Frequently Asked Questions
is the most common type of dementia. Far and away, Alzheimer’s-type dementia represent 70-75% of dementias. Dementia as an umbrella term that means people have difficulty with their memory and their thinking, the ability to use language and impairment of mood, and their ability to do all the things they used to do easily, for example, activities of daily living and this all gets worse over time progressively. That is dementia.
The short answer is yes, and the long answer is yes. Specifically, now there are ways and programs to modify your risk factors for getting Alzheimer’s-type dementia and other dementias not of the Alzheimer’s type. We are on the verge of breakthrough investigational treatments that will revolutionize the treatment of Alzheimer’s. Even now, there are breakthrough treatments currently enrolling patients showing amazing results.
Finally, preclinical, which means before people even have symptoms, types of studies have already begun. This means if you are at risk for getting Alzheimer’s, based on your genetic history and your risk factors, we would actually be able to see if you have the abnormal proteins developing in the brain. Sometimes this can occur 10 to 15 years before anyone were to get symptoms. The Holy Grail then would be to treat people before they have symptoms, and they would never know what they missed!
There is normal brain aging. There is benign forgetfulness, which is common as we age, and the speed of the processing of our brains slows down somewhat with age. However, everything works. The category between normal brain aging and early Alzheimer’s is called “mild cognitive impairment.” That means you actually do have some detectable difficulty with short-term memory, and you may have difficulty with directions,finding words and appreciating things in time and space, and orientation, but the distinction is that you can do all the things you want to do. So there is normal brain aging, and then there is mild cognitive impairment, and it really takes an extensive history with an expert to make those distinctions.
A puff of smoke implies that when people first start to display some differences in their memory and their thinking, there is just this faint puff of smoke that heralds the onset of early Alzheimer’s. It implies that underneath, there are significant changes in the brain, and a brush fire is building. This is the stage at which most of the ongoing investigational treatments are directed, and this is the stage where we are having the most success starting treatment.
Unfortunately, primary care physicians do not have the expertise, or the time, to make a definitive diagnosis. Clearly, they know the patient and their family well, and can be closely attuned to when there begins to be significant differences in a person’s memory, thinking, mood or behavior. At that point, the patient should undergo a full and extensive workup by a neurologist that specializes in dementia to establish an accurate diagnosis, treatment and possible candidacy for ongoing investigational research. Ask your doctor if you can be referred to a research center of excellence in your community.
Well, if a person were to actually have Alzheimer’s, that is a myth. Unfortunately, everybody gets worse, and everybody dies. There are no exceptions.
No, unfortunately. However, there are a number of dubious and false claims by a number of companies making nutraceuticals and supplements, stating otherwise. If, in fact, these drugs were effective in treating Alzheimer’s, we would certainly use them in our fight against Alzheimer’s and disease progression. Unfortunately, if it sounds too good to be true, it is!
The statistics are staggering when you consider 40-50% of people at age 85 have Alzheimer’s. Even more staggering is up to 40-50% of caregivers die before the patient from the extreme stress of being a caregivers for this devastating disease.
There are genes that do, in fact, put people at risk for Alzheimer’s, and there is a rare number of patients who have autosomal dominant Alzheimer’s, approximately 2-3% in the world. However, there are, indeed, genes that confer significantly increased risk of developing the disease, and patients who have a first-degree relative who have Alzheimer’s have a 30-40% increased risk over and above the general population.
The government actually is proactive, and the Alzheimer’s Project Act of year 2011 created a mandate to have appropriate patients referred to bona fide clinical research centers to expedite in finding a cure. This act also supports caregivers and education and day care funding. In addition, there is additional funding for original research by the National Institute of Health and the National Institute of Aging to look for further potential breakthrough treatments.