According to the National Institute on Aging, Alzheimer’s disease is currently ranked as the sixth leading cause of death for the elderly in the U.S., but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer. Alzheimer’s is the most common cause of dementia among older adults. Sunita Tummala, MD, Medical Director of Stroke for McLaren hospitals, shares her expertise about the disease and the latest advancements in treatment.
Q: What is Alzheimer’s disease?
A: This progressive disorder causes brain cells to degenerate and die, leading to memory decline. It can affect a person’s cognitive ability, as well as behavioral and social skills. It can also impact their ability to perform normal, day-to-day tasks.
Early signs of the condition include forgetting recent events or conversations. People can repeat statements or questions over and over again. Word-finding, or “anomia” is another presenting symptom – the person might forget the names of family members and everyday objects. They might get lost in familiar places, or routinely misplace objects and find them in unusual places.
Thinking, reasoning and multitasking becomes difficult, as does judgement and decision-making. Changes in personality and behavior can also occur. Delusions (such as believing items have been stolen) or hallucinations (believing they see objects that aren’t there) can develop. As the condition progresses, a person with Alzheimer’s disease will develop worsening memory impairment and potentially lose the ability to carry out everyday tasks.
Q: What causes it?
A: For most people, Alzheimer’s disease is caused by a combination of genetic, environmental and lifestyle factors that affect the brain over time. In less than one percent of the time, it can be caused by specific genetic conditions and will present in middle age, as opposed to later in life as Alzheimer’s disease typically does.
The fundamental problem is a failure of the proteins within the brain to function properly, which damages the brain cells or neurons. Once neurons are damaged, it causes a series of toxic events to occur. This causes the nerve cells to become damaged, and lose connections and eventually, die. The damage initially starts in the part of the brain that controls memory. This usually begins years before symptoms first appear.
Q: Is there a cure for it?
A: There is currently no cure for the condition.
“Caring for a patient with dementia can often be very challenging. I remind caregivers that it is the disease causing these difficult situations, and not the person, themselves.”
Sunita Tummala, MD
Q: How is it treated?
A: Treatment is aimed at supportive care, as well as medications that can help for a time with memory changes. These include cholinesterase inhibitors or memantine. The medications do not cure the condition, but work at a cellular level to help slow the process of cell death.
It is important to create a safe and supportive environment for a person with Alzheimer’s. Adapting the living situation to their needs is a crucial part of any treatment plan.
Q: Have there been any significant advancements in treatment?
A: Some of the new Alzheimer’s treatments in development target specific proteins. Strategies aimed at decreasing beta-amyloid plaque formation by monoclonal antibodies looks promising. Other research is looking at immunosuppressant medications, which may help by reversing some memory loss. Some therapies are focused on reducing the amount of beta-amyloid protein produced in the brain. Other studies are looking at reducing inflammation, and vaccines to prevent tau proteins from forming “tangles” in the brain.
Q: What should we know when dealing with someone who has Alzheimer’s disease?
A: A person living with dementia will eventually need assistance with daily living. By using creativity and caregiving skills, it is possible to adapt routines and activities as their needs change. Establishing a daily care plan could be helpful. It is also important to encourage proper diet, as well as nutritional guidance. Try to establish a daily routine and anticipate that tasks and simple day-to-day chores may take longer to do. Try to involve the person in the process.
It is important to create a safe environment for someone with dementia, due to an increased risk of injury. It is important to prevent falls. To promote safety, try to eliminate rugs or extension cords that may cause problems. Lock doors and cabinets, and keep potentially dangerous items such as medicine, alcohol, guns, toxic cleaning substances or dangerous utensils behind a lock. Take fire safety precautions by moving matches and lighters out of reach. People with dementia should not smoke.
According to Dr. Tummala, there are local resources for patients with Alzheimer’s disease and their caregivers. Caregiver support groups are available, as well as programs offering patient care. “I always tell patients and their loved ones that this condition affects not just the person, but the entire family,” she states. “Caring for a patient with dementia can often be very challenging. I remind caregivers that it is the disease causing these difficult situations, and not the person, themselves.”