New Guidelines Announced for Diagnosing Alzheimer’s

July 2010

Researchers are now focusing on the accumulation of clumps of a protein called amyloid which occurs in the brain.  This occurs about 10 years before dementia sets in and is viewed as the best place to intervene in the disease.  New imaging agents for PET scans, spinal fluid tests and other tests can also help to predict the onset of Alzheimer’s and are becoming very important.  These protein deposits are referred to as biomarkers and can be tracked by brain scans, blood and spinal fluid tests.

Three medical expert panels put together by the National Institute on Aging and the Alzheimer’s Association suggest that Alzheimer’s should be diagnosed in three stages  advanced disease, mild disease and, the new category, called preclinical disease. “These experts understand that the disease begins many years before dementia,” says Dr. Reisa Sperling of Brigham and Women’s Hospital in Boston.  Many researchers believe most Alzheimer’s drugs have failed because they were tried in people whose disease was too far advanced.

Home health nurses perform an assessment of each patient at the start of  home care. The home care nurse will not only analyze the physical condition of the patient, but asses their competence in performing activities of daily living.  It is noted if the patient is confused or does not understand basic instruction, or appears impaired mentally.  These could be early signs of Alzheimer’s and follow up treatment by the primary care physician can be suggested.

Health professionals are now classifying stages of Alzheimer’s as they would for many prevalent diseases such as cancer, heart disease and kidney disease which are all diagnosed on the basis of tests, even before symptoms appear.  Identifying dementia early can cut the cost of care by nearly 30% said researchers on July 11th, 2010.  Similarly, home health care is much more cost efficient than putting an Alzheimer’s patient with the beginning symptoms of the disease, in a nursing home.

Treatments for patients with a disposition for Alzheimer’s are expanding. Antioxidants neutralize unstable forms of oxygen called reactive oxygen species that can damage cells throughout the body.  The brain is an area of high metabolic activity, so is vulnerable to accumulating oxidative damage over a lifetime.  Higher vitamin E intake is tied to lower dementia risk, but is not proven to have an affect on Alzheimer’s.  Antioxidants like vitamins E and C and beta carotene might help stave off dementia because it is believed that their actions might interfere with the process of brain-cell degeneration.  It is recommended that one consult with their physician before taking any vitamins to understand the best dosages and how they may interact with existing medication.

The consensus is that a thorough examination can identify signs of dementia that may be a precursor to Alzheimer’s.  A healthy lifestyle and preventative diet can also aide in keeping  Alzheimer’s risk low.

The difference between Alzheimer’s and typical age-related changes:

Signs of Alzheimer’s Typical age-related changes
Poor judgment and decision making Making a bad decision once in a while
Inability to manage a budget Missing a monthly payment
Losing track of the date or the season Forgetting which day it is and remembering later
Difficulty having a conversation Sometimes forgetting which word to use
Misplacing things and being unable to retrace steps to find them Losing things from time to time

Early Alzheimer’s Diagnosis is Key

Recent research has found that early detection can allow for more successful treatment and prevent the serious symptoms that incapacitate the patient.

Alzheimer’s disease is a progressive and fatal brain disease. As many as 5.3 million Americans are living with Alzheimer’s disease. Alzheimer’s destroys brain cells, causing memory loss and problems with thinking and behavior severe enough to affect work, lifelong hobbies or social life.  Today, it is the seventh-leading cause of death in the United States and no known cure for the disease, but there is now good news revolving around early diagnosis.

Recognizing the onset of Alzheimer’s is key. Older persons should speak with their primary care doctor about any signs of Alzheimer’s that they may be experiencing.  Home health care professionals are a good source for observing patients in their natural surroundings when the most common warning signs are most evident.  Care givers can take note of any of these signs and report them to the attending physician or family.

Ten Warning Signs of Alzheimer’s:

  1. Memory LossOne of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over or relying on memory aides (e.g., reminder notes or electronic devices).
  2. Challenges in Planning or Solving ProblemsSome people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
  3. Difficulty completing familiar tasksPeople with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget or remembering the rules of a favorite game.
  4. Confusion with Time or PlaceLosing track of dates, seasons and the passage of time can be common with Alzheimer’s patients. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
  5. Trouble understanding Visual Images and Spatial RelationshipsFor some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room.
  6. Problems in Speaking or WritingPeople with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves.
  7. Misplacing ThingsA person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.
  8. Decreased or Poor JudgementPeople with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
  9. Withdrawl from Work or Social ActivitiesA person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby.
  10. Changes in Mood or PersonalityThe mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious

Alzheimer’s Disease Management

Alzheimer’s disease is the most common type of dementia, and it affects a variety of behavioral and intellectual abilities. Since the disease is progressive, symptoms can be slower to develop, but eventually worsen with time. Early symptoms typically involve a decline in memory and struggle with thinking abilities. Later symptoms include the inability to focus on daily activities or actively participate in conversations. Disorientation, mood changes, decreased judgment, and confusion as well as apprehension around loved ones are some other common symptoms.

While there is no cure for Alzheimer’s, there are various treatments available. These methods help patients manage the progressive symptoms of the disease, and allow them to function at a higher level for a longer period of time. Alzheimer’s therapy is one treatment method that helps patients deal with day to day symptoms, and face each new challenge as it emerges. Medications also work well to treat memory loss, behavioral changes and sleep disorders.

Home Treatment Plans

AT Home Care’s team of home health aides, nurses and therapists are a great resource for in-home care and support. As opposed to observing an Alzheimer’s patient in a medical environment, our in-home care team is able to observe each patient in their natural surroundings to determine the best course of action in treatment for their stage of Alzheimer’s. Then, together with the patients family we create a comprehensive in-home care plan that focuses on a high quality of life and symptom management.

Alzheimer’s Statistics:

  • Over 5 million people suffer from Alzheimer’s
  • Every 68 seconds someone develops the disease
  • Alzheimer’s is the 5th leading cause of death for those aged 65 and older

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