What You Should Know About Dementia and Alzheimer’s, But Were Afraid To Ask!

If you suspect you have something wrong, what’s the advantage of going to the doctor?

“If someone is obviously developing cognitive changes that significantly impair their social or occupational functioning, a workup is important because it may be something other than Alzheimers. A prime example is normal pressure hydrocephalus, which could be the result of some insult to the head, perhaps from decades ago, that may have gone unnoticed. This can change the flow of fluid within the brain, and cause it to press against the brain tissue. Three clinical features of normal pressure hydrocephalus are cognitive dysfunction, urinary incontinence and gait disturbance, such as walking more slowly. This is one kind of disorder that you want to look for. Or maybe it’s a stroke. You also want to rule out thyroid disease and brain tumors. Not every cognitive change is dementia.

Let’s assume it is Alzheimer’s. What’s the advantage of knowing?

“If the patient is not going to be able to be involved in making decisions about their own care, in a meaningful way, it’s important to discuss the potential course of their illness and the decisions that will need to be made. The course is variable. Some people go very quickly; some people take decades. The average duration of Alzheimer’s, from diagnosis until death, is seven years.

“In the early stages, a patient may still enjoy some things, even if he no longer can work and is a much-diminished person. He may like the company of family members and may still want to see friends. I don’t want to paint too rosy a picture, however, because the majority of patients, over time, will develop behavioral problems such as agitation, hallucinations, and paranoia.”

Can anything be done to medically help an Alzheimer’s patient?

“The data shows that there is some diminution in the rate of decline for a couple of years, when patients take certain drugs. Some families don’t see the benefit, however, and they want the patient to be taken off the drug. They don’t realize it, but there is a benefit.”

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What would you do if you or a close family member was diagnosed with Alzheimer’s?

Adult Daughter Comforting Father Suffering With Dementia‘I’d try to get them into a drug study. All of the major medical centers have well-funded studies going on now for drugs that have a very good scientific rationale behind them and could possibly work more meaningfully than drugs on the market now. So far, nothing has come out with a positive result, but there could be things in the pipeline with promise. This is something to consider right away. Some people don’t want to be ‘guinea pigs,’ but others see the wisdom.

“We’ve made tremendous progress in seeing how the disease develops in the brain through cellular changes, and there are studies targeting these changes.”

When someone is in the advanced stage of Alzheimer’s, do we know whether or not she’s aware what’s happening? Is she trapped in her own brain?

I don’t think it’s like that. I think there may be moments when someone is a little more with it, but advanced Alzheimer’s patients don’t remember from one minute to the next; they live in an incoherent world. I don’t think they have any awareness. Their world is different from what we’re experiencing in our world.”

Is there any over-the-counter products that can stave off cognitive changes?

“There’s a whole multi-billion-dollar industry that’s preying on our fears. Lots of people come in and they’re taking the latest formulations off the shelves of the health foods stores, where you’ll see a whole wall of these preparations. No one should be taking any of these things. They ARE NOT GOING TO HELP!”

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