Dementia

Q. What is dementia?

A. Dementia is a condition of declining mental abilities, especially memory. The person will find it hard to do things he or she used to be able to do easily. Some examples are trouble balancing a checkbook, driving a car safety, or planning a meal. He or she will often have problems finding the right words and may become confused when given too many things to do at once. The personality of a dementia sufferer may also change. He or she may become aggressive, paranoid, withdrawn or depressed.

Q. Isn’t dementia just old age or senility?

A. Aging along does not stop us from taking care of ourselves. As we get older, it may take longer to remember names or to find the right word to say. Mild changes in thinking and remembering information (also known as mild cognitive impairment) may happen as we age, delaying or making though processes more difficult. The loss of memory and other mental problems caused by dementia are bad enough to keep us from doing things we use to do easily. Researchers are trying to understand if dementia is an abnormal extension-a more sever form-of the mild, expected memory changes experienced by older adults, or it is entirely different situation. While dementia is more common in old age, it is not “normal.” Changes in memory should be evaluated.

Q. What causes dementia?

A. Alzheimer’s Disease is the most common type of dementia. But, there are many other causes of dementia. They include strokes, low vitamin B12 levels, thyroid conditions, depression, AIDS, and other infections. In addition, medications and some illnesses can cause confusion (delirium) in older people. This may look like dementia because it also affects memory.

Q. What is Alzheimer’s Disease?

A. Certain cells in the brain stop working and eventually die. These cells produce important chemicals [acetylcholine and others] needed for memory, language and other thinking functions. As the chemicals decrease, so do the person’s abilities to remember and think clearly. Alzheimer’s disease usually sneaks up on the person and family. It gets worse slowly and silently over several years, before the changes are noticed. Over time (usually 5-8 years), it advances to a point where the person can no longer handle simple tasks like eating or bathing.

Q. How do you get Alzheimer’s Disease?

A. We know that as we get older we have a greater change of getting Alzheimer’s disease. At the age of 65+, about 1 in 15 people has the disease. By the age of 85 and older, between 1/3 and ½ of the population has this disease. We also know that some families pass along genes that increase the risk for developing the disease. There are also factors in our environment that seem to trigger the onset of the disease. But those triggers are not yet known.

Q. Is there any point to seeing my doctor?

A. There are important reasons to get an evaluation. First there are now treatments available for Alzheimer’s disease. They can improve the symptoms and slow the progress of the disease. Second, there are other causes of dementia and confusion. Sometimes the person may return to normal once his or her medications are changed or medical illness is treated, Third, the doctor’s office should be able to assist you in finding community resources for information, support groups and help at home.

Q. What can we expect from the doctor?

A. Your doctor should take your concerns seriously. He or she should provide a careful medical examination and medication review. There should be tests of memory, blood work, and sometimes a scan of the brain. Referral for detailed mental testing may be made. If the diagnosis is clear, the doctor should provide care throughout the illness.

Q. What treatments are there for Alzheimer’s Disease?

A. Medicines approved for treating Alzheimer’s disease are donepezil [Aricept], galantamine [Reminyl] and rivastigmine [Exelon]. They work by raising the levels of acetylcholine in the brain. They all can cause some stomach problems. Otherwise, they are generally well-tolerated. Vitamin E may slow the progress of Alzheimer’s disease. However, since it can increase bleeding, it should be used with caution in people taking blood thinners. So far, none of these drugs cures or stops the disease. But, many researchers are looking for better treatments. Your doctor or the Alzheimer’s Association may be able to help you find a study site, if you want to participate.

Q. How can I convince my loved one to go to the doctor?

A. Ofter, your loved one already knows there is something wrong and may be very frightened. It would be helpful to focus on the available treatment options, and to remind your loved one that early detection will make them more effective.

Q. How do I know when my loved one should stop working, banking, driving or living alone?

A. These are often very difficult questions that your doctor may be able to assist you in answering. In general, if there is a potential for harm to your loved one or to others, it may be time to consider stopping certain activities. Doctors rely on your reports when making recommendations about major life changes. They can be supportive in reinforcing your concerns.

Q. What else can I do as a caregiver?

A. Above all else, the person with dementia needs your care. You can’t provide that care if you don’t care for your own health. Caregiving can be sad and depressing. You can become sick if you ignore your own health needs. You need breaks from caregiving. You need help at home. You need to eat, sleep and exercise regularly. You need to forgive yourself for feelings of anger and guilt. A support group can help you through some very tough times that you are sure to face.

Q. Is a nursing home really necessary?

A. This is a very individual matter. Often families feel guilty about placing a loved one in a nursing home. With good help at home, safety measures (such as removing the knobs from stoves) and day care options, the person can stay at home for a long time. A good nursing home can provide safety and social interactions that may give your lover one a great deal of pleasure and security. It can also give you a chance to sleep and do your daily tasks with some peace of mind.

Q. Where do I go for more information or support?

A. The National Alzheimer’s Association 1-800-272-3900 Email: info@alz.org Website: https://www.alz.org Your local Alzheimer’s Association chapter can help you find local resources and support groups. The Alzheimer’s Disease Education and Referral Center 1-800-438-4380 Email: adear@alzheimers.org Website: https://www.nia.nih.gov/alzheimers

The AGS Foundation for Health in Aging The Empire State Building 350 Fifth Avenue Suite 801 New York, NY 10118 212-755-6810 (ph) 212-832-8646 (f) www.healthinaging.org