2020-04-29
November is National Alzheimer’s Disease Awareness Month, and local and national organizations will be holding events and providing information about the disease and its effect on individuals and society.

Space and time do not allow for a completely thorough discussion of all that Alzheimer’s is and means to the person with the disease and to his or her caregivers. Additionally, the information here is not meant to take the place of consulting with a qualified medical professional.

That said, here are some current myths and important facts about Alzheimer’s disease:

Myth: Only old people get Alzheimer’s disease; it’s a normal part of aging.

Fact: The Alzheimer’s Association (www.alz.org) says that, although the majority of the estimated 5.4 million people with Alzheimer’s disease in the United States are aged 65 and older, approximately 200,000 under the age of 65 have it. They estimate that by 2050, up to 16 million people will have Alzheimer’s disease. The Alzheimer’s Disease International (ADI, www.alz.co.uk) estimates that in 2010, 36 million people were living with dementia worldwide, and that that number will increase to 66 million by 2030.

John M. Ringman, MD, Associate Professor of Neurology, Easton Center for Alzheimer’s Disease Research, in Los Angeles, adds, “Alzheimer’s disease can occur in persons in their 30s due to specific genetic mutations, and persons over 100 years of age can have normal cognition. Alzheimer’s should not be considered a ‘normal part of aging.’”

Myth: Alzheimer’s disease cannot be diagnosed.

Fact: Alzheimer’s disease is “a progressive, degenerative disorder that attacks the brain’s nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes.” (The Alzheimer’s Foundation of America, www.alzfdn.org).

Each person with Alzheimer’s disease will experience symptoms and their timing differently, however the progression is usually described in terms of stages, “Early” (or, Mild), “Middle” (or, Moderate), and “Late” (or, Severe). According to the Alzheimer’s Association, “People with Alzheimer’s die an average of four to six years after diagnosis, but the duration of the disease can vary from three to 20 years.”

A diagnosis of Alzheimer’s disease can be made with up to 90 percent accuracy (www.alzfdn.org). Identifying cognitive issues early (see Beliefnet’s Gallery “10 Warning Signs of Alzheimer’s Disease) can help physicians diagnose Alzheimer’s and/or differentiate between Alzheimer’s disease and other conditions that can cause dementia or cognitive decline, such as Parkinson’s disease, stroke, or side effects from medication.

An early diagnosis can also enable the person with Alzheimer‘s to take proactive steps to start treatment that could preserve a better degree of function for a longer period of time, and to have a say in future plans, such as living arrangements and financial and legal considerations.

“An evaluation should include a direct assessment of cognitive function, including memory,” says Dr. Ringman. “Brain imaging with CT or MRI and routine blood tests (e.g., testing for thyroid function and vitamin B12 levels) should be performed in all persons verified to have a significant cognitive deficit, however these tests do not confirm the presence of Alzheimer‘s disease, but rather rule out other causes of dementia.”

The hallmarks of Alzheimer’s disease in the brain, the accumulation of Beta-amyloid plaques and neurofibrillary tangles (insoluble twisted fibers composed largely of the protein that builds up inside nerve cells) can only be confirmed with 100 percent certainty by an autopsy.

“However,” Dr. Ringman says, “recent breakthroughs in our ability to identify Alzheimer’s changes in the brain with nuclear imaging and by studying the fluid that bathes the brain are improving our ability to definitely diagnose the disease during life.”

Myth: No one knows what causes Alzheimer’s disease.

Fact: Many scientists believe that the Beta-amyloid protein that forms plaques is central to the disease process, and many treatments in development are focused on this.

Other factors that are thought to contribute to development of Alzheimer’s disease include age, serious head injuries, and brain inflammation. Genetics may play an important role, too. People, particularly those with a first degree relative with the disease, can discuss the current availability of genetic testing and its implications with their primary physician or a genetics counselor.

Myth: There is nothing an individual can do to prevent Alzheimer’s disease.

Fact: Until the causes of Alzheimer’s disease are fully known, specific activities to prevent the disease will also not be completely clear. Some scientists are researching proactive steps that people can take to promote brain and overall health throughout a lifetime, including exercise, lifelong learning, and dietary considerations.

Myth: The future is bleak for people with Alzheimer’s disease.

Fact: There is a lot of progress on many fronts, and the future is promising.

Many researchers are working on validating the causes of Alzheimer’s disease, developing more sensitive and specific diagnostic tools, more effective treatments, and defining lifestyle considerations that might help sustain cognitive function throughout a lifetime.

One study, says Keith L. Black, MD, Chairman and Professor, Department of Neurosurgery, Cedars-Sinai Medical Center, in Los Angeles shows promise in identifying the development of the plaques years before someone becomes symptomatic.

“We’ve developed a way to see through the eye into the retina, where you can see the plaques developing,” he says. “We’re very excited about this."

If further clinical trials are successful, this fifteen-minute, non-invasive test may eventually enable physicians to diagnose the disease early enough so that medical intervention will be more effective in slowing down disease progression and, thus, enabling people with Alzheimer’s to better function throughout their lifespan.

The Alzheimer’s Association is one organization among others that keeps a list of U.S.-based trials on its website for people with or without Alzheimer’s who wish to find out more and, perhaps, participate (www.alz.org/Trialmatch).

Another positive development is the number of resources available to people with Alzheimer’s disease and their caregivers.

The Alzheimer’s Association, the Alzheimer’s Foundation of America, Alzheimer’s Disease International and other organizations raise awareness, educate, and provide support for people with the disease and their caregivers.

For more on available resources, see Beliefnet’s “Resources for People with Alzheimer’s Disease and Their Caregivers.”

The societal toll of Alzheimer’s disease is huge, not only in economic terms, but also on the emotional, physical, and relational fabric of all those affected by it. The way is not easy, the burden is great. However, many good people from lab bench to bedside are working toward a better tomorrow, and that is cause for hope.

 Follow Maureen at www.maureenpratt.com and on her Beliefnet blog.

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