September is World Alzheimer's Month

Since Septemer is World Alzheimer's Month, I wanted to post some information and links to help you find reputable information on the Internet.

The National Institute on Aging has a helpful list of symptoms of Alzheimer's Disease by stage:

Mild Alzheimer's disease

-getting lost
-trouble handling money and paying bills
-repeating questions
-taking longer to complete normal daily tasks
-poor judgment
-losing things or misplacing them in odd places
-mood and personality changes

Alzheimer's disease is often diagnosed at this stage.

Moderate Alzheimer's disease

-increased memory loss and confusion
-problems recognizing family and friends
-inability to learn new things
-difficulty carrying out tasks that involve multiple steps (such as getting dressed)
-problems coping with new situations
-hallucinations, delusions, and paranoia
-impulsive behavior

Severe Alzheimer's disease

-inability to communicate
-weight loss
-seizures
-skin infections
-difficulty swallowing
-groaning, moaning, or grunting
-increased sleeping
-lack of control of bowel and bladder

For more information on Alzheimer's Disease, check out these useful links:

Caregiver Stress (Alzheimer's Association)

Alzheimer's Disease (National Institute on Aging)

10 WarningSigns of Alzheimer's Disease (Alzheimer's Association)

Alzheimer's Disease

You may have seen on the news that Alzheimer's diagnostic guidelines have been updated for first time in decades. The NIH-supported revision also proposes staging of disease, potential use of biomarkers.

I have some information about those changes and at the end of this post are some links to general information on Alzheimer's disease as well as important information for caregivers.

To reflect what has been learned, the National Institute on Aging/Alzheimer's Association Diagnostic Guidelines for Alzheimer’s Disease cover three distinct stages of Alzheimer's disease:

Preclinical — The preclinical stage, for which the guidelines only apply in a research setting, describes a phase in which brain changes, including amyloid buildup and other early nerve cell changes, may already be in process. At this point, significant clinical symptoms are not yet evident. In some people, amyloid buildup can be detected with positron emission tomography (PET) scans and cerebrospinal fluid (CSF) analysis, but it is unknown what the risk for progression to Alzheimer’s dementia is for these individuals. However, use of these imaging and biomarker tests at this stage are recommended only for research. These biomarkers are still being developed and standardized and are not ready for use by clinicians in general practice.

Mild Cognitive Impairment (MCI) — The guidelines for the MCI stage are also largely for research, although they clarify existing guidelines for MCI for use in a clinical setting. The MCI stage is marked by symptoms of memory problems, enough to be noticed and measured, but not compromising a person’s independence. People with MCI may or may not progress to Alzheimer's dementia. Researchers will particularly focus on standardizing biomarkers for amyloid and for other possible signs of injury to the brain. Currently, biomarkers include elevated levels of tau or decreased levels of beta-amyloid in the CSF, reduced glucose uptake in the brain as determined by PET, and atrophy of certain areas of the brain as seen with structural magnetic resonance imaging (MRI). These tests will be used primarily by researchers, but may be applied in specialized clinical settings to supplement standard clinical tests to help determine possible causes of MCI symptoms.

Alzheimer's Dementia — These criteria apply to the final stage of the disease, and are most relevant for doctors and patients. They outline ways clinicians should approach evaluating causes and progression of cognitive decline. The guidelines also expand the concept of Alzheimer's dementia beyond memory loss as its most central characteristic. A decline in other aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may be the first symptom to be noticed. At this stage, biomarker test results may be used in some cases to increase or decrease the level of certainty about a diagnosis of Alzheimer's dementia and to distinguish Alzheimer's dementia from other dementias, even as the validity of such tests is still under study for application and value in everyday clinical practice.

Here are some other links to check out:

Alzheimer’s Association Report: 2011 Alzheimer’s disease facts and figures

National Institute on Aging: Alzheimer’s Disease Fact Sheet

Understanding Alzheimer's Disease (National Institute on Aging)

Caregiver Guide (National Institute on Aging)

Caregiver Stress (Alzheimer's Association)

Maintain Your Brain Today

I came across a really great web page from the Alzheimer's Association on Brain Health. Their Maintain Your Brain Today page provides all kinds of information on how we should take care of our brain as we age by urging people to make brain-healthy life choices. There are links called: Stay Physically Active, Adopt a Brain-Healthy Diet, Remain Socially Active and Stay Mentally Active, plus other information as well. It's definitely worth checking out. If you want more information from the Alzheimer's Association, their home page is at www.alz.org.

Alzheimer's Disease

Dementia is a brain disorder that seriously affects a person’s ability to carry out activities of daily living, with Alzheimer’s disease being the most common.

Alzheimer’s begins slowly with the person having trouble remembering things that happened recently or the names of people they know. Over time, these symptoms get worse. They may not be able to remember family members or have trouble speaking, reading or writing. As the disease progresses, they may become anxious or aggressive or wander away from home.

Many Alzheimer’s patients live with a family member until the disease progresses to where the family member is not able to take care of them anymore. This causes great stress to family members.

There is no cure for Alzheimer’s but there are drugs that can slow the progression of symptoms for a time.

Alzheimer’s disease usually begins after the age of 60. The risk increases as you get older. The risk is also higher if a family member has the disease.

Today, the only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles co-exist in brain tissue. There is no 100% accurate way to diagnose Alzheimer’s disease. The only way to confirm diagnosis is to examine the brain after the person dies. However, skilled clinicians have a 90% accuracy rate in diagnosing the disease.

Doctors use several tools to diagnose Alzheimer's disease.

1. a complete medical history with questions about the person's general health, past medical problems, family health, and any difficulties carrying out daily activities
2. medical tests, such as tests of blood, urine or spinal fluid
3. tests to measure memory, problem solving, attention, counting, and language skills
4. brain scans that allow the doctor to look at a picture of the brain to see if anything does not look normal

These tests can help rule out other possible causes of symptoms.

Once Alzheimer’s is diagnosed, doctors have four drugs available to treat symptoms. For people with mild or moderate Alzheimer's, donepezil (Aricept®), rivastigmine (Exelon®), or galantamine (Razadyne®) may help prevent some symptoms from becoming worse for a limited time. Donepezil is also approved for symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda®), is used to treat symptoms of moderate to severe Alzheimer's, although it is also limited in its effects.

For more complete information on Alzheimer’s disease, visit the National Institute on Aging Alzheimer’s web site at http://nihseniorhealth.gov/alzheimersdisease/toc.html

MedlinePlus also has a great page that contains links to information on symptoms, diagnosis, treatment, and all kinds of other helpful resources.