By Gilda Morales, ANP, DC
Today’s column deals with a disease that has probably touched almost every family-Alzheimer’s disease, the most common cause of dementia in the elderly. It usually strikes females much more than males, usually after the age of 65. Even now, the exact cause for the disease is unknown, but many of the theories involve degeneration of brain cells and synapses or electrical connections.
There are several risk factors that can increase the chances of developing Alzheimer’s including increasing age, a family history of the disease, Down’s syndrome, cardiovascular disease, head trauma and especially smoking, which can increase the risk up to 4 times more than a nonsmoker.
Diagnosis is primarily based on clinical presentation and evaluation of memory, attention span, language and visual/spatial skills. One test, the Clock Test, involves evaluating the patient’s ability to draw the face of a clock and the hands pointing to a certain time. Other neurological tests that can help make a diagnosis are the “counting coins test,” which asks the patient to total a certain number of coins. There is also testing to see if a patient can recognize certain objects and tests to see if the patient can perform certain movements.
The more common signs and symptoms found in Alzheimer’s patients, usually reported by family members, include progressive memory loss, depression, loss of interest in most activities, decline in intellect, manifested by difficulty doing math calculations, and forgetting and missing multiple appointments. There can be a social withdrawal, confusion of date and time, personality change, restlessness and sleep disturbances. The patient can also become delusional, pay less attention to hygiene and be unable to function independently at home by performing activities of daily living or being unable to function in social situations. In the late stages of the diseases, the patient may become more aggressive and develop psychotic features.
Before the diagnosis of Alzheimer’s is made, your health care provider should explore other conditions as the cause for symptoms of dementia since many diseases can mimic the disease. Depression, brain tumors, hypothyroidism, drug reactions, alcoholism or other drug addictions, toxicity from liver and kidney failure and even some vitamin deficiencies should be excluded before making the diagnosis.
There are several medications available for the treatment of Alzheimer’s, but families should be aware that medications may stabilize or slow advancement of the disease, but there is currently no cure. The more commonly known medications include Aricept, Exelon, Razadyne, and Namenda, but patients should be made aware that all may carry significant side effects. Additional treatments that are not pharmacological include exercise to reduce restlessness, cognitive stimulation such as word puzzles or computer games, and music, aroma or pet therapy. Unfortunately, the prognosis for Alzheimer’s is poor, with the average survival rate for most patients is 4 to 8 years after diagnosis.