The basics of Alzheimer's

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Expert shares details on nation’s sixth leading cause of death

By Audrey Posten, North Iowa Times

Every 68 seconds. That’s how frequently someone develops Alzheimer’s disease, the progressive brain disorder that destroys a person’s memory and basic functions like speaking, eating and walking before compromising the body’s ability to breathe and swallow. More than five million Americans currently live with the disease, which has no known cure. And as the Baby Boomer generation—one of the largest portions of the U.S. population—continues to age, that number is only expected to grow. 

That amount, paired with the cost of care, has some in the health care industry worried Alzheimer’s disease, as a single entity, could bankrupt the entire health care system.

“We just can’t afford to care for all those people,” warned Sally Timmer, programs and advocacy coordinator for the East Central Iowa Chapter of the Alzheimer’s Association, who spoke at the July coffee house at Monona’s Murphy Helwig Library.

Timmer said Alzheimer’s disease is the most common form of dementia, accounting for 60 to 80 percent of all cases. It most often impacts people over the age of 65, and is always fatal. Although the disease can last up to 20 years from the onset of symptoms, average life expectancy is anywhere from four to eight years.

To demonstrate the impact of Alzheimer’s on the brain, Timmer said people should think of brain cells as factories. The cells, or neurons, group together and perform special functions like thinking, learning and memory. Others help with the senses or tell which muscles to move and when. They receive supplies, generate energy, construct equipment and get rid of waste.

“Scientists believe Alzheimer’s disease prevents parts of the cell’s factory from running well,” Timmer explained. “They’re not exactly sure where the trouble starts, but just like in a real factory, once you start to get backed up and break down in one section, it’s going to start affecting all the other sections. Brain cells lose their ability to do their jobs, then they eventually die, resulting in shrinkage of the brain. The damage spreads.” 

With Alzheimer’s disease, Timmer said changes aren’t once-in-awhile occurrences or simple by-products of getting older, such as occasionally missing a monthly payment or misplacing an item. Instead, they’re ongoing patterns of loss of function and skills in areas that were once reliable—things a person could easily do.

Ten warning signs characterize Alzheimer’s disease, the first being memory changes that disrupt daily life.

“A big one is not being able to remember recently learned information, like what you ate for breakfast or what conversation you just had with a friend,” Timmer said.

The second includes challenges in planning or solving problems. The person might have trouble budgeting or functioning at work, Timmer noted.

Warning sign number three is difficulty in completing familiar tasks.

“They may have trouble remembering how to cook a recipe they’ve had memorized for years,” Timmer quipped.

The fourth involves confusion with time and place, while the fifth signals trouble with visual images and spatial relationships.

“They have trouble judging distance and determining color and contrast,” Timmer said. “This is where it can have some real implications when it comes to driving, if they’re not able to see how far away things are. They also start to lose some of their reaction time. It’s hard to process all that information because, when you are driving, you’re looking at your mirrors, the lights, the cars around you, your speed. There’s a lot of things you don’t recognize you’re doing when you have normal cognitive functioning. ”

The sixth warning sign reveals problems with words, both in speaking and writing. People will have difficulty spelling simple words like “of” and “the.”

“They might mix words around so their sentences don’t really make sense,” Timmer shared. “They could also be in the middle of a conversation and stop because they don’t remember what they were going to tell you.”

With the seventh sign, Alzheimer’s sufferers will find themselves misplacing items, then losing the ability to retrace their steps. Timmer said they may also put things in strange places, like their wallet in the refrigerator or shoes in the sink.

The eighth warning sign is decreased or poor judgment. 

“They might spend large amounts of money they never would have done before,” Timmer said, “or maybe they’re giving their information to telemarketers over the phone.”

The final two warning signs involve withdrawal from work or social activities, as well as changes in mood and personality. Timmer said it will become difficult to be around a lot of people and have conversations.

“They will avoid those things,” she remarked. “There might be more anxiety, agitation, confusion, fear.”

The disease includes three stages, but Timmer said the course of Alzheimer’s is different in each individual.

“Throughout all the stages, it’s the job of the care partner to help the person retain their sense of self and their dignity,” she said. “Even at the end of life, the person may be comforted by touch, sound and taste. Providing those sensations allows the person to connect with others and continue to relate to their surroundings.” 

Timmer said scientists have yet to identify a single reason why brain cells fail, but certain risk factors can increase a person’s chances of potentially developing Alzheimer’s disease.

The primary risk factor is age; that risk increases the older you get.

The incidence of Alzheimer’s is also higher in women.

“[Scientists] think that’s mainly due to the fact that women live longer,” Timmer said. “But they are doing studies to see if there’s another reason. Is it something in our genes or something in the way we handle stress or the types of jobs we take?”

Family history can increase risk, said Timmer, but scientists are unsure if that’s because of the family’s genes or an environmental factor connected to where the family lives.

To better protect yourself, Timmer advocated practices that keep the brain healthy: maintain strong social connections, implement good diet and exercise and keep your brain active.

“Make your brain learn new things or pick up a new hobby,” she said. “Do things that really stump your brain, so your brain  has to work hard to figure out an answer.”

If you have concerns with yourself or a loved one, Timmer said it’s important to schedule a check-up with your primary care physician. He or she can help determine if the issues are dementia-related or something that can be reversed. You will need to provide a log of your symptoms, family and medical history and a list of medications. Full mental and physical evaluations will be performed.

“Because, right now, there’s no single test they give you that tells you ‘yes or no, you have Alzheimer’s disease,’ they have to go through quite a bit in the assessment to rule out other diseases and conditions that have symptoms similar to Alzheimer’s or other types of dementia,” Timmer explained.

To learn more about Alzheimer’s disease or the Alzheimer’s Association, visit alz.org. 

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