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Understanding the
Most Common Dementing Disorder
Initiative on Alzheimer's Disease and Related Disorders
INTRODUCTION
Everyone forgets things from time to time. Occasionally
misplacing keys, forgetting a name, or remembering
a birthday two weeks late is not cause for alarm. But
when memory lapses become routine and start to interfere
with a person's normal daily activities and relationships,
it may be Alzheimer's disease. Early diagnosis and
treatment cannot reverse or cure Alzheimer's disease,
but can relieve symptoms and provide a better quality
of life for those afflicted and for their caregivers.
WHAT IS ALZHEIMER'S DISEASE?
Alzheimer's disease is the most common cause of dementia
(a condition of deteriorating memory and mental functioning)
among adults age 65 and older. For unknown reasons,
some people suffer gradual deterioration of brain cells
that causes irreversible nerve damage in areas that
are vital to memory, decision-making and other mental
abilities. An estimated 4 million Americans suffer
from Alzheimer's disease.
Nearly 10 percent of all people
over age 65 and up to half of those over age 85 are
thought to have Alzheimer's disease or another dementia.
As the population
of older Americans increases, so will the number of people with Alzheimer's
disease.
WHAT ARE SYMPTOMS OF THE DISEASE?
People developing Alzheimer's disease might have trouble
remembering familiar names and faces, recent activities,
today's date or what they ate for breakfast. Family
and friends often don't notice early symptoms of Alzheimer's
disease because they begin as imperceptible behavior
and personality changes and slowly worsen. Other times,
these symptoms are dismissed as part of the normal
aging process. But Alzheimer's disease symptoms are
not normal aging.
A person in the early stages of Alzheimer's disease can continue to carry on
with regular day-to-day activities. This makes recognizing Alzheimer's disease
even more difficult. Later, the symptoms become more noticeable and begin to
interfere with the person's everyday life.
As the disease advances, it may cause drastic changes in mood and judgment
and loss of physical coordination. Ideally, the disease will be diagnosed before
these changes begin occurring. If family or friends suspect that a person has
Alzheimer's disease, they should take him or her to a physician as soon as
possible. A complete psychiatric evaluation and medical exam can determine
whether these symptoms are actually Alzheimer's disease or another disorder.
In either case, early treatment can ease the suffering. And if it is Alzheimer's
disease, early diagnosis will make it easier to cope with the disease later
on.
When someone has Alzheimer's disease, changes in otherwise
normal behavior may be symptoms of the disease. Recognizing
symptoms of Alzheimer's disease
is not always easy. However, below are some common symptoms to look for,
ranging from mild to severe.
MILD SYMPTOMS
- frequent memory lapses
- inability to perform everyday tasks
- confusion and disorientation in familiar surroundings
- noticeable personality changes (agitation, anxiety
or depression)
MODERATE SYMPTOMS
- lapses in speech
- needs help with bathing, grooming and hygiene
- inability to recognize family and friends
- disturbing behavior (aggression)
SEVERE SYMPTOMS
- slowed or incomprehensible speech
- loss of bladder/bowel control
- increased/total dependence on caregiver
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WHO IS AT RISK?
Increasing age and family history of Alzheimer's disease
are the most important risk factors associated with
the development of the disease. With few exceptions,
researchers believe Alzheimer's disease is not caused
by any single factor or gene, but by a combination
of factors acting together. Other risk factors that
increase a person's likelihood of developing Alzheimer's
disease include head injury that causes loss of consciousness,
cardiovascular disease and low educational levels.
Older women are at somewhat higher risk for Alzheimer's
disease than men.
By studying different ethnic, racial
and social groups, scientists continue to identify
risk factors and their role in Alzheimer's disease.
These findings
can help reveal origins of the disease and how it progresses, which may eventually
lead to prevention strategies and early treatment of the illness -- and someday
lead to a cure.
HOW DOES THE DOCTOR KNOW IF IT'S ALZHEIMER'S DISEASE?
The only absolute means of diagnosing Alzheimer's
disease is recognizing symptoms -- then confirming
it after death through an autopsy. Doctors have developed
other reliable means to determine if a patient has
Alzheimer's disease -- with 85 to 90 percent accuracy.
They carefully review a patient's symptoms, record
a thorough medical history and conduct a complete medical
examination. This exam might include a medical, psychiatric
and neurological evaluation, along with other tests
appropriate for diagnosing Alzheimer's disease, and
ruling out other forms of dementia that can mimic it.
The earlier and more accurate the diagnosis, the greater
chance of managing the course of the disease.
WHAT TREATMENTS ARE AVAILABLE?
Currently, there is no treatment that can stop or
cure Alzheimer's disease. Some medications may help
slow the disease and control behavioral symptoms, such
as insomnia, irritability, anxiety and depression.
Treating these symptoms can help the patient feel more
comfortable and can make caregiving easier. People
with Alzheimer's disease may not experience physical
pain that is common in other medical illnesses, but
they do require medical care and continued treatment
just the same.
Research for a cure for Alzheimer's disease continues to challenge scientists,
who persist in testing potential new treatments. In the meantime, understanding
the disease and how to care for someone with it can reduce stress for the patient
and family members. Geriatric psychiatrists, specialists in Alzheimer's disease,
are medical doctors specially trained to help Alzheimer's patients and family
members.
WHAT ARE GERIATRIC PSYCHIATRISTS AND HOW CAN THEY
HELP?
A geriatric psychiatrist's training includes additional
clinical and educational requirements beyond those
of general psychiatrists. These specialists -- often
in combination with primary care doctors and other
health professionals -- provide care for and manage
the unique needs of seniors facing illnesses such as
Alzheimer's disease, depression and anxiety. Geriatric
psychiatrists also can help family members cope with
the psychological toll of caregiving.
CARING FOR THE PATIENT
Ensuring that someone with Alzheimer's disease feels
mentally and physically secure is an important and
meaningful part of caregiving.
People with Alzheimer's disease need help minimizing confusion and maintaining
a sense of stability and comfort in their lives. Establishing a daily routine
in familiar surroundings is one way to help. It is also important to provide
nourishing meals on a regular schedule for proper nutrition and optimal health.
Keeping patients in touch with family and friends and reminding them of past
memories, current events and important dates are good mental exercises.
Safeguarding the home is important for preventing accidents. Caregivers can
remove rugs and cords that cause falls, post a list of emergency numbers near
the phone and keep alcohol and hazardous substances out of reach. Other safety
precautions include placing sharp or breakable objects out of reach, keeping
the temperature at a constant, comfortable level and guarding against electrical
hazards.
There are many ways to reassure and comfort someone with Alzheimer's disease.
One of the most important things a caregiver can do is to obtain as much information
about the disease as possible and identify community resources. Good places
to start are local support groups, information clearinghouses and Alzheimer's
care resources, which can explain what to expect throughout the illness (see
below for a list of resources).
CARING FOR THE CAREGIVER
Caring for someone with Alzheimer's disease can be
a meaningful experience. It can also be exhausting,
overwhelming and physically and emotionally draining.
Most of the caregiver's time and attention is devoted
to the Alzheimer's patient, which leaves little or
no time for caregivers to spend on themselves. As a
result, they may neglect their own needs for emotional
support and respite, or they may recognize these needs
but be unsure how or where to get help. For these reasons,
the caregiver is often called the second, or silent,
victim of Alzheimer's disease.
It is common for caregivers to experience fatigue, anxiety, irritability, anger,
depression, social withdrawal or health problems. They must learn to recognize
these symptoms and seek medical attention or emotional support to maintain
optimal health and well-being. Too much stress can be detrimental to the caregiver
and the patient, which is why it is critical to seek help early (see below
for a list of resources).
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OTHER CONSIDERATIONS
Family members can alleviate stress by planning ahead
for the financial, legal and emotional considerations
that arise as the disease progresses in an Alzheimer's
patient. Consulting an attorney or financial adviser
about such issues as future medical care, power of
attorney, a living will, assets, debts and other considerations
can help ensure that the patient's personal affairs
are organized and in place ahead of time. Whatever
the patient's financial situation, a financial adviser
can help develop a plan to assist the patient and family
in preparing for the financial complications that can
accompany a long-term illness.
WHAT RESOURCES AND SUPPORT GROUPS ARE AVAILABLE?
For more information about the support and referral
resources available, contact the following social,
community, medical and psychological organizations:
American Association for Geriatric Psychiatry
7910 Woodmont Avenue, Suite 1050
Bethesda, MD 20814
(301) 654-7850
www.aagponline.org
Alzheimer's Association
225 N. Michigan Ave., Fl. 17
Chicago, IL 60601
(800) 272-3900
www.alz.org
Alzheimer's Disease Education and Referral Center
PO Box 8250
Silver Spring, MD 20907-8250
(800) 438-4380
www.alzheimers.org
American Association of Retired Persons
Program Division
601 E Street, NW
Washington, DC 20049
(888) 687-2277
www.aarp.org
National Council on the Aging
300 D Street, SW, Suite 801
Washington, DC 20024
(202) 479-1200
www.ncoa.org
National Family Caregivers Association
10400 Connecticut Ave., # 500
Kensington, MD 20895-3944
(800) 896-3650
www.nfcacares.org
National Institute of Mental Health - Public Inquiries
6001 Executive Blvd.
Room 8184, MSC 9663
Bethesda, MD 20892-9663
(866) 615-6464 (toll-free)
www.nimh.nih.gov
National Institute on Aging
31 Center Drive, MSC 2292
Bethesda, MD 20892
(301) 496-1752
www.nih.gov/nia
National Mental Health Association
2001 N. Beauregard St., 12 Floor
Alexandria, VA 22311
(800) 969-NMHA
www.nmha.org
U.S. Department of Health and Human Services
Administration on Aging
Washington, DC 20201
(202) 619-0724
www.aoa.dhhs.gov
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