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Understanding Alzheimer’s and Dementia

 

About 5.2 million Americans currently suffer from Alzheimer’s disease, and the aging population will drive that number to an estimated 7.1 million by 2025, according to the Alzheimer’s Association. Researchers have identified several types of brain abnormalities in people with the disease, notably plaques made of clumps of beta-amyloid protein and tangles of a protein called tau. Both correlate with the death of brain cells, leading to progressive memory loss, dwindling social skills and, eventually, death. As Dr. Marwan Sabbagh, director of the Banner Sun Health Research Institute and co-author of "The Alzheimer’s Prevention Cookbook," puts it, Alzheimer’s memory loss goes beyond the usual “I forgot where I put my keys” to “I forgot what my keys are for.” Age, family history, having the Apolipoprotein E genotype and being female are the leading predictors of the disease. But researchers are finding other predictive correlations, especially in lifestyle:

 

• Several biomarkers seem to correlate with Alzheimer’s, including certain proteins in spinal fluid or blood and mutations detectable by brain imaging.

• Trouble with the vascular system is linked to Alzheimer’s. High blood pressure, especially in midlife, increases your risk. People who have previously had a heart attack are more than twice as likely to develop dementia, whether it's Alzheimer’s or another type.

• Insulin-resistant diabetes could double or even quadruple your chances of getting Alzheimer’s. Obesity also increases your odds, especially for women, who may be three times as likely to develop Alzheimer’s as their thinner peers, according to the Fortanasce-Barton Neurology Center. Obese men increase their risk by about 30 percent. Exercise benefits both the obese and the diabetic.

• Lower levels of formal education and a general lack of mental stimulation correlate with increased risk of Alzheimer’s. Verghese led a study that identified dancing as the most helpful physical activity for avoiding Alzheimer’s, partly due to the social aspect. “You don’t usually dance alone,” he says. “Social interaction has been said to reduce stress levels, which are bad for the brain.”

• Diets low in vegetables may speed cognitive decline. One reason for this involves homocysteine, an amino acid in blood plasma. While all types of vegetables will help, Sabbagh recommends kale, squash, eggplant, collard greens and blueberries as cognitive superstars. Certain spices, notably cinnamon and turmeric, may also have a dramatic effect.

• A deteriorating gait and the inability to simultaneously walk and talk may indicate the onset of Alzheimer’s. “Walking while talking is a divided attention task,” says Verghese, who has long studied gait changes in patients with non-Alzheimer’s dementia.

• Since Alzheimer’s starts in the hippocampus, often called the brain’s seat of memory, disorientation is a hallmark of the disease. This accounts for why people with Alzheimer’s are notorious for wandering off and getting lost.

• People who suffer from depression earlier in life are more likely to develop Alzheimer’s as they age. A study by the Multi-Institutional Research in Alzheimer’s Genetic Epidemiology group, led by Robert Green of Harvard Medical School and published in Archives of Neurology in 2003, found a significant link between Alzheimer’s diagnoses and people who had shown symptoms of depression within the past year.

• Sleep disorders such as sleep apnea have been linked to cognitive deficits. Previous studies found Alzheimer’s plaque developing in mice’s brains when their sleeping schedules were significantly disrupted. A study released in 2012 correlated sleep disruption and Alzheimer’s in humans. The Washington University study, led by David Holtzman of the college's Department of Neurology, studied 145 cognitively normal people. Those with biomarkers for Alzheimer’s, as measured in their spinal fluid, were the worst sleepers.

 

Questions and Answers

Q: What is Alzheimer's?

Alzheimer's is the result of brain cells dying.

Q: What is Dementia?

 It's an overall term that describes a wide range of symptoms associated with a decline memory.

 

Q: What are the common warning signs of Alzheimer's/Dementia?

 

The common warning signs are increased forgetfulness, problems with short term memory and sudden changes in mood or personality.

 

Q: What are some typical behaviors of someone who suffers from frontal dementia?

 

Typical behaviors can be profanity, racial slurs and/or sexual advances among others.

 

Q: What are good approaches for Caregivers to take when caring for someone with Dementia?

 

Caregivers should always remain flexible with care, take an interest in who the client was prior to dementia as this may help the caregiver to communicate with more than just words; possibly a body language and even a reassuring touch can be helpful.

 

Q: Most often, individuals who suffer from Alzheimer's are consumed with a different reality than yours. This can make caring for them rather challenging. What should you do to minimize agitation to the client and yourself?

 

Caregivers should validate their person's reality by sharing it with them. Telling an 82 year old woman, who thinks she is 25 can be upsetting and create other barriers that may prevent care. One suggestion is to ask questions about what she likes to do? Music? TV shows? Friends? Hair? In many ways this can be distracting for the individual and will allow the caregiver to complete their task. It's also positive reinforcement.

 

Q: What is Internal and External Stimuli?

 

Internal and External  Stimuli are the physical causes of agitation and aggression. Internal Stimuli can include: pain, delirium and depression. External Stimuli can include: loud noises, various caregivers in and out of the home and rushing the person to move at your pace.

 

Q: What should you do when a person is being assessed for physical causes of agitation and aggression?

 

Caregivers should listen to what the person is saying, watch their facial expressions and ask "yes" or "no" questions.

 

Q: How should you perform personal hygiene tasks on a person with dementia?

 

Caregivers should remember that their person is an adult and should be treated with respect and dignity at all times. It doesn't hurt to ask your person what their preferences are and the caregiver can adjust according to their person's physical capabilities. Always tell your person what you are doing and take your time while doing it. Remain flexible and move at their pace.

 

Q: How should you care for an aggressive person with dementia?

 

Caregivers should use eye contact, maintain patience and flexibility and refrain from doing personal interests like talking on the phone. Caregivers should approach their person at a 45 degree angle and never approach from behind and always use a soothing and affirming tone of voice.

 

Note: Information provided is only intended as guides and is not intended to be medical/legal advice. Home4Life In-Home Services reserves the right to modify this information at any time. If there are topics you would like added, please use the contact form.