Question of the Week

January 29, 2007


Everybody has moments when they forget things. Whether they are trying to remember where they last had the car keys, what the math homework was supposed to be, what exactly it was they went into the kitchen to get, or that word that is right on the tip of the tongue... everyone has forgetful moments.

Often the stereotype is that memory fades as people age, and young people are able to remember everything. If you are one of those young people, then you probably know that this is not the case. As for memory fading as people age, that is not necessarily the case, either.

"Everybody's memory fades as they get older, right? Not so, according to recent research funded by the National Institute on Aging (NIA), a component of the National Institutes of Health. These studies suggest that memory loss is not a normal part of aging, and that keeping your mind active is the key to maintaining brain function." http://www.nih.gov/news/WordonHealth/oct99/story02.htm

If "memory loss is not a normal part of aging," then what is really going on?

"Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities. Alzheimer's disease is the most common form of dementia among older people. It involves the parts of the brain that control thought, memory, and language." http://nihseniorhealth.gov/alzheimersdisease/defined/01.html

While "the most common form of dementia," it can still sneak up on people with signs and symptoms that can be subtle.

"Alzheimer's disease begins slowly. At first, the only symptom may be mild forgetfulness. People with Alzheimer's disease may have trouble remembering recent events, activities, or the names of familiar people or things. Simple math problems may become hard to solve. Such difficulties may be a bother, but usually they are not serious enough to cause alarm." http://nihseniorhealth.gov/alzheimersdisease/symptoms/01.html

As people age, they may fear the worst if any of the signs associated with Alzheimer's disease start to appear in their life, or in the life of a loved one. Before settling on a diagnosis, it is important to know:

"[T]here are many health conditions which mimic the symptoms of Alzheimer's disease but are treatable. ... Ask Your Doctor About:
* Possible Medication Interactions - If you take even two medications, you may be experiencing dizziness, memory loss, or other symptoms due to medication interactions. Make a list ... including: Prescription Medications, Vitamins, Herbal supplements, Over the counter products (such as aspirin and cold medicine), Smoking cessation products, Water and weight loss products, Topical Items (such as arthritis ointment, athlete's foot treatment, etc.), Other Items. ...
* Effect of Weight Loss/Gain & Medications - If you have recently gained or lost even 10 pounds, you should ask your doctor to check your medication levels. Some medications are prescribed according to our weight ...
* Symptoms from Dehydration - If you are dehydrated or malnourished, your body may not be processing your medications correctly. ...
* Falls & Concussions - If you have fallen or hit your head recently, you could have a concussion which can result in sudden memory loss, dizziness, etc. Although you may not realize it, a recent fall or serious bump on the head may be the cause of your memory problems. ...
* Depression - Depression is a common problem among older adults and affects as many as one in five older people. The symptoms of depression are remarkably similar to those of dementia. Physicians often mistake depression for dementia ... Remember that depression is treatable...
* Alcohol Use - Consuming too much alcohol, or drinking alcohol while taking certain medications may result in symptoms of memory loss."

First eliminating these other possible causes is key to a proper diagnosis. Once other causes for the symptoms have been ruled out, then the doctors and nurses assessing the patient will ask further questions and run further tests with the hope of confirming a diagnosis.

"It has been shown that word learning and recall and some maze tests are impaired even in early Alzheimer's. Hence, based on experience with many people, the assessor will probably have some idea from the results obtained as to whether the symptoms are merely normal aging or something more serious. They will often want to repeat the tests after a few weeks or months to see if there has been any change. The doctor or nurse will also want detailed information on other members of the family who have had dementia, and also details of how the symptoms have developed in the person being examined. Armed with all this information, an experienced practitioner will be able to diagnose Alzheimer's with 80 to 90 per cent certainty. Brain scans such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) can be used to confirm diagnosis, but in the very early stages they often fail to show very much change. Later on, there will be a significant and clear loss of brain tissue and an enlargement of the fluid-filled spaces (ventricles) in the brain, but by then the diagnosis is probably fairly certain. Scans are most likely to be performed in early-onset cases or to eliminate other causes, for example, if a brain tumour is suspected." http://www.abpi.org.uk/publications/publication_details/targetAlzheimers/detection.asp

With the early stages of Alzheimer's disease, it is often difficult to get a diagnosis with 100% certainty. It is key to have an assessor with experience, but even then it is difficult to know for certain until the disease has progressed into its later stages. Once Alzheimer's is suspected, it is important for the family to get together and discuss the needs of the patient, and how the diagnosis will affect the family as a whole.

"Challenging decisions and important choices arise, along with uncertainty and often confusion, anxiety or fear. Some decisions might need to be made right away. Others lie ahead. The best future for you and your family depends on understanding what is most important to each of you. Recognizing and communicating your personal values about everyday care enables you and your family to make the right choices, one by one, as the situation changes. Today, in many communities, resources exist to assist you and your family now and in the future. For example, support groups, counseling services and volunteer programs can help with the emotional impact of the disease or disorder and enable you to stay involved and active." http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=406

Adults who are dealing with the severe health problem of a parent or loved one may not realize the affect that the disease is having on the children, teens, and young adults in the family. Even if they do, there are some things that it can be difficult to prepare for.

"Eventually, the person may have trouble remembering the names and faces of family members - or even who he or she is. This can be very sad for the person and their families. It's important to know that Alzheimer disease does not affect kids." Kids Health

While Alzheimer's disease does not affect kids in the sense that people do not get the disease as a child or teen, Alzheimer's does affect the children and teens who know someone with the disease.

"You might feel sad or angry - or both - if someone you love has Alzheimer disease. You might feel nervous around the person, especially if he or she is having trouble remembering important things or can no longer take care of himself or herself. ... If you visit a loved one who has Alzheimer disease, try to be patient. He or she may have good days and bad days. It can be sad if you no longer are able to have fun in the same ways together. Maybe you and your grandmother liked to go to concerts. If that's no longer possible, maybe bring her some wonderful music on a CD and listen together. It's a way to show her that you care - and showing that love is important even if her memory is failing." Kids Health

For more ideas of things to do with a friend or relative who has Alzheimer's disease, you can visit:

"101 ways to spend time with a person with Alzheimer's disease" http://www.alz.org/living_with_alzheimers_101_activities.asp

Questions of the Week:
What do children, teens, and young adults need to know about Alzheimer's disease? Why do people who are to young to have symptoms of the disease need to know about it? What do people of different generations need to know about Alzheimer's? How is this information similar to (and different from) the information that younger people need? How can you help someone you know who has Alzheimer's? What can you do to help yourself -- or someone else -- best manage with a diagnosis of Alzheimer's in the family?

Please email me with any ideas or suggestions. Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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