appointment. People who are battling Alzheimers will have trouble retaining recently learned information. They may forget major events, and seem to block out people that should be familiar to their environment.

    • Having a growing difficulty with language or numbers. It will go beyond the occasional search for a certain word and develop into the loss of common words such as “chair” for example. Or the need to replace one word for another such as “food” instead of “drink”. The ability to communicate with others will greatly diminish.

    • People suffering from Alzheimers will begin to have difficulty handling very simple routines such as getting dressed or preparing a meal.

    • They will be easily disoriented and in neighborhoods and routes that should be familiar to them. They also begin to lose track of time.

    • They begin to have trouble making simple judgment calls as simple as what to wear on a colder day.

    • Due to the confusion and pressures from increasing dementia an Alzheimer victim will feel understandably frustrated, angry, and afraid. This will escalate into dramatic mood swings and ultimately a possible change in their basic personality.

    • The challenges that face some patients becomes too much and they eventually seek to withdraw from any normal activity. They may show increasing indifference to their surroundings or circumstances.

    If an individual begins to exhibit some of these signs it is important to contact their doctor as soon as possible. Whether or not it is a temporary condition brought on by a period of stress or other disease, or if it is Alzheimers, the key to battling it with any success is to get it diagnosed early on and get to receiving the necessary help and best care to slow its progress.

    Alternative Treatments

    The scientific world is still on the hunt for a cure to the dreadful disease known as Alzheimers. From time to time there is news that a new drug seems to have some effect on the symptoms of Alzheimers. While it is encouraging to hear that some of these forms of treatment can help improve an individual's memory or alleviate some other symptoms there are patients that choose to pursue alternative treatments separately or in conjunction with traditional medicine. They believe that this will ameliorate their chances of getting better.

    One of the primary areas that alternative treatments focus on is that of stress. Understandably, living with Alzheimers can arouse many negative emotions for the patient. When the person realizes that they may slowly be losing control of their lives and their senses they may feel anger and great anxiety. This disease reaches to the very core of how we define ourselves and destroys it. In order to face this disease head on and take practical measures to adjust - the individual may first need someone to express themselves to. This may be too emotional a subject to share with the ones that are closest. For this reason it is suggested that some counseling with a professional therapist would be beneficial in allowing the patient to work out their feelings and try to find the path to a positive approach.

    This focus of dealing with the issue of stress is meant to help the mind and body of the individual suffering from Alzheimers to relax. This can improve vital aspects of the healing process such as circulation. With the body's natural healing energies stimulated it is hoped that some of the symptoms of Alzheimers are alleviated. In line with this some people have pursued music therapy and aromatherapy.

    Other alternative treatments include acupuncture and acupressure. These as well work to relieve the mind and body of stress and stimulate natural healing properties inherent in all of us. There has been some preliminary evidence that acupuncture helps slow the deterioration of certain brain functions.

    Of course much of alternative medicine includes the use of herbal remedies and nutritional supplements. Some of the more highly touted ones include that of Ginkgo Biloba, Coenzyme Q10, Huperzine A and Coral Calcium. It must be noted however, that because these treatments are often outside of the jurisdiction of the Food and Drug Administration there is not a large body of scientific research to verify their effectiveness. As well, it may difficult to research the quality of the products used as once again many of these are not officially regulated as to purity and potency. Nonetheless, many personal testimonials have proved to be very encouraging.

    Whether one chooses to work with traditional medicine or alternative methods, or perhaps combine the two it is vital to have open communication with your personal doctor so as to coordinate your treatments safely. If you choose to focus mainly on alternative medicine it is wise to choose a respected health care professional with legitimate credentials. Without a doubt, the challenge presented by this debilitating disease will deserve the best possible resources and personnel at our disposal.

    Preventative Measures

    Alzheimers is a disease that is characterized in the brain by the evidence of tangled fibers and protein clumps. It appears to generally affect people who are older and thus for a long time was lumped together with other more common forms of dementia or senility.

    After the discovery of Alzheimers and the subsequent realization that there was no immediate cure - the next imperative question was whether or not it was possible to prevent the disease from starting in the first place.

    To determine whether or not it was preventable it needed to be determined how high the risk factor was if genetics played a role. To date, the best information has come from the study of identical twins with the same genes but who have lived life in different fashions. The results demonstrated that while one may develop the disease the other while at obviously greater risk didn't necessarily get it. In other cases, while both twins got Alzheimers it was not to the same degree. This showed that other factors played a role besides any genetic influence. This opened the possibility that there were factors that could be focused on and altered that would lower the risk of getting the disease.

    One connection that is noted is the link between those that have suffered a severe head trauma and the existence of Alzheimers. It is a disease that attacks the nerve cells in the brain. Any severe head injury could logically open up the brain to this vulnerability. Thus a very practical measure is to protect the brain by safety measures such as wear a helmet when bicycling, skate-boarding or indulging in any high risk activity.

    Another facet of working to prevent this disease is to keep the brain stimulated. By challenging ourselves to learn new things, perhaps the playing of a musical instrument, learning a new language or activity, doing crossword puzzles, playing numerical games, or just reading and researching subjects outside our normal environment we encourage the growth of neural pathways and thus work at keeping our brain growing and healthy. Vital stimulation can also come from staying socially active and involved in talking with and caring for others. Besides encouraging good mental health this can go a long way to promoting emotional health and this is important in fighting any disease.

    Given the nature of this particular disease it seems logical that the best preventative measures that we can take involve living a productive and active life. We do well to underscore this with good choices in what we eat and by keeping our body physically active. This will keep our body's healing mechanism at it's optimum and go a long way in preventing the development of Alzheimers.

    Care For People With Late Stages of Alzheimers

    Alzheimers is a horrible disease in that it robs one of everything that defines them. In disrupting the healthy activity of the brain it takes away one's memories and the brain's ability to communicate with the rest of the body so that normal functions begin to inevitably shut down. Unfortunately, someone who is suffering from the final stages of Alzheimers is going to need round the clock care.

    If you are the primary caregiver to someone with Alzheimers you will eventually need to look into what type of care facilities are available. It will become a profound challenge to address this emotional situation in the most practical yet caring way possible.

    It will help to begin by visualizing what it would be like to be in the place of someone facing the diagnosis of Alzheimers. By understanding the fear, frustration and anger at knowing how dramatically one's life is going to change we can come to appreciate how much we would need the patience and understanding of others. So we can start by giving our assurance that, no matter what, we will be there to support them and see that they get good care. Honest communication, and letting them have a say in how their treatment and care will proceed will be vital.

    It may be that by initially choosing to live in a home with assisted care such as retirement housing or by utilizing in home care services that someone suffering from the onset of Alzheimers can continue in a reasonably normal environment. At times, having a 'normal' environment can relieve some of the growing anxiety that is associated with the disease. However, as the disease progresses, independent care agencies will no longer be sufficient. Caring for someone in this situation at home will require other personnel. If that is not possible then the remaining option will mean a nursing home. Though this is a very difficult decision to make, it will ultimately mean the best in terms of keeping someone with Alzheimers safe. There are more and more facilities that have developed specialized programs to treat people with dementia. These licensed homes are required to have regular inspections and thus use professionals that can administer the proper medications and tactfully handle the ensuing loss of dignity this disease inflicts.

    Another form of care is available with a hospice. It is an option when any patient is facing a terminal illness. Hospice workers are typically some of the most thoughtful and caring individuals who are specifically chosen to deal with one of the trying and difficult times of an illness.

    Perhaps most importantly, the decisions about the type of care that may be needed, the options available and the reliability of these options as well as the costs involved are best made earlier on when both caregiver and patient can make the most thoughtful decisions possible. It may not be easy to plan these matters but it will be better than waiting till a time when one's resources are exhausted and emotions are distraught.

    There is no easy way to deal with this matter. But honest forethought can help prevent some difficult and emotional issues later on. And always remember that there are some excellent services available that offer counseling and support in making the best decisions for your loved one.

    Caring for Someone with Alzheimers

    In many cases when someone is diagnosed with a serious disease those closest to them may decide to personally care for them at home. This may not always be possible, and there are certainly some fine institutions that exist to help in extreme situations, but for the most part it is understood that the kind of care that can be given by someone who loves the patient can be of a quality that adds to the dignity, comfort and overall feeling of security for the patient.

    This is not an easy path to take and will require good communication amongst everyone involved. You will need planning, extra help, and an awareness of what is available to you in the way of community services.

    In the case of individuals suffering from Alzheimers there are some basic approaches that can help ensure that the quality of their lives is preserved to the best extent possible. Alzheimers can progress at different rates. It may be that your loved one has many good days. If so, it is good to plan to make the most of these times by arranging to participate in activities that have always been of interest to them. Do they enjoy going for walks in the park? Going to Museums, or on a picnic? Some people find sitting near the water restful and rejuvenating. Others like to be where there is a little bit of socializing and action going on, like at a mall or a local fair. Or perhaps family visits and meals. By arranging an activity that has always been a source of pleasure it will help to keep your loved one involved and may help stimulate to some degree their mental abilities. At the very least it will contribute to their sense of self-esteem and dignity and thus contribute to their overall health.

    With the progress of Alzheimers comes the increasing difficulty to express clearly one's thoughts and desires. The caregiver will need to take a calm and patient approach while keeping their tone light. It has been suggested that using shorter sentences that perhaps contain one simple idea at a time will lessen the possibility of added confusion. Give thoughtful, kind eye contact and allow sufficient time for them to complete their thoughts.

    Another area to given attention to is providing a home environment that will ensure the safety of someone who may at times be unaware of certain hazards. This may mean locking securely certain substances such as cleaning solutions, painting products or any chemicals that would be harmful if ingested. In fact, it would be good to find a system of monitoring any medication that the patient may need to take in case they have a bad day and forget their prescribed dose.

    The home may need to be prepared to allow for protected movement. For example, staircases may need a small gate to prevent falling, area rugs may need to be taped down to prevent slipping, furniture may need to be moved or removed to allow a greater freedom of movement. Especially if a wheelchair is needed at some point. As well, it is good to install solid grab bars in the washroom. It may be advisable to install a shower chair or invest in a tub that allows the person to enter through a small door that later closes and seals securely against water leakage. This will help eliminate some of the chances of your loved one falling and seriously hurting themselves.

    As noted before, the caring of someone with Alzheimers will be a challenge. But caring for the person you love as they go through this difficult time and seeing that they have a measure of dignity and a sense of security is something that has it's own deep rewards.

    Vital Ideas to help the Caregiver

    In many cases the primary caregivers are family members who are close to the patient. Whether the individual with Alzheimers is an older parent or the wife or husband it will become increasingly apparent that there are changes taking place that make the dependency of the patient new emotional ground to navigate. Understanding and preparing for this issue will help everyone concerned to learn to cope with the times that frustration, confusion or even anger make an appearance.

    It is essential in matters of long term care that practical issues take the forefront. This will provide a mechanism for coping with the highly emotional aspect of a long term illness. So it follows that one of the groundworks for long term care will be establishing a solid routine for the patient. Regular meal times, bath times, times for medication and times for other enjoyable activities help both the patient and caregiver to move forward. Creating a calm, clean and if need be quiet environment as well can help the Alzheimers patient focus a little better and encourages cooperation. As well, when it becomes obvious that some tasks are becoming difficult to perform, for example, tying one's shoes - the caregiver can look for a solution and substitute perhaps some slip-ons. Even issues such as having comfortable clothes can sometimes help ease a situation.

    As much as possible the caregiver will want to project a positive and cheerful attitude. Often, as this disease progresses, the patient will become frustrated with their inability to perform even simple tasks. Everyone is benefited if the patient is given the secure feeling that there is no pressure or rush. That they are in a safe environment and will be treated with care and dignity. Though some patients may not be aware of what their behavior is incurring they may certainly pick up on hearing negative remarks and understand that they are causing problems. This will only add to their anger and frustration at having failed in some way. So if a caregiver needs to let out some of their frustration it is best to seek out good friends and perhaps people in similar situations that can really understand and give them the emotional and practical support they need.

    It is vitally important that whoever is the primary caregiver take a break when they start to feel that matters are taking a toll on their emotional or physical health. This will require finding suitable people who are able to step in from time to time and allow the caregiver to step away for a while. As well, it is suggested that searching out local support groups (and there are increasingly more of them) will help the caregiver to give voice to the frustrations and anger in an environment where others truly understand what they are going through.

    Another source of support and help will be the family doctor. By making the physician aware of the particular circumstances you are facing he or she will be in a better position to monitor your health and possible direct you to other avenues of support.

    Ultimately there can be no hard and fast rules that apply to everybody. And it is good to keep that in mind. Everyone's circumstances will vary. It is a loving gesture to be ready to care for someone who has a long term illness. Hopefully, with insight, care and planning the caregiver will find the best way to cope with their unique circumstance.