What do Glen Campbell, a singer, Pat Summit, a coach and Ronald Regan, a former president of the U.S have in common? All three of these celebrities had Alzheimer’s disease. Today, whether reading about a celebrity with Alzheimer’s disease or being affected personally, this devastating disease has taken and touched thousands of lives.
The Scope and Cost of Alzheimer’s disease in America
During the month of June healthcare providers and organizations such as the Alzheimer’s Association are promoting the Go Purple campaign to highlight Alzheimer’s disease and Brain Health. Alzheimer’s disease is the 6th leading cause of death in the U.S. and more than 5 million Americans are living with it.
According to the Centers for Disease Control (CDC), Alzheimer’s disease is the most common type of dementia, which causes memory loss, affects cognitive abilities and the ability to function in one’s environment. Alzheimer’s disease is progressive, starting with mild symptoms and progressing on to where a person loses the ability to hold a conversation. Aging is the most important risk factor in the development of the disease. Family history and genetics also play a role. The number of people living with Alzheimer’s doubles every 5 years beyond age 65, however, younger individuals can also develop Alzheimer’s disease. In the U.S. 200,000 people under age 65 are living with early onset disease. By the year 2050, it is estimated that 16 million Americans will be living with this disease.
Alzheimer’s disease also has a huge impact on the economics of the healthcare system. The Alzheimer’s Association has estimated the cost of caring for people with this disease in the U.S. at $277 billion dollars a year. This cost does not include one important feature and that is the cost of unpaid caregivers, usually family and friends, which is estimated at over $200 billion dollars per year. You can go to https://www.alz.org/ and learn more.
Memory Loss- a major sign of Alzheimer’s disease
Since decreasing cognitive function and memory loss are key symptoms of Alzheimer’s disease the question is always raised, when is memory loss a real concern? Everyone has had times when they don’t remember someone’s name or they can’t remember where they put the car keys. It’s during these moments we may wonder “is this normal aging” or is something more going on? When should someone become concerned about being forgetful? The experts tell us that normal aging memory loss does not prevent someone from living a full life. When memory loss and impairment in thinking disrupts your life functioning, this is cause for concern. The Alzheimer’s Association has outlined ten warning signs to be aware of. If someone you know or a loved one is experiencing these signs they should be evaluated by their physician. The ten warning signs of Alzheimer’s disease include:
Memory loss that disrupts daily life
Challenges in planning or solving problems
Difficulty in completing familiar tasks at home
Confusion with time, place, dates and seasons
Trouble with visual images and spacial relationships
Problems with words and speaking
Misplacing things and losing the ability to trace steps
Poor judgement
Withdrawal from work or social activities
Changes in mood or personality
Seeing a physician is important to evaluate these signs since some may be caused by other agents or conditions such as: medications, emotional disorders, minor head injuries, alcoholism, vitamin B12 deficiency, hypothyroidism and brain diseases.
Making the diagnosis of Alzheimer’s disease
Making the diagnosis of Alzheimer’s is not always an exact science. Currently, the diagnosis is based on symptoms and cognitive testing. The National Institute on Aging and the Alzheimer’s Association has convened a committee to work on changing how the diagnosis is made. The proposal includes brain imagery to detect amyloid plaques and spinal fluid testing for protein. The down side is that these tests are expensive and not covered by insurance. However, researchers are stressing that, although memory loss is often the symptom that brings a patient in for evaluation, it is often not the first change that occurs. Studies are showing that changes in the brain that are characteristic of Alzheimer’s can occur 20-30 years before symptoms develop! Because of these brain changes, scientists are saying that lifestyle changes taken earlier in life can affect brain health and could improve and prolong cognitive function! Another benefit of early diagnosis is that it affords the patient the opportunity to enter into clinical research trials.
The importance of making the correct diagnosis
In 2016, The Alzheimer’s Association launched the Imaging Dementia- Evidence for Amyloid Scanning (IDEA) study. This four-year study will be testing 18,000 participants by PET scan to evaluate Medicare patients with mild cognitive impairment (MCI) or dementia with amyloid plaques. Patients without amyloid plaques do not have Alzheimer’s disease. The importance of this study is for patients to be correctly diagnosed and treated properly. Many patients today with MCI are placed on medications such as Aricept and Namenda, which may not be needed.
Is there anything that can be done to prevent the development of Alzheimer’s disease?
Currently, there is no one-way to prevent the development of Alzheimer’s disease. However, a person’s overall health can affect the development of cognitive decline. Currently, scientists are looking at the relationship between cognitive decline and vascular conditions such as heart disease, stroke and high blood pressure. Metabolic disorders, such as diabetes and obesity can also affect the development of dementia. Although there are risk factors for Alzheimer’s that cannot be altered such as age, family history and genetics the risk factors from vascular and metabolic diseases can be addressed. The Alzheimer’s Association has outlined key lifestyle habits that can help improve a person’s overall brain health in Ten Ways to Love Your Brain. These lifestyle habits include:
Physical activity/regular exercise
Formal education at any age/learning new information
Stop smoking
Take care of your heart
Avoid head injuries, wear a helmet when riding a bike, wear a seat belt
Eat a healthy diet
Get enough sleep
Take care of your mental healthy
Stay socially engaged
Challenge yourself, learn a new language
Your thoughts have power
Did you know that your thoughts could affect your overall brain function a well as lifestyle changes? Researchers have linked our thoughts and low self-esteem to the development of mental health conditions such as depression, addictions, anxiety and isolation. So how can we combat this thinking and build “cognitive reserve”? Scientists have shown that through neuroplasticity, the brains ability to adapt, change and build new neuro pathways, we can respond positively to environmental changes, physiological changes and experiences. People who manage stress, maintain an active lifestyle and build a strong social network, develop resilience, which buffers against dementia. This concept creates hope for all of us and emphasizes that our thoughts can affect our biology.
Barbara Bradley Hagerty, the NY Times best-selling author, talks about this concept in her book, Life Reimagined: The Science, Art and Opportunity of Midlife. Ms. Hagerty, who’s father suffered from dementia states in her book that because of this new science anyone with a family member who had dementia does not automatically have to succumb to this disease, “Now scientists are discovering that the way you think affects every aspect of your life: it can slice through the haze of Alzheimer’s disease even if your brain has plaques and tangles. It can add years to your life and protect you from all manner of disease”.
There is hope for the future
Although there is no cure for Alzheimer’s disease or a way to reverse the process, scientists are telling us that there is hope in the future through early recognition and implementing brain health strategies. A large study called the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) launched by the Alzheimer’s Association in 2018 involves five large healthcare networks. They have 2000 volunteers, ages 60-79 who will be followed for two years. The study will compare two lifestyle interventions and their affects on brain health. Overall, there are four lifestyle interventions that will be studied: exercise, nutrition counseling and modification, cognition and social stimulation and improved self-management of health status. Participants will be given two to work with depending on intensity and structure. The overall goal of the program is to develop a sustainable community health model for the prevention of this disease.