Alzheimer’s Disease (AD): What Everybody NEEDS to Know

There may be as many as 5.3 million people with Alzheimer’s disease living in the United States. (NIA) But if you care for someone with Alzheimer’s or another dementia, your person is more than a number. Here’s help, for you and the person with dementia.

Diagnosis makes a difference!

Early diagnosis is important and accurate diagnosis is critical!

Why? Because!
1. Early treatment is more effective than waiting.
2. Early and accurate diagnosis allows for better planning and opportunity to include the person with dementia in the process. Planning makes a difference in options the person may have as the disease leads to changes in abilities and needs.

How is Alzheimer’s disease diagnosed?
Diagnosis is complicated and includes gathering lots of information, including:
1. History of the changes
2. Health history
3. Medication review
4. Physical exam (especially focusing on neurological and cardiovascular systems)
5. Laboratory studies
6. Imaging study of the brain (MRI, CT, PET)
7. Cognitive assessment (what’s working well and what’s not working well)
8. Emotional assessment
9. Others (ECG, EEG etc as indicated)
It’s important as this information is gathered people are compared to themselves and to others of their age and situation.

How is Dementia Different from Aging and Forgetfulness?

1. Aging happens to everyone. Dementia is ALWAYS a disease; it DOESN’T happen to everyone.

2. With forgetfulness, new information can be stored; it may take more effort or practice, but new information can “stick”. With dementia, new information cannot be predictably retained.

3. Forgetful people can use reminders, calendars, lists and to be able to DO. With most dementias, these prompts CAN’T help after the earliest stages.

4. Being forgetful makes an independent life difficult; having dementia makes independent life impossible.

What is “Normal Aging”?

Normal aging includes:
Being more forgetful…for you
Taking longer to learn new information…again for you
Requiring more practice to learn new skills or technologies (you can do it, just have to try harder than earlier)
Having more trouble recalling people’s names (more than you used to have)
Knowing the word you want but hesitating (different for you)

Get the theme? FOR YOU…or the person you’re working with. If you don’t know where the person started…you don’t know where they are now.

What is Mild Cognitive Impairment?

Mild cognitive impairment is a fairly new term and is used when:
1. An individual experiences more that expected cognitive change (especially in memory and/or language)
2. But typically doesn’t show changes in thinking or judgment
3. And can still function and do everyday activities

MCI is now being diagnosed and treated, although what that treatment might be may fluctuate greatly.

Some people with MCI will experience continued decline and develop dementia; some will reach a plateau and not progress to dementia.

More research is needed to understand why.

What is Dementia?

Dementia is a non-specific or “umbrella” term used to describe a person having changes in brain function that interfere with ability to function and do everyday activities.

The person with dementia has problems in multiple areas of brain function. These problems can include; memory, language, impulse control, ability to do things for self, personality, understanding of time, etc.

Common types of dementia include: Alzheimer’s disease, vascular dementia, Lewy body dementia, frontal-temporal dementia (FTD) and mixed dementia (more than one type of dementia occurring in the same brain). Different types of dementia impact the brain in different ways, have different symptoms, cause changes in different abilities…in different orders…and at different rates.

What is AD?

AD is one type of dementia. It is a progressive and terminal disease. The changes typically occur slowly, over months and years not hours and days.

If the person has a sudden change in health status, living situation or caregiver system (for example, death of a spouse) he or she may APPEAR to change quickly. The brain has actually been changing slowly but since the person was in a routine, the person’s abilities weren’t being challenged and he or she was relying on OLD patterns and memories to function.

The pattern and progression of the disease is predictable BUT the experience is individual and ultimately, the person’s entire life is affected by AD.

What are the early signs?

Early signs might include:
• Memory loss of recent events and information
• Confusion about place and time
• Familiar tasks become challenging
• Trouble finding words, finishing thoughts and sentences, following directions
• Decreased reasoning ability and altered judgment
• Changes in mood and personality, frequent mood swings, disinterest or withdrawal, suspicion
• Difficulty with complex mental tasks, planning, problem solving

Caregiver “think about its”.

Much of the care of people with dementia is provided by unpaid caregivers: family members, friends, neighbors, faith communities.

However, not everyone is made to be a direct caregiver for someone with dementia!

As a caregiver—you must take care of yourself or you will NOT be able to care for the person with dementia.

Each year we lose too many caregivers to chronic illness and stress!

This is a long term commitment—You can’t sprint a marathon!!!

We are learning more each year; you need to make sure you stay up-to-date.

Final words

What YOU do makes a difference…to the person with dementia… to your other partners in the journey of caring…to your community and…to those who come after you.