Alzheimer’s Disease

What Causes Alzheimer’s Disease?

There is no known specific cause of Alzheimer’s. It’s likely caused by several factors. Age is a risk factor, and this risk doubles every five years after age 65. Genetics may also play a role in the development of Alzheimer’s, and education, diet, and environment are also being studied as potential risk factors. Certain heath conditions may also be linked to Alzheimer’s; these include the same risk factors for heart disease and stroke (high blood pressure and high cholesterol).

What Are the Symptoms?

Symptoms of Alzheimer’s include:

• Memory problems
• Confusion
• Trouble recognizing family and friends
• Mood and personality changes (agitation, anxiety, anger, or depression)
• Getting lost or wandering
• Taking longer to complete regular tasks or inability to complete them
• Hallucinations, delusions, and paranoia
• Sleeplessness

Diagnosing Alzheimer’s

Alzheimer’s can only be definitively diagnosed after death with an autopsy. Doctors will instead make a diagnosis of “possible” or “probable” Alzheimer’s. Steps used to make these diagnoses include:

• Information about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality
• Tests of memory, problem solving, attention, counting, and language skills
• Medical tests such as blood, urine, or spinal fluid tests
• Brain scans such as computed tomography (CT) scan or magnetic resonance imaging (MRI)

How Is It Treated?

There is no cure for Alzheimer’s and no treatment to slow its progress, but there are several FDA-approved drugs used to treat symptoms. By treating symptoms, some individuals are better able to carry out the activities of daily life, as these medicines can help them maintain thinking, memory, or speaking skills. FDA-approved drugs for symptoms of Alzheimer’s include Aricept® (donepezil), Exelon® (rivastigmine), Reminyl® (galantamine), and Namenda® (memantine).

Certain lifestyle factors may also help manage symptoms of Alzheimer’s. These include diet, physical activity, social engagement, and mentally stimulating pursuits.

Living with Someone with Alzheimer’s

Caring for an individual with Alzheimer’s can be very challenging. As caregiver, your burden may be physical, emotional, and financial. It’s therefore important to find personal support and resources that will educate you and help you deliver safe and effective care.

Support groups can be helpful for caregivers. You can share concerns, experiences, and tips as well as ask questions and find emotional comfort. The Alzheimer’s Association (www.alz.org), other national organizations (see Resources below), as well as local organizations offer in-person support groups, and support groups can also be accessed online.

Effective coping skills can help you with daily activities like dressing, bathing, and eating that can become very difficult with a person who has Alzheimer’s. Some general tips for caring for a person with Alzheimer’s include:

• Ask the doctor questions about Alzheimer’s disease, treatment, and lifestyle factors that can help your loved one feel more comfortable.
• Develop a routine to help things go more smoothly. This may involve choosing to do certain activities—like bathing—when your loved one is less confused, more cooperative, and functioning better. A schedule for activities such as dressing can help the day go more smoothly, as the person can expect a routine.
• Consider using adult day care in order to give yourself a break.
• Learn how to best communicate with your loved one. Simple words, short sentences, and a calm tone may help. Make eye contact. Gently help him or her find a word he or she is searching for or complete a thought.
• Make safety adjustments in the home, such as secure locks (especially if wandering is a risk), no-slip mats and handrails in the bathtub or shower, and good lighting.
• Make sure that your loved one always carries a form of identification or wears a medical bracelet.
• When it’s no longer safe for your loved one to drive, make sure that he or she doesn’t have access to a car or car keys.
• Know when it’s not safe to leave your loved one alone and never do so in those circumstances—such as in the bath or around kitchen appliances.

End-of-life Care and Legal Steps

At some point during the course of caring for a loved one with Alzheimer’s, many caregivers find, as the disease progresses, that they can no longer continue home care. The decision to move your loved one to a residential care facility is likely difficult and emotional. This where a good support network can help—by supporting you emotionally and giving you access to valuable information about your options.

Options for residential facilities include group homes, assisted living facilities, and nursing homes. It’s helpful to begin looking into these options before you have to make the decision to move your loved one from home. Start by learning about facilities in your area. Healthcare providers, friends, family, and hospital social workers may be able to help you find facilities. As you research and visit possible facilities, consider what types of services are important to you and your loved one and make a list of questions to ask the staff. Services you may be looking for include activities, transportation, or special units for people with Alzheimer’s. Get a feel for each facility by talking with administration, nursing staff, and residents and observing how residents are treated.

Once you decide on a residential care facility and find an available room, determine the cost and whether Medicare or Medicaid is accepted. As well, be sure you clearly understand the contract and financial agreement. It may be helpful to discuss these with a lawyer before you sign them.

Finally, when the time comes to move your loved one into a facility, be aware that this a major transition for him or her, and for you. This may be an important time to call upon family and friends, support services, or a social worker.

Caregivers can find more information about support groups and services in the resources listed below.

Resources

Alzheimer’s Disease Education and Referral Center

Alzheimer’s Association

Alzheimer’s Foundation of America

Children of Aging Parents

Sources

Alzheimer’s Disease Fact Sheet. The National Institute on Aging website. Available at: http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm. (Accessed October 2010).

NINDS Alzheimer’s Disease Information Page. National Institute of Neurological Disorders and Stroke (NINDS) website. Available at: http://www.ninds.nih.gov/. (Accessed October 2010).

Alzheimer’s Disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/aging/healthybrain/alzheimers.htm.
(Accessed October 2010).