Alzheimer's Disease
Chapter 24. Chronic Illnesses

Alzheimer's disease afflicts nearly 4 million Americans. It strikes over 45 percent of the population over age 85 and about 10 percent of those over age 65. In rare instances, Alzheimer's comes earlier than age 65.

No one knows what causes Alzheimer's disease. Some research hints that a virus or infectious agent is the culprit. Other studies point to a genetic link, environmental toxins, such as aluminum, and/or brain chemical deficits. Two brain chemicals are known to be produced less in Alzheimer's disease. These chemicals (acetylcholine and somatostatin) are needed for normal communication between nerve cells. Whatever the cause, the end result is the death of brain cells that control intellect (the way your brain receives and processes information).

Signs and Symptoms
Alzheimer's disease has a gradual onset. The signs and symptoms may progress in stages. How quickly they occur varies from person to person. The course of the disease averages 8 years from the time symptoms start.

Stage One
Forgetfulness
Disorientation of time and place
Increasing inability to do routine tasks
Impairment in judgement
Lessening of initiative
Lack of spontaneity
Depression and fear

Stage Two
Increasing forgetfulness
Increasing disorientation
Wandering
Restlessness and agitation, especially at night
Repetitive actions
Muscle twitching and/or convulsions may develop

Stage Three
Disorientation
Inability to recognize either themselves or other people
Speech impairment (may not be able to speak at all)
Develop need to put everything into their mouths
Develop need to touch everything in sight
Become emaciated
Complete loss of control of all body functions

{Note: The stages very often overlap.}

Treatment and Care
If someone you care about shows signs of Alzheimer's disease, see that they get medical attention to confirm (or rule out) the diagnosis. Not everything that looks like Alzheimer's is Alzheimer's.

There are many diseases or other problems that can cause dementia (severe problems with memory and thinking). These include:
Brain tumors
Blood clots in the brain
Severe vitamin B12 deficiency
Hypothyroidism
Depression
Side effects of some medicines

Unlike Alzheimer's, these problems can be treated.

There is no known cure for Alzheimer's disease. Good planning and medical and social management are necessary to help both the victim and caregivers cope with the symptoms and maintain the quality of life for as long as possible. An advance directive should be drafted in the early stages to allow for the victim's wishes. (See Advance Directives.) It's especially helpful to put structure in the life of someone who's in the early stages of Alzheimer's. Some suggestions include:
Maintain daily routines.
Post reminders on a large calendar that can be easily seen.
Make "to do" lists of daily tasks for the person with Alzheimer's to do, and ask him or her to check them off as they are completed.
Put things in their proper places after use, to help the person with Alzheimer's find things when he or she needs them.
Post safety reminders (like "Turn off the stove") at appropriate places throughout the house.
See that the person with Alzheimer's eats well-balanced meals, goes for walks with family members, and continues to be as active as possible.

Two prescription medications, tacrine (Cognex), and donepezil (Aricept) may help some persons with mild to moderate Alzheimer's disease. Sometimes medications to treat depression, paranoia, and agitation, etc., can minimize symptoms, but they will not necessarily improve memory.

At late stages, providing a safe environment is very important. Alzheimer's victims should wear identification bracelets or necklaces so they can be identified should they be separated from their home environment. Seeking adult foster care or nursing home care for those who require supervision or medical management may be necessary.

Most persons with Alzheimer's disease eventually need 24-hour care. Caregivers of Alzheimer's victims should also be given "care." They must deal with a number of financial, social, physical, and emotional issues. Care for caregivers can be provided by professionals of home care, day care, respite care, service programs, and self-help groups.

(See "Places to Get Information & Help" under Alzheimer's Disease.)

HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine. 

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Date updated 02/01/99