5 Oct 20220 Comments
An umbrella term describing a range of symptoms, including changes in memory and behavior, dementia can be caused by a variety of disorders such as Alzheimer’s disease, vascular disease, Lewy bodies, and frontotemporal dementia.
“Over six million Americans age 65 and over are living with dementia caused by Alzheimer’s disease, and more than 11 million Americans provide unpaid care for these individuals,” says Claire Sexton, DPhil, senior director of scientific programs and outreach at the Alzheimer’s Association. “So Alzheimer’s really has a tremendous impact on the family.”
Caring for Someone with Alzheimer’s
Taking care of someone with Alzheimer’s is quite different from caring for someone with another health condition. Alzheimer’s is a long disease, lasting for years and even decades, and those who have it don’t get better. As the disease progresses, night time sleep disruptions are common, and can put an enormous physical and psychological burden on the caregiver. Knowing how to best care for a loved one with Alzheimer’s and knowing when to reach out for help is essential, Dr. Sexton advises.
Each person living with Alzheimer’s is different, she explains. “So everyone’s day looks different. It’s important to find the types of activities the person enjoys.” For many people, music can lessen anxiety and even aid in triggering memories. “Art therapy can be helpful, too. When choosing an activity, keep in mind it could be the same activity the person enjoyed before. It depends on what stage of the disease they are at.”
If someone has always enjoyed doing the daily crossword puzzle, this is a wonderful past-time to continue. But don’t force it, Dr. Sexton cautions. Do try to find activities that can be enjoyed both by the person with Alzheimer’s as well as his or her caregiver, she suggests.
There is not one definitive test for dementia. Instead, physicians use a variety of tools and approaches to make a diagnosis. Typically, the person’s physician will take a medical history and conduct an exam, along with diagnostic and mental status tests. Biomarkers, which have the potential to aid in an early and accurate diagnosis, may be obtained through PET and MRI brain scans, blood and plasma tests, retinal imaging, and cerebrospinal fluid (CSF) samples.
Some of the warning signs of Alzheimer’s are memory loss, difficulty completing familiar tasks, and needing another family member to step in and manage tasks the person used to handle on their own. “A change in memory can occur with normal aging, but if there is memory loss that disrupts daily life—where the person asks the same question repeatedly—this could signal a problem,” Dr. Sexton notes.
Age is the greatest risk factor for Alzheimer’s disease, as it mostly affects people over 65. “Genes can increase or decrease someone’s risk as well,” she says, “But the types of genetic factors that guarantee someone will develop Alzheimer’s disease are very rare.” There may be some families where there are more cases of Alzheimer’s disease, but this may be due to a variety of different factors, such as shared [poor] lifestyle habits.
Dr. Sexton comments that 40 percent of dementia cases could potentially be prevented or delayed by targeting modifiable risk factors, such as diabetes, hypertension, smoking, alcohol consumption, and physical activity. So making necessary lifestyle changes—getting at least 150 minutes of physical activity each week, addressing diet and stress, among other risk factors—are critical to brain health. And these risk factors are controllable.
The Newest Drug
Aducanumab (brand name Aduhelm) is the first treatment to address the underlying biology of Alzheimer’s disease. Although the drug has been approved by the Food and Drug Administration, the Centers for Medicare and Medicaid Services will [currently] cover this drug, under Medicare, only for people who receive it as part of a clinical trial. Some doctors and Alzheimer’s experts caution that this treatment may have uncertain benefit and grave safety risks.
The more hopeful news: There are currently 143 unique therapies in 172 trials for Alzheimer’s disease registered in the United States. “So it’s a very active field,” Dr. Sexton says, with more drugs under study or in the pipeline.