It’s Alzheimer’s – that devastating diagnosis that has taken the place of cancer as a literal death sentence. Incurable. Fatal. The patient destined to a long period of progressive deterioration. Sometimes as much as 8 to 10 years. Losing memory, not recognizing loved ones, gradually becoming unable to do most things for him or her self.
And the diagnosis also dooms caregivers and loved ones to a long period of constantly watching their loved one go through the throes of this terrible disease. Added to this is the continuing need to do more and more for the Alzheimer’s patient as he/she becomes less able to do for self.
For the entire time Alzheimer’s Disease has been around since first described, there has been no effective treatment. No medication to attack the multiple elements of the disease, no non-medical treatments to do more than blunt the effects of peripheral symptoms.
But maybe that’s about to change.
Potential Breakthrough Research
Two recent research projects appear to shed significant light on treatment of Alzheimer’s patients and on early detection of potential Alzheimer’s patients.
In a small study (Bredesen, 2014), a personalized, comprehensive treatment program brought significant and lasting improvement in memory function in 9 of the 10 participants. The improvement in memory began within three to six months of the beginning of the treatment program. To this point, some two and a half years after initial treatment, the improvements have been sustained. Six of the participants who had jobs successfully returned to those jobs or continued in the jobs with increased performance of their duties. The one subject who did not improve with this treatment regimen was diagnosed with late stage Alzheimer’s.
This comprehensive treatment program included dietary changes, exercises designed to stimulate the brain, physical exercise on a regular basis, increased sleep, medications and vitamins thought to be specific for aspects of Alzheimer’s, and reduction of stress.
The basic assumption behind this research goes against the conventional belief that Alzheimer’s is caused by the build-up of plaque in the brain. Rather, Bedesen’s research is based on the theory that an imbalance in nerve-signaling between those signals that strengthen memory and those that allow forgetting brings on the symptoms.
Normally, the nerve signals that allow us to forget information that doesn’t really matter keeps us from being flooded by “noise” in our environment. In Alzheimer’s, these signals increase, leading to increased forgetting, even of important information. The comprehensive program investigated in Bredesen’s research strengthens the nerve signals that correspond to remembering, thus improving memory functions.
Granted, the small sample size of this research makes the results only preliminary. But promising. Much more research of this nature has been called for.
The other research (Hawkins & Sergio, 2014) was related to potential diagnostic considerations in the early detection of Alzheimer’s disease. The researchers required subjects to think prior to making specific hand movements in relation to a target on a screen.
Three groups, two without a family history of Alzheimer’s and one with this history, were in the research. Findings showed 81.8% of the group with a family history of Alzheimer’s or who were diagnosed with mild cognitive impairment (MCI) experienced difficulties with the task.
The researchers do not suggest these findings will predict who will have Alzheimer’s. They do suggest strongly that something is different in the brains of those with family history of Alzheimer’s or who have been diagnosed with MCI. This type of difficulty may indicate early pathology in the brain and may be useful in future diagnostic possibilities for early detection of Alzheimer’s risk. Further, early detection may lead to treatment that may decrease the severity of later symptoms.
Other studies reported at the 2014 Alzheimer’s Association International Conference focused on specific factors associated with the disease. One of these (Okonkwo and Schultz, 2014) reported in a paper presented at the conference regarding subjects at risk for developing Alzheimer’s engaging in games that stimulated cognitive functioning. Their findings showed those subjects who participated in stimulating games significantly increased verbal learning and memory, immediate memory, and speed and flexibility. These findings have implications for developing ways to possibly prevent the onset of Alzheimer’s disease.
Another paper presented at the 2014 AAIC (Geda, et al., 2014) investigated the role of exercise in midlife and the effect on the development of dementia, a significant element of Alzheimer’s. This research showed even moderate exercise in midlife decreased the risk of developing dementia.
One other study (Yaffe, et al., 2014) was reported in a paper at the 2014 AAIC also. This study examined sleep disturbance as a risk factor for development of dementia. The subjects were veterans, primarily male. Those with a diagnosis of some type of sleep disorder had a 30% increased risk of developing dementia. With an accompanying diagnosis of PTSD, the increased risk rose to 80%. Researchers noted further study of the relationship of sleep disturbance and future development of dementia is needed to determine if this is a risk factor or early symptom of dementia.
How Serious Is The Diagnosis Of Alzheimer’s Disease?
When the significance of a diagnosis of Alzheimer’s is considered, the above research becomes even more promising. Earlier detection of the potential for this devastating disease can lead to earlier treatment of the type in Bredesen’s research, or even to more effective treatments to be yet developed.
Alzheimer’s currently affects over 5 million Americans (Alzheimer’s Association, 2014). The vast majority of those affected are over age 65, but around 200,000 are under 65, also. Women outnumber men in the affected group almost two to one.
With the “graying” of America, these numbers will likely increase dramatically. Projections to the year 2050 suggest the number of those age 65 or older diagnosed with Alzheimer’s will triple to as many as 16 million.
In addition to those Americans diagnosed with the disease, those also affected significantly are the caregivers to the diagnosed. 2013 saw over 15 million family and friends providing over 17 billion hours of care. This translated to a monetary value of over $220 billion.
And that number doesn’t take into consideration the emotional and physical toll on those caregivers.
The cost to the nation in terms of the expense of care for Alzheimer’s patients is projected to be $214 billion in 2014. About 20% of the Medicare dollars spent in the U.S. goes to the care of Alzheimer’s patients. Medicaid expenditures for the treatment of Alzheimer’s patients is $37 billion. Out of pocket expenses from caregivers for other treatment is about $36 billion.
It’s easy to see the magnitude of the cost of Alzheimer’s disease. And with the aging of the population of the U.S., this cost will certainly increase.
What Are The Typical Symptoms Of Alzheimer’s?
Alzheimer’s is one of the most feared disorders. Much of this fear is associated with the gradual onset of symptoms. Memory is typically the most seriously affected domain. People who suffer from Alzheimer’s usually lose their memory for even loved ones over a varying period of time.
Other cognitive or brain functions are also affected. The ability to use language, to recognize even familiar objects, and to plan and organize thoughts and behavior are also affected. These difficulties can lead to problems finishing even routine tasks at home, confusion about where the Alzheimer’s sufferer is or where home is, difficulty using words in speaking or writing, poor judgment, and withdrawal from others.
The emotional toll on Alzheimer’s patients is not always discussed. There may be hallucinations, hearing or seeing things or people who aren’t really there. Delusions are possible in which the patient believes others are out to get them, for instance. Their loved ones may even be the targets of these delusions. Alzheimer’s patients may become agitated due to their inability to keep track of where they are or who others are. They certainly often develop depression. Wandering may become a significant issue.
Depression that develops in Alzheimer’s patients may not present as it does in people without Alzheimer’s. The symptoms may be less severe, may show up and go away in a cycle, and will not be talked about by the patient as much as in those without Alzheimer’s.
Treatment of depression in Alzheimer’s patients may take a different course, as well. Medications will be beneficial, if needed. Participating in groups for support may be helpful, especially in early stages of the Alzheimer’s disease. A daily routine will be helpful to keep the patient oriented and to perform difficult tasks at the patient’s best time of day. Ensuring the patient participates in enjoyable activities is good. Helping the patient contribute whatever possible with family and friend recognition of that contribution will be helpful. Nurturing and reassurance of the caregiver’s continuing presence is necessary, also.
All of these signs and symptoms gradually increase in severity and frequency as the illness progresses. In the most severe cases, the depression may seem to resolve, but this may also be due to the Alzheimer’s patient being unable to communicate emotions.
These emotional and behavioral symptoms may bring the most difficulty to caregivers of Alzheimer’s patients. Especially when the behavioral outbursts that may come are directed toward them. Significant distress for both patient and caregiver results. Many times, this distress will lead to much lower quality of life for both groups. On the other hand, even a relatively small reduction in these symptoms can result in improved quality of life for both groups.
Thus, it is easy to see how early detection leading to early treatment can be very beneficial to Alzheimer’s patients and their caregivers. This is one reason for the importance placed on the preliminary research referenced in this article.
Alzheimer’s Association. (2009).
Alzheimer’s Association. (2014). Disease facts and figures. Retrieved from http://www.alz.org/alheimers_disease_facts_and_figures.asp.
Bredesen, D.E. (2014). Reversal of cognitive decline: A novel therapeutic program. Aging.
Geda, Y., et al. (2014). Proceedings from AAIC 2014. Any level of midlife exercise may keep dementia at bay. Abstract P2-153.
Okonkwo, O., & Schultz, S. (2014). Proceedings from AAIC 2014. More evidence brain games boost cognitive health. Abstract 1C-O1-03.
Sergio, L., et al. (2014). Visuomotor impairments in older adults at increase Alzheimer’s disease risk. Journal of Alzheimer’s Disease. doi:10.3233/JAD-140051.
Yaffe, K., et al. (2014). Proceedings from AAIC 2014. Sleep disturbance and risk of dementia among older veterans. Abstract P2-291.