You can’t watch late-night talk TV, listen to talk radio or watch a prime time sitcom without hearing some reference to “senior moments.” The reference is generally a lighthearted way of coping with deep-rooted fears about aging. For one family, however, “senior moments” are no laughing matter.
The Hopson family* has been hard hit by Alzheimer’s disease. Six of 14 siblings have been diagnosed with Alzheimer’s disease, three of whom are still living. “Of course I think about it, but I don’t dwell on it. You can’t do anything about it, so there’s no point worrying, ” says Beverly, the 71-year-old baby of the family. Beverly, who does not have Alzheimer’s, cares for her 81-year-old sister, Janice, the only sibling with the disease still living at home.
Janice was diagnosed four years ago, after demonstrating symptoms of Alzheimer’s disease for a year. “After having gone through this five times before, we knew what to look for,” says Beverly. “For about a year, Janice would repeat the same thing over and over and wouldn’t remember having done so.”
A common sign of Alzheimer’s disease is memory loss, says Dr. Suzanne Smith, a neurologist and medical director of the MCG Memory Disorders Clinic. Other symptoms may include difficulty with language, disorientation, misplacing things, difficulty with activities of daily living and changes in personality, mood or behavior. “Memory loss is the main precursor for Alzheimer’s disease,” says Dr. Smith. “This is what makes this disease so tragic for both the patient and family and why it’s important that treatment involve both.”
“When we told Janice [about the diagnosis], she was devastated,” says Beverly.
But Dr. Smith says early diagnosis of the disease has several benefits. “It is important that patients who experience memory loss seek treatment earlier, rather than later,” she says. “Fear of a diagnosis may lead people to avoid visiting their physician even when there is an obvious problem. But as with all disease, early diagnosis can make a huge difference in a person’s well-being.”
Early diagnosis of Alzheimer’s disease can mean time to slow progression and provide the patient with more time for planning. Medications such as cholinesterase inhibitors work to block the enzymes that break down acetylcholine, ensuring that more of this chemical is available to the brain. Acetylcholine deficits have been found in the brains of those with Alzheimer’s disease.
“Cholinestrase inhibitors can help improve cognitive function and behavior and may delay the progression of Alzheimer’s for six to 18 months,” says Dr. Smith.
Early diagnosis also gives patients and family members time to seek out resources and find help. “While great strides are being made to find treatments for Alzheimer’s, currently supportive care for the patient and family remains our most important goal,” says Dr. Smith. “We work closely with the Alzheimer’s Association to assist families and the community with education and awareness.”
The Memory Disorders Clinic also provides caregiver counseling, including advice on coping with the challenges of incontinence, wandering and sundowning, a state of agitation and anxiety in the late afternoon or early evening.
The time comes when most patients with Alzheimer’s disease can’t be managed at home. Beverly should know. She has watched two siblings move into nursing homes. “I have already told my children that if I get Alzheimer’s and get to the point where I don’t recognize them, then they should let someone else take care of me,” says Beverly. “When I no longer have a good quality of life, they can put me in a nursing home.”
A unique component of the Memory Disorder Clinic is enabling patients and families to participate in genetic studies on Alzheimer’s disease. The Hopson family is enrolled in one.
“For the past four to five years, Dr. Shirley Poduslo (a professor of neurology in the MCG Institute of Molecular Medicine and Genetics) has been attending our family reunions,” says Beverly. “She draws blood from all of the children and grandchildren as part of a genetic study.” Dr. Poduslo is trying to identify the mutated genes responsible for late-onset Alzheimer’s. She hopes the information will help lead to the cause, and ultimately, prevention. For more information about her research, visit www.mcg.edu/alzres.
The National Institute on Aging plans a major study on the early warning signs of Alzheimer’s and ways to test new therapies more quickly. Because of that, and a predicted 45 percent increase in the number of Georgia patients by 2025, Dr. Smith expects Alzheimer’s disease to remain an area of major public interest. “Alzheimer’s disease slowly but surely robs families of their loved ones,” says Dr. Smith. “It’s a cruel disease for both the patients and families. But this is why our clinic is so passionate about what we do in offering clinical treatment, support, education and research into the causes of Alzheimer’s.”
--Deborah Humphrey
*Pseudonym
It Isn’t Necessarily Alzheimer’sWhen patients begin experiencing memory loss, their first thought may be that they have Alzheimer’s disease. This reaction isn’t unfounded since about 5 percent of people age 65 and older develop Alzheimer’s, with a much larger proportion in people older than 80. “But,” Dr. Smith points out, “there are many other conditions that can cause memory impairment, some of which are reversible.” These conditions include depression, metabolic imbalances, thyroid conditions, stroke and prior head trauma. Dr. Smith routinely screens and treats these conditions as part of her practice. She sees a wide variety of patients, ranging from those with forgetfulness to those with Alzheimer’s disease or other forms of dementia. |