More than six million Americans battle Alzheimer’s disease, the most common form of dementia. Although the number of affected patients continues to climb worldwide, myths and misconceptions still abound when it comes to this progressive neurological disease. Arming yourself with the right information can help you better support your loved ones in the fight against Alzheimer’s.
Fiction: Memory loss is a natural part of aging.
Fact: Regularly having difficulty with short-term memory, such as forgetting what you had for breakfast, forgetting why you drove to the store, raises more concern since Alzheimer disease typically affects short-term memory in the beginning. But the symptoms generally are followed by other more significant problems with inability to manage finances, drive or interfere with normal relationship with friends and family.
“Many people start to have trouble with memory and concentration as they get older but do not necessarily develop dementia”, says Dr. Steven Goins, a Neurologist at Summit Health. “Doctors often diagnose people with mild memory problems as having “mild cognitive impairment” or MCI.” Roughly half the people with MCI will eventually develop dementia but the other half may be demonstrating only mild cognitive changes of aging or have other medical problems such as sleep apnea, depression or symptoms from medications.
Fiction: Alzheimer’s is a disease that only affects older people.
Fact: Although most people who develop Alzheimer’s disease are over the age of 65, it can also affect people as early as in their 30s, 40s, and even 50s. These early-onset patients account for about 1-2 percent of all cases.
It is true, however, that the older we get, the higher our likelihood of developing Alzheimer’s — the percentage of people with this disease doubles for each five-year span beyond age 65.
Fiction: Alzheimer’s is always caused by genetics.
Fact: There are probably many factors that contribute to development of Alzheimer disease and most of these are not well understood. Genetic factors are only part of the story. Alzheimer disease beginning before age 65 years refer to it has early onset Alzheimer’s disease. Genetic causes of Alzheimer disease usually affect individuals with symptom onset between 40 and 65 years of age. So-called late onset Alzheimer’s disease, occurring after 65 years of age also has genetic contributors. “A gene on chromosome 19, the apolipoprotein E or APOE gene is considered to be a “susceptibility gene” for Alzheimer’s disease,” explains Dr. Goins. “If a person has 2 copies of APOE gene type 4, the person has a 30% chance of eventually developing Alzheimer’s disease. But that also means that most people who have 2 copies of APOE gene type 4, will never develop Alzheimer disease.” Many other people develop Alzheimer disease without any evidence genetic abnormalities.
While we don’t yet know how to prevent it, there are certain steps you can take to manage the risks of developing dementia. These include making brain-healthy choices such as following a Mediterranean diet and being physically, socially, and mentally active.
Fiction: Alzheimer’s and dementia are the same.
Fact: There are different types of dementia. Alzheimer disease is the most common form of dementia but only accounts for 51% of patients with dementia. Another 12% of patients with dementia have a combination of Alzheimer disease and vascular dementia. 13% of patients have pure vascular dementia, the second most common cause of dementia. There are several other types of dementia that are also encountered regularly in a neurology practice such as Lewy body dementia and frontotemporal dementia. Most of these less commonly encountered forms of dementia, like Alzheimer disease, do not have a specific treatment but still require medical management.
Dr. Goins emphasizes the need for medical evaluation for an accurate diagnosis of dementia. “There are several forms of dementia that are treatable such as normal pressure hydrocephalus, B12 deficiency or pseudodementia from other medical conditions. But precise diagnosis of Alzheimer disease can be challenging.” Most testing will not directly confirm the diagnosis but is done to rule out other treatable conditions of dementia. If a precise diagnosis is necessary, analysis of cerebrospinal fluid after a lumbar puncture or PET scanning can provide the most reliable diagnostic information. But there are several laboratories that are working on sensitive new blood tests for Alzheimer disease which may become available in the near future.
Fiction: There is nothing you can do for someone diagnosed with Alzheimer’s.
Fact: “For most patients, during the first five to seven years of their disease, they can still enjoy a good quality of life,” says Dr. Goins. “However, this requires a supportive, familial environment.” Family members need to sit down and discuss necessary lifestyle changes, such as addressing safety issues around the house, planning for long-term care and medication compliance, and physical and mental exercises to slow down the course of the disease. It’s also important to make every year count. Planning ways to make each year a happy year with recreational activities and time with family and friends is essential. Families can continue to enjoy life by reassigning roles and responsibilities. For example, the unaffected spouse can become the memory specialist for the team.
Fiction: People don’t die from Alzheimer’s disease.
Fact: Alzheimer’s disease is the sixth leading cause of death for adults. Most people live eight to 10 years after diagnosis, though some may live for up to 20 years. As the disease progresses, there ultimately will be continued loss of abilities to perform basic activities of daily living. And sometimes behavioral problems will emerge. Eventually, the person affected in the late stages of dementia is simply unable to care for themselves can become susceptible to medical problems such as pneumonia, blood clots or dehydration. It is important that families work together to agree on an Advanced Directive so that medical care will be appropriate in the late stages of dementia and care is designed to prevent suffering rather than to necessarily prolonging life and suffering.
Although science offer some hope for an eventual preventive treatment or cure for Alzheimer disease, treatment is currently mainly supportive. If you or a loved one is experiencing memory loss or if you are concerned about Alzheimer’s disease, please consult your primary care provider or consult one of our neurologists.