Forgetfulness is normal. Everyone has bouts of
it; and even more with age. Whether a name, address
or appointment, these facts slip through a person’s
mind easily. For someone with Alzheimer’s disease,
they don’t return; that’s the difference. The most
common early symptom is a short-term memory loss.
The Alzheimer’s Association agrees that early
detection is crucial to long-term management and
symptom maintenance. According to the National
Institute on Aging, “Alzheimer’s disease is an
irreversible, progressive brain disease that slowly
destroys memory and thinking skills, and eventually
even the ability to carry out the simplest tasks.”
Researchers today have hope, however, that catching
it early can prevent most of the worst damage to a
loved one.
When an early diagnosis is made, a caregiver
becomes more of a task manager. A loved one will
need help remembering appointments, names,
medications, managing money and other simple
planning efforts. A caregiver is the best encourager
a loved one has. You must be a friend and a shoulder
to lean on, as well as an observer. You are the
person to go to events with, and help your loved one
communicate when they can’t find the words. At some
point, family and friends will need to be told.
Life’s average days that included what used to be
menial tasks will no longer be taken for granted.
Recognizing the symptoms earlier rather than later
can make the difference in the number of good days
and number of bad days in the first stage of the
disease.
The Diagnosis Process
If you suspect your loved one may be dealing with
more than simple memory loss, the most important
thing is not to ignore it. Hoping it may get better,
or thinking it’s just a phase, could only lead to
late diagnosis if in fact the situation proves to be
more serious. Remember, too, that there can be
many treatable causes for memory loss not related to
Alzheimer’s and the sooner your loved one sees the
doctor, the better the outcome for everyone.
With a physical examination, doctors may test a
loved one for reflexes, muscle tone and strength,
rising and walking, sight and hearing, coordination
and balance. Lab tests rule out any other
possibilities for the memory loss and confusion,
such as thyroid disorders or vitamin deficiencies.
While basic mental status testing can take just 10
minutes, a doctor may want more extensive
neuropsychological tests done. These can take
several hours to complete, but are helpful if the
medical professional does suspect early onset
Alzheimer’s as a diagnosis. These tests show the
functionality of a loved one compared to that of the
average person their age.
Brain imaging also is a popular diagnosis option
in use today. From CT scans to MRIs and PET scans,
brain imaging allows medical professionals to
pinpoint abnormalities and also specific changes
known to relate to Alzheimer’s disease. These are
very important if the diagnosis is in fact
Alzheimer’s. Brain imaging gives insight to the
stage of the disease, the rate of progression and
shape, position and volume of brain tissue. The
brain of a person with Alzheimer’s is different than
that of someone without the disease.
New Tests on the Horizon
As scientific understanding about the nature of
Alzheimer’s disease has progressed, so has the
urgency to find definitive tests to diagnose and
manage the disease. Certain genes have been
identified as being associated with Alzheimer’s
disease; but while genetic tests give insight to the
possibility of Alzheimer’s, they don’t confirm it.
Also the only genes isolated so far have been linked
to so called early-onset Alzheimer’s, which is only
associated with about five percent of the cases
occuring in people under age 65. The other 95
percent are diagnosed with the more common
late-onset form. The risk of developing the
late-onset form is still not yet understood, but
believed to be caused by a variety of factors
including environment, genetics and lifestyle
factors.
Researchers are also pursuing the development of
a blood test to screen for an individual with
Alzheimer’s by looking for certain proteins in the
blood called biomarkers. The goal of a successful
biomarker test would enable doctors to detect
Alzheimer’s before the symptoms appear.
Another example of an Alzheimer’s screener is an eye
test that would act as a diagnostic tool.
Early Treatment Counts
For someone with Alzheimer’s, changes have
occurred in their brain possibly even 20 years prior
to diagnosis. With an early diagnosis, or even
pre-diagnosis, as researchers are hoping to have in
the next decade, treatment options can be tailored
to a more preventive focus.
In the early stages of Alzheimer’s, a loved one
may experience increased irritability, depression or
anxiety. These typically are the result of increased
confusion and memory loss, but yet the ability to
know they can’t focus as well. For
behavioral-type symptoms, there are medications
available to assist. They can be targeted to a
specific symptom of the disease. However, looking
for reasons behind the behavior and addressing those
may be just as successful for a caregiver.
Many times, the person is overwhelmed, by a
setting or even a conversation they just can’t
participate in at the level they used to. A loved
one will benefit greatly by managing these “trigger”
situations. Find out what makes a loved one “tick”
so to speak, and avoid those at all costs. Between
fear, and then mental and physical fatigue, the
wrong setting can set a person into another door of
frustration. A calm, friendly environment is usually
the best medicine for someone with Alzheimer’s, even
in the early days.
For the physical symptoms of memory loss,
confusion and problems with thinking/reasoning,
medication is the current mainstay. Two types are
approved by the U.S. Food and Drug Administration:
cholinesterase inhibitors (Aricept, Exelon, etc.)
and memantine (Namenda). Current medications can’t
stop the progression of the disease, but can lessen
or stabilize the symptoms for a period of time in
some people. Many caregivers report
frustration with the current medications, feeling
that they are doing little or nothing to help their
loved ones, especially over a period of time when
the disease continues to progress despite the
medication.
The other treatment measure for early Alzheimer’s
comes in the form of sleep management. A loved one
with this condition will most likely have a change
in sleep patterns and difficulty with sleep. While
scientists still do not understand why, they do know
the “what.” People tend to wake up more and stay
awake longer during the night. Brain wave studies
show a decrease in dreaming and non-dreaming sleep
stages.
The Role of Clinical Trials
There is a great need for people to participate
in clinical trials, notes the Alzheimer’s
Association. The group says this is the only way to
further advance the prevention, diagnosis and
treatment of the disease. There are a few types of
clinical research, including: treatment trials,
diagnostic studies, prevention trials, screening
studies and quality of life studies.
The biggest challenge for all trials and studies
today is finding people willing to participate. The
funding is available, and a cure will not be without
more research and treatment development.
While researchers continue to piece together how
and when brain damage begins, the five million
people in this country diagnosed with Alzheimer’s
will continue to hope for the cure. Their caregivers
wish for the same. Noticing symptoms early on is
still the first line of defense in Alzheimer’s
management. When it seems like normal forgetfulness
has escalated, it’s time to take that next step, for
your loved one and yourself, and seek a diagnosis as
soon as possible.
EARLY SIGNS OF ALZHEIMER’S
Memory loss that disrupts daily life
Challenges in planning or solving problems
Difficulty completing familiar tasks
Confusion with time or place
Trouble understanding visual images and
spatial relationships
New problems with words in speaking or
writing
Misplacing things and losing the ability to
retrace steps
Decreased or poor judgment
Withdrawal from work or social activities
Changes in mood or personality
Alzheimer’s Association 10 Warning Signs
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