Commonly Asked Questions and Myths About Alzheimer’s Disease
September is World Alzheimer’s Month so there’s no better time to separate myths from facts about this form of dementia that affects an estimated 5.7 million Americans, most of whom are over the age of 65.
A startling one in 10 people age 65 or older will develop Alzheimer’s. We don’t know why, but the disease affects women and people of color in disproportionately larger numbers. In fact, older African-Americans are twice as likely have Alzheimer’s or other dementias as older whites, while Hispanics are one and one-half times as likely, according to the Alzheimer’s Association.
Duc Tran, M.D., a neurologist and physician on the medical staff at Texas Dallas, has been counseling and treating Alzheimer’s patients and their families and caregivers for almost two decades. Despite advances in research about the disease and general public awareness, many of us remain confused or uninformed about Alzheimer’s disease.
We sat down with Tran to better understand what Alzheimer’s is, and to sort out fact from fiction.
Many of us are confused about the difference between dementia and Alzheimer’s disease. Are they the same?
Alzheimer’s disease is the most common form of dementia — a brain condition that affects the brain’s control of thought, memory and language. Alzheimer’s disease and related dementias can severely impact a person’s ability to carry out daily activities, because they affect memory and interfere with day-to-day living.
We seem to only hear about older people with Alzheimer’s disease. People younger than 65 don’t get the disease, do they?
The vast majority of people living with Alzheimer’s disease are 65 and older. Although it’s rare, people younger than 65 can develop the disease.
It seems like Alzheimer’s or other forms of dementia are an unfortunate and expected part of aging. Is that right?
Everyone’s brain changes with age, and that’s a normal part of getting older. But it’s important to distinguish Alzheimer’s disease from a normal aging process. It is normal for older folks to occasionally forget stories or names but there are signs that someone may be entering the early stages of the disease if it’s more than simple occasional forgetfulness.
Tell us more about the distinction. When should we take notice with a friend or family member?
Many people believe that if someone can remember an occurrence from long ago, everything is fine. In cases where individuals may have Alzheimer’s, they may not remember what they ate for breakfast. That may not seem important but doubling up on medication because they did not remember they took them is a problem.
With Alzheimer’s, the brain’s circuitry is interrupted and doesn’t allow one to retrieve a recent memory. Long-term experience, on the other hand, is stored in our brains, and that’s why someone with Alzheimer’s may remember experiences from high school but is unable to remember activities from earlier in the day. In a sense, these are learning disabilities — initially affecting short-term memory — that families and caregivers should recognize.
I’ll share a quick story. I remember a brilliant college history professor who was writing two books — at the same time — on World War II. He wrote beautifully from ‘old memory’ but he had trouble recalling activities from earlier in the day.
What are the signs that my friend or family member may be in the early stages of Alzheimer’s disease?
First, I’d say to look for things that are out of character for the individual. If the individual has always been a bit forgetful, misplacing items around the house, for example, I wouldn’t be alarmed. But if your loved one is leaving keys in the refrigerator or getting lost in familiar settings, this would be something to make note of. Family members and caregivers should also look for confusion around money issues or paying bills, repeating questions, mood changes or poor decision-making.
What causes Alzheimer’s? Is it hereditary?
Frankly, we don’t know what causes this disease, but like other chronic conditions, it may be more than one factor. There’s a tremendous amount of research on Alzheimer’s and other dementias being conducted by public and private institutions. We are attentive to the potential for a hereditary link, and it raises our vigilance when a family member already has the disease, especially if they acquired it earlier in life.
Is there a cure for Alzheimer’s disease?
Unfortunately, there is not a pill or vaccine to prevent this disease, but again, there is significant ongoing research. This is not to say that there are not things that we can do to help, including medications to help with symptoms, social interventions, lifestyle modifications, managing and aligning expectations, assessment of safety, and family/caregiver education. These all may have a direct impact on quality of life.
What about diet, exercise and lifestyle? What role do they play in preventing or minimizing Alzheimer’s disease?
Lifestyle choices may help reduce the chances of getting the disease or minimizing its symptoms. I stress the importance of controlling blood pressure and getting regular exercise. Even a short walk every day has benefits and gets our blood circulating, and at the same time, minimizes bad cholesterol and the potential for diabetes. Social engagement is also important. It’s basically all the things we know we’re supposed to do.
Can you tell us about how an Alzheimer’s patient is diagnosed? What should they and their caregivers expect?
Each person may be a little different, but typically, a doctor first conducts a detailed patient history, asking about medical conditions and family history, emotional condition, living conditions, and details about the evolution of the symptoms. Sometimes a physician will speak with the patient’s family to gain insights into personality, memory or other issues.
Next is a physical examination followed by lab tests to rule out or identify complicating factors. The doctor likely will conduct memory or neuropsychological testing such as the most common — Mini-Mental State Exam (MMSE). These include a series of questions to evaluate the patient’s mental status. Diagnoses also may include MRI and CT scans to rule out other conditions that may simulate dementia. On occasion, studies such as spinal fluid and PET imaging may offer additional information.
Last, how important is the role of family and caregivers in the treatment of a loved one with Alzheimer’s?
I can’t stress enough the role of family, friends and caregivers in the care and treatment of an Alzheimer’s patient. A core of support is integral to the successful treatment of someone with the disease. It’s gratifying to me when family members or good friends take an active role in caring for the patient — helping her remember her medicine, or assisting with meals, bedtime and other daily activities.
If you or a loved one is starting to show signs of memory trouble, make an appointment to see one of Texas Health’s geriatric specialists.