Alzheimer’s disease – Coast Contact

Personally this is a difficult topic for me. My mother had advanced Alzheimer’s Disease in the last two years of her life. It was so bad that she could not speak. She could not recognize me. She could not recognize my sister. Basically she was a vegetable. She died two months before her 96^th birthday. Until that loss of cognizance she had a very wonderful life.

Looking back on her senior years I knew something was wrong when she drove her car into cupboards in the garage. She refused a pill organizer box my sister bought her. She was actually angry that the box was bought. Small memory problems became apparent about 10 years before those horrible last two. Never overweight and very well educated her favorite games were Bridge and Mahjong. She did not suffer from high blood pressure, high cholesterol and other diseases common to the elderly.

Most recently there have been articles posted and printed recommending more exercise as a way of reducing the chance of dementia. There was also an article saying most elderly have the bodies of 40 year olds. Wouldn’t that indicate we are being careful of what we eat and are obtaining adequate exercise? If that is accurate then what would additional exercise do for our minds?

Forget Prevagen. The Federal Trade Commission and New York’s attorney general charged Quincy Bioscience, maker of Prevagen, with fraud for selling a memory supplement based on a glowing jellyfish protein. Prevagen isn’t FDA approved.

Mayo Clinic posts this on their web site: Scientists believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time. Less than 5 percent of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease. Your risk of developing Alzheimer’s appears to be somewhat higher if a first-degree relative — your parent or sibling — has the disease. Scientists have identified rare changes (mutations) in three genes that virtually guarantee a person who inherits them will develop Alzheimer’s. But these mutations account for less than 5 percent of Alzheimer’s disease.

People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia.

There’s no lifestyle factor that’s been definitively shown to reduce your risk of Alzheimer’s disease.

However Mayo Clinic says some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include:

Lack of exercise
Obesity
Smoking or exposure to secondhand smoke
High blood pressure
High blood cholesterol
Poorly controlled type 2 diabetes
A diet lacking in fruits and vegetables

These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain. Working with your health care team on a plan to control these factors will help protect your heart — and may also help reduce your risk of Alzheimer’s disease and vascular dementia.

It does not appear there is any specific cause of dementia. With an aging and older population the world is in for many more cases of this disease.

My mother died from the disease. My father lived to 86. He was sharp as a tack until he had a stroke. He had high blood pressure for years. I don’t have that disease.

I think I have chance of living to my mid 90s without a stroke or dementia.

Bleak reality of Alzheimer’s may be brighter in the future

Caution: If this is too painful for you, do not read anything beyond this sentence.

This was the title of an article appearing in last week’s Los Angeles Daily News. My mother died from Alzheimer’s disease three years ago. I have seen all five stages. Stage five is devastating. Still, you should know what is likely to happen if you or a loved one develops this horrible disease. I am changing my Medical Power of Attorney by adding instructions pertaining to the disease.

DEAR DOCTOR K »
My mother has Alzheimer’s disease. What should I expect in the coming years?

DEAR READER»
It’s impossible to predict exactly how Alzheimer’s disease will affect someone. Symptoms of the disease, and how quickly they progress, can vary widely from person to person. In some people, for reasons we don’t understand; the disease progresses very slowly.

However rapidly Alzheimer’s disease progresses, it generally un-folds in five stages:

• Stage 1. Memory problems begin. The person may misplace valuable objects. Their performance at work or in social situations begins to suffer. They may have more trouble expressing their thoughts.

Personality changes also begin. A person may become withdrawn, apathetic, moody, depressed, irritable or anxious.

• Stage 2. Memory problems are more obvious. It may be difficult for someone with Alzheimer’s to follow conversations. The person may have difficulty recalling current events or even bits of information from their own lives. Depression of-ten becomes prominent. Reasoning and judgment skills are impaired.

• Stage 3. Memory can fluctuate daily or even hourly. People sometimes forget major events in their lives. Often they are unaware of the date or the time of .year. Their conversations may become disjointed and veer off track.

You may see episodes of paranoia or anger. Stressful situations can trigger shouting, cursing or hitting.

At this stage, people with Alzheimer’s can still manage many basic activities of daily living. But they can no longer live independently.

• Stage 4. In this stage, you’ll see dramatic changes. Language skills drop sharply. Memory impairment becomes profound. A person remembers only bits and pieces of his or her past.

People become less withdrawn, but they often develop behavior and emotional problems, including delusions and hallucinations. Sleep disturbances and wandering are also common.

By this stage, the person will likely require help to bathe, toilet, dress and eat.

• Stage 5. This stage has been called “the long goodbye.” There seems to be very little left of the person’s “self.” Motor skills decline until the person can no longer walk, sit up, chew and swallow food, or control bladder and bowel movements. As the brain shuts down, the person becomes unresponsive, lapses into a coma and finally dies.

I am sorry to paint such a bleak picture, but unfortunately today we have no way of preventing or treating this terrible disease. However, there is reason to hope that the picture will become brighter in the future. In the past 20 years, scientists have begun to unravel what goes wrong with the chemistry of the brain in Alzheimer’s. I am cautiously optimistic that this knowledge will lead to true breakthroughs.

But like the pace of the disease itself, the pace of our growing knowledge is hard to predict. It may take decades, but I think medical research will make major advances. I know that gives little comfort to people who must deal with this terrible illness today.

Dr. Komaroff is a physician and professor at Harvard Medical School.
To send questions, go to AskDoctorK.com, or write:
Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.