Seeing a loved one develop dementia can be daunting and frustrating. Perhaps they are no longer able to do the things that were once second nature to them. Maybe they start to show a change in disposition, from pleasant to agitated and paranoid.
For patients with Alzheimer’s, an irreversible neurological condition in which the death of brain cells causes memory loss and cognitive decline, symptoms can lead to significant frustration and depression. If patients don’t understand that something is wrong, recognizing that they are ill can be a long process that may involve distrust and fear. Gaining insight into the disease can help all parties involved in strengthening communication, resolving misunderstanding, and keeping patients safe.
June is Alzheimer’s and Brain Awareness month. Alzheimer’s disease, named for Dr. Alois Alzheimer who first described the disease in 1906, is the most common cause of dementia, accounting for 60-80% of dementia cases. It is the sixth-leading cause of death in the U.S., and the average Alzheimer’s patient lives four to eight years after diagnosis. An insidious and slowly progressive disease, it can be mild in its early stages, initially presenting with deficits in short-term memory. Over time, patients suffer from long-term memory loss and lose the ability to carry on a conversation and respond to their environment. Social graces are also spared until late in the disease.
There is no screening test involved with Alzheimer’s. It usually comes to clinical attention when a family member notices symptoms such as worsening memory, language difficulties, confusion, or personality changes in the patient; the most common early symptom is difficulty remembering newly learned information. The first step in clinical assessment involves conducting a mini-mental status exam (MMSE). Once dementia is suspected, routine labs are obtained to rule out reversible causes or conditions that mimic dementia, like thyroid disorders or depression. If a CT is ordered, it will show diffuse atrophy of the brain. Unfortunately, there is no cure, and current medications for Alzheimer’s are used primarily to slow the worsening of the disease and improve quality of life, but do not reverse the disease.
While Alzheimer’s disease does have a heritable component, with approximately 70% of the risk attributed to genetics, there are several modifiable risk factors. Careful treatment of hypertension, diabetes and obesity can reduce one’s risk of developing Alzheimer’s, even with a family history of the disease. There are several protective factors as well—cognitive reserve, physical activity, and diet have been associated with a lower risk of disease incidence. Today, extensive research on Alzheimer’s disease continues, with a focus on better understanding how it affects the brain so as to develop newer, more effective treatments.
Dr. Gulshan Uppal, MD
Dr. Uppal is a board-certified neurologist at Freeman NeuroSpine. If you have any questions around Alzheimer’s, migraines, or other brain health concerns, you can contact Dr. Uppal at Freeman NeuroSpine, 1905 32nd St., Joplin, MO 64804, 417-347-7200.