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Alzheimer’s-The Checklist
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Thursday, November 29, 2018
 

STORY AND PHOTO BY KAREN BOSSICK

The numbers are jarring.

One in three people die with Alzheimer’s or other dementias.

And Alzheimer’s is the sixth leading cause of death in the United States, as it starts in the brain and shuts down the rest of the body.

“It kills more people than breast cancer and prostate cancer combined. And it’s coming at us in epidemic proportions,” said Danielle Lyda, who represents the Alzheimer’s Association of Idaho.

“It wasn’t that long ago that 2 million people were diagnosed with Alzheimer’s—now it’s nearly 6 million. And it’s increasingly exponentially.  We had a 123 percent increase in Alzheimer’s-related diagnoses between 2000 and 2015 and we’re expecting to have 14 million Americans living with Alzheimer’s by 2050,” she added.

Lyda talked about Alzheimer’s—a brain disease that causes a slow decline in memory and reasoning skills--at the new Silvercreek Living memory residence in Hailey Tuesday night in honor of National Alzheimer’s Disease Awareness Month.

She readily addressed the most-asked question: Is misplacing my car keys a sign of Alzheimer’s or just part of getting old?

Lyda said there are 10 warning signs, any of which can signal a person is suffering from Alzheimer’s or other dementias.

  • Memory Loss That Disrupts Daily Life

    This includes forgetting recently learned information, dates or events. And it includes increasingly needing to rely on reminder notes or family members to keep up with daily life.

    “It helps if you tell someone who’s struggling with Alzheimer’s, ‘You remember so-and-so, don’t you?’ And it helps to let people know that Grandma is struggling and she may not remember them,” Lyda said.

    Keep familiar pictures and traditions. And ask them if they would like to get out the pumpkin pie recipe they made for decades, she added.

    IN CONTRAST sometimes forgetting names or appointments but remembering them later is a typical age-related change.

  • Challenges in Planning or Solving Problems

    This includes having trouble following a familiar recipe or keeping track of monthly bills. The person may have difficulty concentrating and take longer to do things than they did before.

    IN CONTRAST making occasional errors when balancing a checkbook can be chalked up to a typical age-related change.

  • Difficulty Completing Familiar Tasks at Home, Work or at Leisure

    This includes having trouble remembering how to drive to a familiar location or remembering the rules of a favorite game. It could involve forgetting how to use a phone.

    IN CONTRAST a typical age-related change involves occasionally needing help to record a television show.

  • Confusion with Time or Place

    This includes losing track of dates or seasons. An Alzheimer’s patient, for instance, might go outside in 10 inches of snow wearing shorts and flip flops. Sometimes they may forget where they are and how they got there.

    IN CONTRAST a typical age-related change is getting confused about the day of the week but figuring it out later.

  • Trouble Understanding Visual Images and Spatial Relationships

    Vision problems can be a sign of Alzheimer’s, causing the person difficulty reading, judging distance or determining color. They may not be able to see white cauliflower and potatoes on a white plate. And it may be scary for them to walk into a white shower with a white floor and white curtain. This can be solved by plastering colorful decals on the shower wall and floor and even buying them a colorful shampoo, said Lyda.

    IN CONTRAST vision changes caused by cataracts would be a typical age-related concern.

  • Problems with Words in Speaking or Writing

    People with Alzheimer’s may have trouble following a conversation. They may stop in the middle of a conversation because they have no idea how to continue. Or, they may repeat themselves. They may have problems finding the right word. And they may call things by strange names—a watch, for instance, may become a “hand clock.”

    BY CONTRAST a typical age-related change is sometimes having trouble finding the right word.

  • Misplacing Things and Losing the Ability to Retrace Steps

    People with Alzheimer’s may put things in unusual places. One woman, for instance, put a ring in a cup and stacked cups on top of that cup, said Lyda. They may lose things and be unable to retrace their steps to find those things. They may accuse others of stealing.

    IN CONTRAST misplacing things from time to time may simply be an age-related change, provided the person can retrace their steps to find the lost item.

  • Decreased or Poor Judgment

    People with Alzheimer’s may easily be suckered into telemarketing scams—elderly women may, for instance, be talked into subscribing to Sports Illustrated when they could care less about reading about sports.

    They also may pay less attention to grooming or keeping themselves clean. One woman, a 62-year-old former social worker, never wanted to take her shirt off, said Lyda.  This may be because she wanted to wear something she felt comfortable in and not risk wearing something that was itchy or scratchy.

    IN CONTRAST a typical age-related change might involve making a bad decision once in awhile.

  • Withdrawal from Work or Social Activities

    A person with Alzheimer’s might start to withdraw from social activities, sports or hobbies—in part, because they can’t keep up with things anymore.

    “If you can’t remember the rules of Monopoly, it’s hard to play,” said Lyda.  “How frustrating must it be to not remember what you sat down to do!?”

    IN CONTRAST a typical age-related change might involve sometimes feeling weary of work, family and social obligations.

  • Changes in Mood and Personality

Those with Alzheimer’s disease can become confused, suspicious, depressed, fearful or anxious. They may be easily upset when they feel out of their comfort zone. It’s important to make sure they know the schedule for the day and, “If we do this, this is what happens,” Lyda said.

Live in their reality. If a woman wants to be Wonder Woman, drape a cape around her shoulders, Lyda said.

If a person becomes agitated, ask if there’s something you can do for them, she added. If they get belligerent, redirect the conversation.

“Tell them something like, ‘What a beautiful sweater!’ ” she said

IN CONTRAST a typical age-related change might involve a person developing specific ways of doing things and becoming irritable when a routine is disrupted.

African-Americans are twice as likely have Alzheimer’s or other dementias as whites because they’re more likely to have vascular disease or problems with blood circulation. And Hispanics are one and one-half times as likely to have it as whites.

Can it be prevented? There are no clear-cut answers yet.

Researchers are studying whether antibodies to beta-amyloid can reduce the risk. And it’s hoped there’ll be a vaccination to prevent the onset of Alzheimer’s by 2025, said Lyda.

There is some evidence, however, that people can reduce their risk with regular exercise and good heart health. High blood pressure, diabetes and high cholesterol increases the rick—as many as 80 percent of those with Alzheimer’s disease have cardiovascular disease. And exercise may benefit brain cells by increasing blood and oxygen flow.

Both the Mediterranean diet and the DASH diet appear beneficial.

Maintaining strong social connections and keeping mentally active may lower the risk of cognitive decline.  And wearing a helmet when taking part in activities and fall-proofing your home may help—there’s a strong link between Alzheimer’s and serious head trauma, particularly when the injury involves loss of consciousness.

Abstaining from tobacco and alcohol may hedge against Alzheimer’s, as well.

Clinical trials are being conducted in Boise for the first time. The study is taking people who are not currently exhibiting symptoms.

While there’s no treatment yet, it’s important to get an early diagnosis as it helps the person plan for the future with things like care facilities that provide lock down and other amenities, said Lyda. Early diagnosis could save up to $7.9 trillion in medical and care costs nationwide.

Long-term care insurance is important—and it’s less expensive if purchased before the diagnosis, Lyda said.

 “You have exceptional resources in the Wood River Valley in the Senior Connection, the Wood River Y,  St. Luke’s and Silvercreek Living,” she added.

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