Issue Date: Dec. 9, 2001
Alzheimer's
Seeking the unknown
Until researchers find a cause or a cure, it makes sense to learn how to cope with this devastating disease.
Your response to our Aug. 31-Sept. 2 cover story on Alzheimer's was so strong that USA WEEKEND asked medical editor Tedd Mitchell to continue the coverage.
In 1982, my grandparents abruptly moved next door to my parents. I was shocked that they left the quiet little town that had been their home since childhood. Soon I understood why.
My grandfather, a retired school superintendent and World War II veteran, was slowly becoming forgetful. At first, misplaced keys and mismatched clothes went unnoticed by all but those who knew him well. Later, confusion and inability to drive or carry on long conversations made it obvious he had Alzheimer's disease. Fortunately, with family support and medical care, he lived a relatively independent life until the last few months. He died in 1986.
Today, 4 million Americans have Alzheimer's. Fourteen million baby boomers are expected to develop this fatal, progressive disease unless a cause or cure is found. Things you should know:
The diagnosis
Many of my patients are afraid they have Alzheimer's (ALTS-hi-merz), but they are just having normal age-related lapses of memory. In fact, as Alzheimer's progresses, it's often family members who seek help: The ill person is unaware of how much his capacity has diminished.
Seeking help is important. Here's what will happen: First, a doctor learns a patient's complete medical history and past level of functioning, which may involve speaking with friends and relatives to get the big picture. Next, a battery of basic lab studies and detailed psychological tests will be performed. These studies are done to look for causes that may be treatable (such as infections). If Alzheimer's remains likely, the doctor orders tests to look at the brain. Magnetic resonance imaging (MRI), positron emission tomography (PET) and computed tomography (CT) scans all are used to evaluate brain tissue. Again, the doctor is looking for an illness that can be treated, such as tumors, pressure changes, blood flow problems and other pathologies. Drug interactions, thyroid disease, depression and vascular disease all can lead to symptoms that mimic Alzheimer's, and all can be treated with some success.
If the doctor still hasn't found a treatable disease, the presumptive diagnosis of Alzheimer's is made. The only certain diagnosis is made in an autopsy.
What do you do then?
I've heard it said (especially with couples) that Alzheimer's often kills two people: the patient and the caregiver. If a loved one has this illness, get help.
First, keep seeing the doctor. Tacrine and a few other drugs are useful treatments in specific, tailored situations. Other drugs can control symptoms such as anxiety, sleep disturbances, depression and aggression. That makes the patient more comfortable and, in turn, can help with family support.
Early on, most patients find comfort at home. As physical needs increase, professionals such as home health nurses can help with bathing, dressing and taking medications. In the end stage, Alzheimer's units specialize in appropriate care. Don't feel guilty about getting help. Health care providers are equipped to deal with special needs; not seeking help is more harmful to your loved one.
For more information, contact:
Alzheimer's Disease Education and Referral Center. This is part of the National Institute on Aging, which funds Alzheimer's Disease Centers around the country. Call 1-800-438-4380, write P.O. Box 8250, Silver Spring, Md. 20907, or visit www.alzheimers.org.
The Alzheimer's Association. Call 1-800-272-3900 or visit www.alz.org.
Ongoing research
Two major risk factors are certain: old age and a family history of Alzheimer's. Researchers are pursuing these possible connections: past head injury, the presence of the protein apolipoprotein E, environmental factors (metals including zinc and aluminum have been found in Alzheimer's brain tissue) and lower levels of education. Others are studying whether viruses cause Alzheimer's disease.
Let's hope research keeps our grandchildren from the emotional pain of this dreadful illness.
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