Alzheimer’s Dementia update – part 1



I am a witness to the effects of Alzheimer’s Dementia in my adorable 85-year-old mother. I have learned more about this disease process recently that are worth sharing. Let’s begin with some interesting statistics.


Alarming statistics[1]

Alzheimer’s dementia is the 6th leading cause of death in the united states. That may not sound so impressive until you consider that 1 in 3 seniors dies having Alzheimer's or another dementia. Worse, it is increasing dramatically. From the years 2000 to 2015 heart disease deaths decreased 11% and Alzheimer's deaths increased 123%. Do you wonder why? Part of the answer is that this condition cannot really be prevented or cured, although medications can help lessen memory loss and confusion for a limited time—and does so better, the earlier treatment is started.


What’s more arousing is the caretaker burden Alzheimer’s and other dementias cause. It is estimated that 16.1 million Americans currently provide unpaid care for Alzheimer's or other dementia patients. Approximately 83% of those who provide help to these older American adults are their very own family members—and these patients are not easy to care for! There is twice as much emotional, financial and physical difficulty among those who care for older dementia patients compared to those who care for older folks without dementia, as you can imagine! The changes in personality are the most difficult changes for family members to deal with.


I can remember when my mother (now age 85) agreed bring her mother-in-law (my father’s mother) into their home in a full care arrangement. My mom used to complain how mean and unreasonable grandma was, even verbally mistreating her with hurtful profanities for no apparent real reason.


The cost of this illness is clearly rising too. The 2018 total cost of Alzheimer's and other dementias to Americans was estimated at $277 Billion ($186 billion of which is paid by Medicare and Medicaid), and by 2050 this will quadruple to $1.1 Trillion! The lifetime cost of care for dementia has risen to $341,840 per person.


Dementia spectrum

Mild cognitive impairment is a sort of “pre-dementia.” Mild cognitive impairment is estimated to affect up to 1 in 4 Americans over the age of 65.[2] [3] [4]


Full on dementia is a permanent mental disorder characterized by progressively worsening short-term memory and higher brain functions. In the case of Alzheimer's dementia, symptoms usually just start with mild memory loss. Of course, this progresses until there is a serious impairment with verbalizing, concentration, reasoning, and even personality. Eventually they are unable to function independently in normal life.


Benefits of early diagnosis

There are some financial and other benefits of diagnosing dementia early. If all dementia patients could be diagnosed early on (in the mild cognitive impairment stage), an estimated $7 trillion would be saved in health and long-term care costs according to the Alzheimer’s Association.[5]


More importantly, personal benefits of diagnosing Alzheimer’s dementia early on include:

  • Better symptom treatment options: treatment for symptoms early in the disease work more effectively than in advanced disease.

  • More time to make preventive lifestyle changes to slow the progression of this disease. These include: mental and social activity, exercise, blood pressure control, not smoking, physical exercise and supplements shown to preserve cognitive function.

  • Time to discuss safety issues, such as driving or wandering, before they occur.

  • Less anxiety about dementia symptoms.

  • Maximize time with loved ones before mental decline progresses.

  • Clarify what each family member will do care-taking and prevent disagreements.

  • Appoint a power of attorney for health care and what you want for each stage of the mental decline process.

  • Get personal finances, property and wills in order.

Benefits of early natural treatments, not prescription drugs

There are many nutrient supplements shown to slow the progression of dementia. This is important because of the fact that synthetic prescription medications used for Alzheimer’s dementia may be modestly effective—but their effects are unfortunately short-lived. Let me share more about these drugs.


The current FDA-approved prescription medications for Alzheimer’s disease are first off, the cholinesterase inhibitors Aricept, Exelon, and Razadyne. These slow the breakdown of the neurotransmitter acetylcholine by blocking the enzyme acetylcholinesterase, which dismantles acetylcholine. Unfortunately, these drugs typically only last 6-12 months while the underlying disease process of brain cell damage continues to progress. Only about half of the individuals who take them get this benefit.


A newer prescription drug, Namenda, also does not slow the progress of the underlying disease process. This drug works by protecting brain cells from the effect of too much calcium caused by the overstimulation of glutamate. Glutamate is the chemical messenger on the Namenda (NMDA) receptor responsible for retrieval, processing, and storage of mental information in the brain.


Therefore, in my next article I’ll be looking closer at the many nutrient supplements shown to slow the progression of dementia.


To feeling good with health of mind and body


Michael Cutler, M.D.


_____________________________

[1] https://www.alz.org/alzheimers-dementia/facts-figures

[2] Graham JE, Rockwood K, Beattie BL, et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997;349:1793-6.

[3] Lopez OL, Kuller LH, Fitzpatrick A, Ives D, Becker JT, Beauchamp N. Evaluation of dementia in the cardiovascular health cognition study. Neuroepidemiology 2003;22:1-12.

[4] Unverzagt FW, Gao S, Baiyewu O, et al. Prevalence of cognitive impairment: data from the Indianapolis Study of Health and Aging. Neurology 2001;57:1655-62.

[5] https://www.alz.org/alzheimers-dementia/facts-figures

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