By Stephen Des Georges
Desert Haven Home Care and Apollo Residential Assisted Living provides residents with high-quality supervision and treatment reflective of its proprietary three cornerstones of managed care for seniors: meaningful, patient-centered care, best-class service and passionate advocacy. Healthcare professionals at each residence are knowledgeable and respected servants, familiar with the latest evidence-based research and outcomes. It is our privilege to regularly share with you timely and topical insights into issues that impact elderly loved ones. In this installment, we unravel the complexities of dealing with Alzheimer’s disease.
Like cancer, Alzheimer’s disease (AD) is a debilitating, life-threatening condition that strikes fear in the heart of those diagnosed. And while treatments of AD are slow in discovery, Mayo Clinic notes that experts are cautiously hopeful about developing Alzheimer's treatments that can stop or significantly delay the progression of AD. A growing understanding of how the disease disrupts the brain has led to potential Alzheimer's treatments that short-circuit basic disease processes.
What is Alzheimer’s?
Alzheimer's disease is a neurodegenerative brain disease that causes brain atrophy (shrinkage) and brain cell death. Neurorefers to the nervous system, which is made up of the brain and spinal cord. Alzheimer’s is the most frequent form of dementia, which is a slow and steady decrease in the behavioral, social and thinking abilities that undermine a person's capability to work and live independently.
Alzheimer’s and dementia are not the same thing. Dementia is an umbrella term for different conditions associated with a decline in an individual’s cognitive function. Alzheimer’s is the most common dementing illness in the elderly.Alzheimer's disease is the most common type of dementia. It is associated with the buildup of plaques and the development of tangles in the brain. In the United States, approximately 5.8 million people aged 65 and over are living with the disease. Of those, 80 percent are 75 years or older.
Alzheimer's does not only develop in old age. If diagnosed before age 65, it is referred to as early-onset Alzheimer'sdisease. Medical literature reports that between 1 and 5 percent of all Alzheimer’s cases are early-onset.
While research has yet to discover an actual cure for the disease, a growing understanding of how the disease disrupts the brain has led to potential Alzheimer's treatments that short-circuit basic disease processes. Different treatment options – including medicines and supportive programs for senior living, older assisted living, and home care services – are available that can aid in improving the quality of life of patients.
Causes of Alzheimer’s
The specific causes of Alzheimer's disease are unknown. What is known is that brain proteins become dysfunctional with the onset of Alzheimer’s. This dysfunction leads to a corruption in the activity of brain neurons, or cells, which are responsible for processing and carrying information by means of electrical and chemical signals. These activities injure neurons and, as a result, neurons lose their connections and eventually die. This damage to the cells sets off a series of harmful and irreversible events in the brain.
Increasing age is the most important known risk factor for Alzheimer’s, but environmental and genetic factors, as well as lifestyle, also can play important roles in the development of the disease. Environmentally, factors such as living in rural versus urban areas, exposure to pollution and socioeconomic status, along with individual external factors such as diet, cigarette smoking, exercise and infections. Genetically, two categories of genes influence whether a person develops a disease: risk genes and deterministic genes. Alzheimer's genes have been found in both categories. It is estimated that less than 1% of Alzheimer’s cases are caused by deterministic genes (genes that cause a disease, rather than increase the risk of developing a disease).
Additionally, research show that irreversible damage most frequently occurs in the specific brain part responsible for memory, although this degenerative process can begin years before the appearance of the first symptom. One of the first areas of the brain impacted by the onset of Alzheimer’s is the hippocampus, which is responsible for recent memories. The disease progresses to areas in the cerebral cortex, which manages language, behavior and social reasoning. The brain also shrinks significantly during late stages of the disease.
Symptoms of Alzheimer’s
Alzheimer’s impact begins, insidiously, with symptoms of mild memory loss and personality changes that differ from typical aging-related memory issues. Alzheimer's patients appear to be more easily fatigued, agitated or nervous. They may have a difficult time adjusting to change. For instance, they may be able to follow known routes, but traveling to a new location is a confusing undertaking; they can get lost and become frustrated. Alzheimer's patients also have a higher risk of developing depression at the initial onset of the disease.
Memory loss worsens as the disease develops, and decision-making becomes increasingly difficult. Alzheimer’s patients can become irritable, even resentful, when a loved one or caregiver offers assistant with daily tasks. Eventually, social interactions become difficult; as the disease progresses, Alzheimer's patients are unable to recognize family members or friends, resulting in increased isolation. Similarly, individuals with late-stage Alzheimer's lose physical coordination, requiring additional attention and care. Other symptoms of AD include:
Disorientation
Increasing confusion about events and time
Suspicions about medical professionals, family or friends
Difficulty with swallowing, speaking and walking
Such signs and symptoms of the onset of Alzheimer’s should be quickly shared with medical professionals who are able to diagnose and prescribe treatments.
Treatment of Alzheimer Disease
Although a cure is not known to exist for Alzheimer’s, treating the symptoms of Alzheimer’s can provide people with comfort, dignity and independence for a longer period of time, and can encourage and assist their caregivers as well. Different treatment options are available to manage symptoms and slow the progression of Alzheimer's disease. These treatments temporarily improve symptoms of memory loss and problems with thinking and reasoning, boosting performance of chemicals in the brain that carry information from one brain cell to another. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer’s symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.
In recent years, scientists have made tremendous progress in better understanding Alzheimer’s and in developing and testing new treatments, including several medications that are in late-stage clinical trials. Future Alzheimer's treatments may include a combination of medications, similar to how treatments for many cancers or HIV/AIDS include more than a single drug.
Several prescription drugs have already been approved by the U.S. Food and Drug Administration to help manage symptoms in people with Alzheimer’s disease. In June 2021, the FDA provided accelerated approval for the newest medication, aducanumab, which helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimer’s, although it has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.
Most medicines work best for people in the early or middle stages of Alzheimer’s. However, it is important to understand that none of the medications available at this time will cure Alzheimer’s.
Alzheimer’s care in assisted living environments
Besides medical treatment, there are other supportive programs including assisted living, senior living services, and therapies available. Such programs focus on assisting individuals with sustaining brain health, managing behavior symptoms and enhancing the quality of life for patients.
At Desert Haven Home Care and Apollo Residential Assisted Living in Greater Phoenix, Arizona, professional healthcare team members are on hand to make certain the proper treatments for Alzheimer’s disease are always in place and constantly practiced. Team members know the symptoms of the disease and are prepared to ensure all appropriate measures are taken to ensure the good health and comfort of their residents.
Among the foundations of our care, as endorsed by the Alzheimer’s Association Campaign for Quality Residential Care, are:
Quality relationships shared with residents by professional team members; a supportive environment
Assessment of each resident’s abilities for proper acre and planning; recognition of special needs
Person-focused strategies; working with residents to ensure the best-possible quality-of-life results
Meaningful, daily social interactions
Formal and informal activities that provide personal meaning and sense of community and choices.
For more information about Desert Haven Home Care and Apollo Residential Assisted Living, visit www.deserthavenaz.com.
References
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Bobba, A., Petragallo, V. A., Marra, E., & Atlante, A. (2010). Alzheimer's proteins, oxidative stress, and mitochondrial dysfunction interplay in a neuronal model of Alzheimer's disease. International Journal of Alzheimer’s Disease, 2010.
Reisberg, B., Borenstein, J., Salob, S. P., & Ferris, S. H. (1987). Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. The Journal of Clinical Psychiatry.
Zhu, X., Su, B., Wang, X., Smith, M. A., & Perry, G. (2007). Causes of oxidative stress in Alzheimer disease. Cellular and Molecular Life Sciences, 64(17), 2202-2210.
Castellani, R. J., Rolston, R. K., & Smith, M. A. (2010). Alzheimer disease. Disease-a-Month, 56(9), 484.
NIH National Institute on Aging (NIA). (2017). Causes of Alzheimer’s disease. What Happens to the Brain in Alzheimer's Disease? https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease#:~:text=Alzheimer%E2%80%99s%20disrupts%20processes%20vital%20to%20neurons%20and%20their,in%20memory%2C%20including%20the%20entorhinal%20cortex%20and%20hippocampus.
NIH National Institute on Aging (NIA). (2021). How is Alzheimer’s Disease Treated? https://www.nia.nih.gov/health/how-alzheimers-disease-treated.
Miller, Jannesse (2019). Scientists propose new approach to Alzheimer’s research to address environmental risks. University of Southern California. https://news.usc.edu/160629/alzheimers-environmental-risk-factors-usc-research/.
Tilly, Jane, and Peter Reed (2009). Dementia Care Practice Recommendations. Alzheimer’s Association Campaign for Quality Residential Care. https://www.alz.org/media/documents/dementia-care-practice-recommend-assist-living-1-2-b.pdf.