FACTS ABOUT ALZHEIMER'S DISEASE
"Alzheimer's Disease" is the term used to describe a dementing
disorder marked by certain brain changes, regardless of the
age of onset. Alzheimer's disease is not a normal part of aging
- - and it is not something that inevitable happens in later
life. Rather, it is one of the dementing disorders, a group
of brain diseases that lead to the loss of mental and physical
functions. The disorder, whole cause is unknown, affects a small
but significant percentage of older Americans. A very small
minority of Alzheimer's patients are under 50 years of age.
However, most are over 65. Alzheimer's disease is the exception,
rather than the rule, in old age. Only 5 to 6 percent of older
people are afflicted by Alzheimer's disease or a related dementia
- - but this means approximately 3 to 4 million Americans have
one of these debilitating disorders. Research indicates that
1 percent of the population aged 65-75 has severe dementia,
increasing to 7 percent of those aged 75-85 and to 25 percent
of those 85 or older. As out population ages and the number
of Alzheimer's patients increases, costs of care will rise as
well. Although Alzheimer's disease is not yet curable or reversible,
there are ways to alleviate symptoms and suffering and to assist
families. And not every person with this illness must necessarily
move to a nursing home. Many thousands of patients - - especially
those in the early stages of the disease - - are cared for by
their families in the community. Indeed, one of the most important
aspects of medical management is family education and family
support services. When, or whether, to transfer a patient to
a nursing home is a decision to be carefully considered by the
family. The onset of Alzheimer's disease is usually very slow
and gradual, seldom occurring before age 65. Over time, however,
it follows a progressively more serious course. Among the symptoms
that typically develop, none is unique to Alzheimer's disease
at its various stages. It is therefore essential for suspicious
changes to be thoroughly evaluated before they become inappropriately
or negligently labeled Alzheimer's disease. Problems of memory,
particularly recent or short-term memory, are common early in
the course of the disease. For example, the individual may,
on repeated occasions, forget to turn off the iron or may not
recall which of the morning's medicines were taken. Mild personality
changes, such as less spontaneity or a sense of apathy and a
tendency to withdraw from social interactions, may occur early
in the illness. As the disease progresses, problems in abstract
thinking or in intellectual functioning develop. You may notice
the individual beginning to have trouble with figures when working
on bills, with understanding what is being read, or with organizing
the days work. Further disturbances in behavior and appearance
may also be seen at this point, such as agitation, irritability,
quarrelsomeness, and diminishing ability to dress appropriately.
The average course of the disease from the time it is recognized
to death is about 6 to 8 years, but it may range from under
2 years to over 20 years. Those who develop the disorder later
in life may die from other illnesses (such as heart disease)
before Alzheimer's disease reaches its final and most serious
stage. The reaction of an individual to the illness and the
way he or she copes with it also varies and may depend on such
factors as lifelong personality patterns and the nature and
severity of the stress in the immediate environment. As research
on Alzheimer's disease continues, scientists are now describing
other abnormal chemical changes associated with the disease.
These include nerve cell degeneration in certain areas of the
brain. Also, defects in certain blood vessels supplying blood
to the brain have been studied as a possible contributing factor.
There is no way at the present time to determine who may get
Alzheimer's disease. The main risk factor for the disease is
increased age. The rates of the disease increase markedly with
advancing age, with 25 percent of people over 85 suffering from
Alzheimer's or other sever dementia. Other things often noticeable
may be depression, severe uneasiness, and paranoia or delusions
that accompany or result from the disease, but they can often
be alleviated by appropriate treatments. Alzheimer's disease
has emerged as one of the great mysteries in modern day medicine,
with a growing number of clues but still no answers as to its
cause. Researchers have come up with a number of theories about
the cause of this disease but so far the mystery remains unresolved.
Because of the many other disorders that are often confused
with Alzheimer's disease, a comprehensive clinical evaluation
is essential to arrive at a correct diagnosis of any symptoms
that look similar to those of Alzheimer's disease. In most cases,
the family physician can be consulted about the best way to
get the necessary examinations. Stress on the family can take
a toll on both the patient and the caregiver alike. Caregivers
are usually family members - - either spouses or children -
- and usually wives and daughters. As time passes and the burden
mounts, it not only places the mental health of family caregivers
at risk. It also diminishes their ability to provide care to
the diseased patient. Hence, assistance to the family as a whole
must be considered. As the disease progresses, families experience
increasing anxiety and pain at seeing unsettling changes in
a loved one, and they commonly feel guilt over not being able
to do enough. The prevalence of reactive depression among family
members in this situation is disturbingly high - - caregivers
are chronically stressed and are much more likely to suffer
from depression than the average person. If caregivers have
been forced to retire from positions outside the home. They
feel progressively more isolated and no longer productive members
of society. The likelihood, intensity, and duration of depression
among caregivers can all be lowered through available interventions.
For example, to the extent that family members can offer emotional
support to each other and perhaps seek professional consultation,
they will be better prepared to help their loved one manage
the illness and to recognize the limits of what they themselves
can reasonably do. Though Alzheimer's disease cannot at present
be cured, reversed, or stopped in its progression, much can
be done to help both the patient and the family live through
the course of the illness with greater dignity and less discomfort.
Toward this goal, appropriate clinical interventions and community
services should be vigorously sought. While Alzheimer's disease
remains a mystery, with its cause and cure not yet found, there
is considerable excitement and hope about new findings that
are unfolding in numerous research settings. The connecting
pieces to the puzzle called Alzheimer's disease continue to
be found.
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