News

Understanding dementia and Alzheimer's

By Scott Wagar

11/22/2011

It might have been a blustery evening Thursday evening with the snow and wind, but the Good Samaritan Society of Bottineau’s solarium was filled to its capacity with staff, residents and visitors to listen to Jodi Keller of Minot’s Alzheimer Association speak on dementia and Alzheimer’s.
Keller presented, “Understanding Memory Loss,” a symposium with the goal of teaching individuals how to tell the difference between dementia and Alzheimer’s disease.

“Dementia in itself is not a disease process,” Keller said. “It is a group of symptoms, and the significance of that group of symptoms.”

When it comes to dementia, there is a number of disorders which cause progressive descent in any part of an individual’s nervous system, which create a collection of signs and symptoms commonly referred to as dementia.

The signs and symptoms of dementia include a decline of in or loss of memory, judgment and reasoning. 

As dementia sets in, individuals may also see a change in personality and show abnormal behavior. As the end stage of dementia becomes present, people with the disorder could possibly lose their ability to conduct common, everyday tasks like speaking and eating.

Keller stated that signs and symptoms of dementia differ from person to person, and it also depends on the individual’s genetic makeup, their lifestyle, ethnicity and their personal way of life.

There are also certain brain disorders that Keller said will cause dementia, which include Lewy body dementia, vascular dementia, frontotemporal dementia, Creutzfeldt-Jacob disease (mad cow disease), multiple sclerosis, Parkinson disease, Huntington’s disease and HIV-AIDS.

“There are many different types of dementia,” she said. “In reality, there are actually 70 different types of dementia.”

She pointed out that when it comes to vascular dementia, individuals will see narrowing and blockage of arteries in the brain, which causes strokes.

Keller made note that symptoms from this disorder can come on slowly or rapidly, and at times, be difficult to tell from dementia or Alzheimer’s disease.

Keller also stated that individuals have to be aware that depression and delirium can mimic dementia, but are not dementia. She added that by treating these illnesses through proper medical care, medical personal can then determine if people have dementia or are suffering from depression or delirium. 

In recent years, a memory loss disorder called Mild Cognitive Impairment has been discovered, and it can be a precursor to Alzheimer’s.

“There is a risk factor, but it doesn’t mean a person will be diagnosed with Alzheimer’s disease, but there is a risk factor for it,” Keller said.

In mild cognitive impairment, individuals will see memory loss that is associated between normal aging and Alzheimer’s disease. People with the disorder may encounter forgetfulness not associated with their age, and it is a trigger that can give physicians the ability to tell their patients that it could possibly lead to Alzheimer’s.   

Alzheimer’s

From dementia, Keller changed course and went into the physiology of Alzheimer’s disease.

“Alzheimer’s disease is a progressive, degenerative and neurological disease of the brain,” Keller said. “Individuals will see a steady decline in memory and intellectual functioning that’s severe enough to interfere with everyday life. It’s kind of a line in the sand and it’s not reversible.”

The causes and risk factors of Alzheimer’s disease include age, genetics, hardening of the arteries, high cholesterol, high blood pressure, heart disease, and Down syndrome.

Keller made mention that individuals who are diagnosed with diabetes later in life can be a prelude to Alzheimer’s, which can affect diabetics’ immune system, the healing process, and even organs, especially in kidney failure. 

When it comes to diagnosing Alzheimer’s, Keller stated there is no single test that can be done. Alzheimer’s disease is diagnosed through a history and physical, lab test, cognitive screening, neurological exam, and, at times, through brain imagining and psychological exams.

Keller told those in attendances that there are three stages of Alzheimer’s, which include:

• Early Stage: It can last from two to four years in duration. It’s very manageable, but individuals will see forgetfulness, have list reminding them to do everyday chores (examples would be lists telling them to shut the water off, turn the stove off, feed the cat, brush their teeth), personality changes (being crabby, defensive, angry, accused people they live with of doing bad things to them, showing up at the wrong time or place), changes in appearance (layering of clothes when it is hot or dressing down when it is cold and not being well kept or shaved), functional changes (not being able to managing their households like not getting their bills paid, not caring for their yards, doing their laundry or cooking; not eating or forgetting to stop when eating), they withdraw from society (stop going to activities and stay close to home).  
• Middle stage: It can last from two to ten years in duration. Individuals will begin to wander, they have sleep disturbances, changes in appetite, can’t stop eating, not recognizing of self or others (spouses are often referred to as mom and dad and children become their siblings), and behavioral changes like depression, paranoia, defensiveness and anger.  
• Late Stage: It can last one to three years in duration. Individuals start to see severe disorientation, time and place becoming confusing for them, their short term memory basically becomes eliminated but the long term memory stays in tact, loss of speech, difficulty walking, incontinent, family members cannot be recognized at times and survival depends on total care.

In the end stages of life, people with Alzheimer’s will normally die from pneumonia, infections, organ failure, and even by falling down and breaking their bones.

Keller noted that there are ways of sustaining the functional behavior of people with Alzheimer’s.

“Emotions do not go away and playing music is a huge way of retaining their functions. However, when you play music to patients make sure you are playing songs that they remember from the time when they were growing up. Music from barn dancers like polkas or religious music, that’s what they remember and it will assists them in their disorder. But, remember, too, that will be changing as baby boomers are diagnosed with Alzheimer’s and the type of music they listened to while growing up,” she said. “They also keep their sense of humor and their ability to read non-verbal language. They know when someone is being hurried or there is lack of respect by someone towards them.

“They also have their sense of touch, but when interacting with people with Alzheimer’s make sure you know the person. Some people like to be touched others do not. So, you have to be careful,” Keller continued to state.  “And, they keep their social graces, their thank you’s and appreciations.”

There are also medications for the disease, but Keller points out they are not cures for Alzheimer’s.

“There are medications like Aricept, Namenda, Exelon and Razadyne, which are FDA approved,” Keller said. “However, they are not, and they don’t stop the process, the drugs slow the progression.  People can sometimes live two years longer in their homes and have the ability in decision making, they have power and control.”

Individuals can also maintain the sustainability of their thought pattern by eating right, getting physical and mental activity, challenging their thought process, socializing, and by having good blood pressure, cholesterol, weight and blood sugars.

Keller also stated that even though people might have symptoms and signs of Alzheimer’s disease, it could possible be another disorder.

“The number one reason why people end up in assisted living is because their medication is mixed up. The elderly sometimes forget to take their medications, or they take too much or at the wrong time. At other times, they do not take their pills as prescribe or have side affect of medications,” Keller said. “Individuals might also have another disorder of dementia or have an infection, which causes people to become psychotic.

“Other aliments can be metabolic disorders, hypo and hyper thyroidism, dehydration, malnutrition, tumors and depression.

When it comes to Alzheimer’s, 5.3 million Americans have the disease, every 69 seconds someone is diagnose with Alzheimer’s, 13 percent (or one in eight) are 65 and older, while four to five percent have younger onset Alzheimer’s disease, which normally affects individuals that are in theirs 30’s and 40’s.

“Younger onset is very rare, and there is genetic testing that can be done to diagnose it,” Keller said.

Keller added that North Dakota statistics pointed out that between the years 2000 and 2025, North Dakotans can expect Alzheimer’s disease to triple in the state.

“This is mainly due to the large number of elderly people in the state,” she said. “And, the baby boomers will be turning 65 this year and the next year, which means they will be entering that high risk territory.

For more information on dementia and Alzheimer’s disease, contact Keller at (701) 837-0062 (phone), (701) 340-6450 (mobile), or jodi.keller@alz.org. Individuals can also go to a 24/7 Information helpline at (800) 272-3900, or the Minnesota-North Dakota Alzheimer Website at www.alz.org/mnnd.