Serene Karplus, Nederland. The Center for Disease Control and Prevention reported recently that the number of people dying from Alzheimer’s disease in the U.S. has increased 55% over the past 15 years. We don’t know that it occurs at any higher percentage than before, as the statistics may reflect the increased numbers in the aging population, greater longevity, improved diagnoses, and an increased willingness among doctors to identify Alzheimer’s as a cause of death.
This disease is an incurable neurodegenerative condition which results in the loss of critical brain function. It is not an inevitable process of aging. So, why the stigma? When our friends battle cancer or Parkinson’s, we cheer them on and rally support around them. We recognize that these are physical ailments that western medicine tries to relieve or cure and we raise our hopes that our friend will land on the success side of the statistical odds. We can provide the same support for friends living with this disease, as they may struggle with it for a long time and research regarding treatments may improve.
In order to ensure that symptoms that may resemble this disease are not caused by something more easily remedied, we consider our sleep patterns, our diet/water intake, our cardiovascular exercise, our home or work environments, vitamins/medications and any changes they’ve incurred in brand name or dosage. Instead of developing dementia, we may simply be incurring a toxicity issue with a specific chemical we ingest or breathe, or not circulating enough blood/oxygen to the brain, or battling a different curable ailment.
When all the “easy” solutions are addressed, we turn to a neurologist, or if older folks can find one, a gerontologist. Doctors diagnose Alzheimer’s and other types of dementia based on a review of medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. It is difficult to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap.
Some risk factors for dementia, such as age and genetics, cannot be changed. Habits we can control may help keep the body and brain healthy and potentially reduce the risk of cognitive decline: physical health and exercise, diet and nutrition, cognitive activity, and social engagement.
The same strategies that protect the heart help the brain – not smoking; taking steps to keep blood pressure, cholesterol and blood sugar levels within recommended limits; cardiovascular exercise to maintain blood and oxygen flow to the brain; and maintaining a healthy weight. What you eat may have its greatest impact on brain health through its effect on heart health. A Mediterranean diet that includes relatively little red meat and emphasizes whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats is considered the most beneficial for both the heart and brain.
Research has suggested that combining good nutrition with mental, social and physical activities may have a greater benefit in maintaining or improving brain health than any single activity. A two-year clinical trial of older adults at risk for cognitive impairment showed that a combination of physical activity, nutritional guidance, cognitive training, social activities and management of heart health risk factors slowed cognitive decline.
Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer’s disease, brain cells die and connections among cells are lost, causing cognitive symptoms to worsen. While current medications cannot stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among the brain’s nerve cells. Doctors sometimes prescribe both types of medications together. Some also prescribe high doses of vitamin E for cognitive changes of Alzheimer’s disease.
The U.S. Food and Drug Administration (FDA) has approved two types of medications that may temporarily improve symptoms of memory loss, confusion, and problems with thinking and reasoning: cholinesterase inhibitors (Aricept, Exelon, Razadyne) and memantine (Namenda). One medication (Namzaric) combines one of the cholinesterase inhibitors (donepezil) with memantine.
Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes. They prevent the breakdown of acetylcholine, a chemical messenger for learning and memory and keep nerve communication levels higher. This may delay or slow worsening of symptoms, but effectiveness varies between individuals. They are generally well tolerated, but if side effects occur, they commonly include nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Memantine regulates the activity of glutamate, a chemical involved in information processing, storage and retrieval. It can improve mental function and ability to perform daily activities for some people, but can cause side effects including headache, constipation, confusion and dizziness.
The path to effective new treatments is through clinical trials. Trials are currently recruiting people with Alzheimer’s and mild cognitive impairment (MCI), as well as healthy volunteers to be controls. Find out more about participating in a clinical study through the Alzheimer’s Association TrialMatch service at http://www.alz.org/research/clinical_trials/find_clinical_trials_trialmatch.asp, a free tool for people with Alzheimer’s, caregivers, families and physicians to locate clinical trials based on personal criteria (diagnosis, stage of disease) and location.
All adults are welcome at all Mountain MidLife and Nederland Area Seniors events, attended mostly by folks over age 50. Everyone is invited to all meals at the Nederland Community Center. Please call two days ahead for lunch reservations (a week ahead for dinners and breakfasts if possible) to 303-258-0799. Missed the deadline? Call anyway. Costs listed show first the over-age-60 requested anonymous contribution, then the under-age-60. Please note that all over age 60 are welcome regardless of ability to contribute financially.