What is Alzheimer's disease?
Alzheimer's disease gradually destroys nerve cells in the brain. It affects the areas of the brain that control memory, thought, language mood, and behaviour, causing the loss of these and other related functions. Alzheimer's disease is not a normal part of aging.
Although Alzheimer's disease can strike at any age, most people affected are over the age of 65. In fact, 1 in 20 people over 65 years of age develops the disease. Today, almost 250,0001 Canadians suffer from Alzheimer's disease.
Alzheimer's disease usually begins with small memory disturbances, changes in mood and behaviour. Eventually, it interferes with many aspects of the person's life, such as their ability to think, understand, learn, remember, communicate, and perform routine tasks.
1 Adapted with permission from the Alzheimer's Society of Canada
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What causes Alzheimer's disease?
No one knows what causes Alzheimer's disease or how to stop its progression. There are probably several factors that can lead to the development of the disease. What we do know is that scientists have discovered deposits called plaques and strands of fibres called tangles that are present in large numbers in the brains of people with Alzheimer's disease. These plaques and tangles replace or crowd out healthy brain cells, damaging the brain.
We also know that many of the nerve cells in the brain use a chemical called acetylcholine to send messages to each other. The chemical messages play a part in controlling a person's memory and functional abilities. People with Alzheimer's disease have a lower level of acetylcholine in the brain. Two enzymes, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) are primarily responsible for this lower level of acetylcholine. Medications used to treat the illness work to increase the levels of acetylcholine in the brain by inhibiting the enzymes' activities. This can help the remaining nerve cells work better.
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Does Alzheimer's disease run in the family?
Anybody can develop Alzheimer's disease. However, a person who has a parent or sibling with the disease carries a greater risk of developing Alzheimer's disease than people who have no family history of the disease. Yet, it can also strike only one member of a family. Since many factors affect the development of the disease, having Alzheimer's disease in the family is a risk factor, but it doesn't mean you will develop the disease.
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What are the symptoms of Alzheimer's disease?
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Memory loss that affects day-to-day function |
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Difficulty performing familiar tasks |
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Problems with language |
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Disorientation of time and place |
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Poor or decreased judgment |
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Problems with abstract thinking |
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Misplacing things |
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Changes in mood or behaviour |
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Changes in personality |
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Loss of initiative |
IT'S IMPORTANT TO KNOW THAT ALZHEIMER'S DISEASE IS MORE THAN MEMORY LOSS.
It is not a normal part of aging, simple memory lapses or mere forgetfulness. The symptoms are usually mild at the beginning, but they worsen as the disease progresses.
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What should be expected as the disease progresses?
There are 3 main stages of Alzheimer's disease. Not all people with Alzheimer's disease fit clearly into the 3 main stages, but there is a predictable pattern to the disease's symptoms. These stages offer a guideline to better understand the disease. Each person with Alzheimer's disease is unique, and the stages may not be clear-cut-they change from person to person and the stages may overlap one another.
In the beginning or mild stage, the person starts to lose short-term memory. He or she may forget appointments, names of friends, or new information. Depression, apathy, and anxiety are common. Most people at this stage can still live on their own, requiring little help.
In the moderate stage, the person needs more help with everyday activities like eating and bathing. Agitation, confusion, restlessness, and anger are common. Safely living alone becomes an issue.
In the severe stage, the person can no longer make any decisions, has difficulty speaking, and may not recognize loved ones or oneself in the mirror. People in this stage may also have trouble controlling their bowels and bladders.
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Managing Alzheimer's disease
There is presently no known cure for Alzheimer's disease. However, it can be managed with appropriate medications to help stabilize-and sometimes temporarily improve-symptoms, together with professional counselling and support.
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What is the goal of treatment in Alzheimer's disease?
The goal of treatment is to help control the symptoms that affect memory and thinking. The drugs indicated for AD may keep symptoms from getting worse for a while. Your doctor may suggest drugs and other changes to help control these symptoms.
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Tips for the Caregiver
Caring for your loved one:
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Monitor your loved one's overall health. Go for regular check-ups and be alert for any health problems that are separate from the disease. |
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Exercise, good nutrition, and social activities are all important for people with Alzheimer's disease. |
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Establish a routine and keep it focused on enjoyment instead of achievement. Plan together and post daily activities- this helps give a sense of structure and meaning in the patient's day, and provides a feeling of accomplishment. |
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Be flexible. Adapt routines to the time of day your loved one is at their best, and to their fluctuating skills and abilities. |
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Avoid speaking in long, complicated sentences. Give your loved one simple choices, and let them decide. For example, rather than asking a question like "Where would you like to go today?" ask instead "Would you like to go to the store or sit in the backyard?" |
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Help them be as independent as possible. Allow them to complete tasks that you have started. Encourage them to mark off days on the calendar to keep track of time, and write down family and friends' (and emergency) phone numbers and keep them posted by the phone. |
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Talk about old times. Long-term memories are easier for Alzheimer's disease patients to recall. Ask simple questions to encourage their participation. |
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Take frequent trips down memory lane. Looking at family photo albums helps bring memories to the surface and provides a sense of comfort. Label the pictures with the names of the people featured in them. Listen to old songs and conjure up familiar or favourite smells (baking, perfume). |
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Labelling is a great tool to provide cues for the Alzheimer's disease patient. Label drawers and cupboards with what each should contain, label objects to explain their uses, etc. |
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Keep your loved one's environment safe. Hide matches and car keys. Don't rearrange the furniture. |
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Respect their privacy. Close doors and curtains or blinds. Following bathing, offer them a bathrobe or large towel. |
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Plan for the future. Decisions about care should be made before your loved one becomes unable to participate. Put financial and legal papers in order, including investments, insurance policies, a living will . |
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Tips for taking care of the Caregiver
Frustration, anger, anxiety, and guilt are all normal emotions when caring for a loved one who is ill. It sometimes helps to recognize that it is the disease and not your loved one that is causing them to behave a certain way. Taking care of yourself is the single most important thing you can do to help your loved one. Too much stress is harmful to both yourself and to the person you are trying to help.
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Become an educated caregiver. Books, the Internet, and Alzheimer's disease associations contain a wealth of information about the disease and how to manage it. |
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Make time for yourself. Set time aside to pursue your own interests and hobbies, and to just have relaxing 'you' time. |
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Don't isolate yourself-share your experiences, both ups and downs, with other caregivers, if possible. Accept help from others. |
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Don't neglect your own physical and mental health. Get regular check-ups, have balanced meals, exercise, and get plenty of rest. |
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Get support when you need it. Find out what other family members and friends can do to help and seek out the available resources in your community that will become necessary in the future. |
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Community resources, including churches and synagogues, volunteer and neighbourhood groups frequently offer companion services. |
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If you notice you are regularly feeling angry, irritable, are withdrawing from friends or family, have trouble sleeping or are sleeping too much, have increased health problems, or any other symptoms that are not normal for you, ask your doctor to screen you for stress or depression. |
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When you feel overwhelmed, angry, or frustrated, take time-out to refresh and calm down. Write in a journal, phone a friend or a mental health organization to vent your feelings. |
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