Understanding Alzheimer's Disease

Is it normal aging or has your grandmother developed dementia?  According to Fred Walbrun, MD, a geriatrician at Prevea Health, there is a difference between normal aging and dementia. Dementia is a broad term that can take many different forms with Alzheimer's disease being the most common.

Alzheimer's is a fatal disease and the fourth leading cause of death in persons over 65. Warning signs include memory loss, difficulty with familiar tasks, disorientation of time and place, problems with language, inability to perform complex tasks such as balancing a checkbook, poor judgment, change in personality, misplacing items and the loss of ambition. If these symptoms are present, seeking early diagnosis is extremely beneficial to both the patient and his/her family members.

Since Dr. Alois Alzheimer first described the disease in 1906 by noting changes in brain tissue, researchers have been searching for clues to the cause of Alzheimer's. Without completely understanding the cause, patients today are given medications that treat their symptoms, which do not cure the disease, but rather improve the patient's quality of life.

Alzheimer's can only be positively diagnosed by examining brain tissue. Physicians therefore use the term "possible Alzheimer's disease" while describing the disease in patients because a positive diagnosis is only possible through a brain biopsy or an autopsy, which would need to be completed after the patient passes away.

If your grandma is diagnosed with "possible Alzheimer's disease," is the rest of the family at risk genetically?  There is some research suggesting that Alzheimer's has hereditary factors, however, non-hereditary factors, including the patient's level of education, have also been identified. The Alzheimer's Association supports this finding stating that people with fewer years of education have a greater risk of developing the disease than people who have achieved higher levels of education.

With any fatal illness, each patient will go through a variety of stages and may develop coping mechanisms to manage each. When patients are in denial, they cover up memory loss by transferring tasks to other people. A second coping method is humor, allowing patients to make light of a situation and not reveal how their abilities are deteriorating. And a third is confabulation, which Dr. Walbrun describes as providing "totally made up information" in response to questions—evident when a series of people ask the same question, each getting different answers.

As the disease progresses, families need to consider living arrangements. Safety is the number one issue. Can the patient feed and care for herself without assistance? Will she be able to manage a household emergency? These are hard questions, but family members need to put their loved one's needs first.

Finally, Dr. Walbrun shares two recommendations for families affected by Alzheimer's disease. First, educate yourself. Read, watch and learn as much as possible to get a better understanding of the illness. Second, get all legal documents such as living wills and powers of attorney in order as soon as possible. These two steps will lessen the struggle of dealing with "the biographical end" of your loved one's life.

To schedule an appointment with Dr. Walbrun, call (920) 496-4700.