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Just Aging... Or Something More?

Jun 14, 2016

  Before I get started, I’m legally obligated to present this disclaimer. I am NOT a clinical person. I have no medical training, just education on Alzheimer’s Disease (AD) and related dementias. I’m just here to share and to be of assistance to families we see professionally as we help them cope with family matters. These are the most common questions I’m asked:

  1. Why do some people get dementia, and others don’t?
  1. What causes Alzheimer’s Disease?

WE DON’T KNOW. This is the best answer I can give. If this isn’t satisfactory, I’m sorry. If you feel the need to leave the blog right now, I’ll understand. I CAN tell you, however, that we now know more about the disease than we ever have, but not much about the causes. Is it cooking with aluminum pots and pans? (Not proven) Is it the use of aerosol cans? (No proof) Greenhouse gases? (No proof) Our sedentary lifestyle? (Doesn’t help) Ninety percent of what we know, we have learned over the last 20 years. When AD was discovered in 1906, the average life span in the US was 50 years. Few people reached the age of greatest risk. As a result, the disease was considered rare and attracted little interest. That all changed as our life span increased and scientists began to realize how often AD strikes people in their 70’s and 80’s. BTW, the Centers for Disease Control and Prevention recently estimated life expectancy to be 78.5 years. Today, AD is at the forefront of biomedical research, so “WE DON’T KNOW” is currently our best answer. Here are some facts and figures that may scare you:

  • 1 in 3 Seniors die with Alzheimer’s or Dementia
  • AD is the 6th leading cause of death in America, and the 6th leading cause of death in Arkansas
  • 2 in 3 AD sufferers are women
  • 50% of those with AD don’t know it

What’s the difference between Alzheimer’s Disease and Dementia? Dementia is a decline in memory, PLUS reduced ability to do a number fo things that interfere with daily life:

  • Speak coherently or understand words
  • Recognize objects
  • Perform motor activities
  • Think abstractly, make judgments, plan and carry out tasks

It is important to know that some forms are treatable/reversible. Alzheimer’s Disease, on the other hand, is one form of dementia—NOT just a little memory loss, and NOT a normal part of aging. It is a progressive disease. It destroys brain cells. It causes problems with memory, thinking and behavior. It eventually takes away the ability to communicate, move and swallow. It ultimately is fatal. That last point is probably why physicians have hesitated to give a diagnosis of AD. In fact, it used to be said the only way to positively diagnose AD is in an autopsy. Things have changed. As we mentioned earlier, people are living longer. More than 10,000 people turn 65 each day in the US. TEN THOUSAND! The number of people in the US age 65+ is at its highest-ever and is growing exponentially. The annual number of new cases of Alzheimer’s and other dementia is projected to DOUBLE by 2050. Every 68 seconds, someone in the US develops AD. By mid-century, it will be every 33 seconds. When the first baby-boomers reach age 85 in 2031, it’s projected that more than 3 million people age 85+ are likely to have AD. Dementia is a bit like an ice sculpture. (Stay with me here.) At a wedding reception, there’s a beautiful ice sculpture of a swan. At the beginning of the evening, Bridezilla looks at the swan and says, “This is so beautiful! Look at the intricate details—the feathers, the eyes…this is my dream wedding.” As the party goes on, the room heats up as people are dancing (this is a fun wedding) The swan begins to melt. Most people, especially Bridezilla, aren’t going to notice, because they scrutinized the sculpture at the beginning of the party, not a few hours later. What’s the first thing you lose as the ice melts? Those fine details are lost. The feathers, the eyes…. What’s left is a vague representation of our swan, rather than our intricate, detailed work. If we forced people to scrutinize it, or if we forced the swan to perform at a higher capacity…. Let’s say that the catering company tries to save a buck and take the slightly used, slightly melted swan, put it in the freezer for another wedding tomorrow. It won’t look the same as when we first saw it, and it will be noticeably different! That’s what we see with Dementia. With the changes in the brain, the ability to perform at a higher capacity is lost. We aren’t going to notice that someone isn’t capable of the minutia, unless we press them for details. Being admitted to the hospital is a great example of when a person fails to perform.

  • You take them out of their environment, add those teeny, tiny, toiletry items, which are different than what they have at home….
  • And don’t even get me started on patient gowns! They’re counter-intuitive, because they don’t go on like a shirt.
  • Then you add all those surgical precautions and instructions – “nothing by mouth after midnight, TAKE THIS medicine, but NOT THAT one.”

All of it requires new learning, which our “swan” no longer can do. (As an advocate for elders, I’m going to point out that our swan, no matter what state of melting, is still beautiful.) Many of us are like Bridezilla –-Everything is perfect, and they don’t notice. Those family members who come in for the wedding, though, they look at our melted, abstract swan that used to be “Mom,” and wonder when things got so bad. Risk Factors Here are some of the top risk factors for AD:

  • Age is the primary risk factor. We’re living longer, and the symptoms that used to show up rarely are much more frequent.
  • Family history/genetics. Yes, there is a link between Alzheimer’s Disease and family history. But don’t consider yourself to have a death sentence, just because a parent, grandparent or sibling had it. Your chances are slightly greater, than someone with no genetic link, but nothing is guaranteed.
  • The head-heart connection is AD induced by cardio-vascular disease, high blood pressure and the like. They’re noticing a more direct correlation between blood flow and the development of plaques and tangles in the brain.
  • Social-Cognitive Engagement is scientific for “If you don’t use it, you’ll lose it….” That’s why we’re supposed to work puzzles, be creative, stay active and engaged in our community, church, family or whatever makes us happy.
  • And Traumatic Brain Injury (TBI) which we don’t have a lot of control over.

How Do I Know? Here’s what the Alzheimer’s Association says you need to know: First, when you recognize that something’s wrong, go to the doctor. Medical professionals will review your history, and ask about your family history. They’ll conduct mental or memory tests and try to find out what’s going on in your head. Then, they’ll attempt to confirm their findings through physical or neuro exams. Remember, AD is a disease of exclusion – if we can’t explain what’s happening any other way, it must be AD. Your doctor will evaluate your overall health and identify any conditions that could affect how well your mind is working. Your doctor may refer you to a specialist:

  • Neurologist – specializes in diseases of the brain and nervous system
  • Psychiatrist – specializes in disorders that affect mood or the way the mind works
  • Psychologist – has special training in testing memory and other mental functions
  • Geriatrician – specializes in the care of older adults and Alzheimer's disease

    Brian Rega is the Director of Senior Services/Housing for St. Bernards Healthcare based in Jonesboro. St. Bernards offers almost 300 housing units for adults age 55+ including the flagship St. Bernards Village; Cottage Homes; Benedictine Manor, (affordable housing for low-income elderly), and the latest addition, St. Bernards Villa featuring memory care and assisted living. He has held the position since 1998. A native of Ash Flat, (Arkansas); Rega is a licensed residential care/assisted living facility administrator, and is an instructor in the administrator certification program. He holds a bachelor ‘sdegree in communications from Arkansas State University-Jonesboro, and is a certified business trainer. In 2006, he completed studies to become one of only two “Certified Aging Services Professionals” in the state of Arkansas, through the University of North Texas.   He was first elected to the Board of Directors of the Arkansas Residential Assisted Living Association in 2000, and then appointed chairman of the board by his peers each year between 2003 and 2013. He remains on the Board today.