Frequently Asked Questions

It's estimated that 4.5 million American have Alzheimer's Disease (AD) and the number of people with the disease doubles every five years. Worldwide, 26 million people have AD and it has been called the "looming global epidemic" as the world's population ages. Without medical intervention, the number of people with AD will quadruple, with 1 in 85 persons with AD by the year 2050.

Today, the only definite way to diagnose AD is to find out whether there are plaques and tangles in brain tissue. This can only bedone by autopsy so doctors can only make a "probable" diagnosis of AD while the person is still alive. Geriatric specialists can diagnose AD correctly up to 90% of time using several tools including:

• Questions about the person's general health, past medical problems and ability to carry out daily activities;
• Tests of memory, problem-solving, attention, counting and language;
• Medical tests such as those for blood, urine or spinal fluid; and,
• Brain scans.

Family history of AD is a risk factor and scientists now believe that genetics likely play a role in many AD cases. They have determined that early-onset familial AD, a rare form of AD that occurs between the ages of 30 and 60, is inherited, and they have identified the 3 genes that cause early-onset. The more common form of AD is known as late-onset as it occurs later in life and no obvious inheritance pattern is found.

AD is a slow disease that starts with mild memory problems and ends with severe brain damage. The course AD takes and how quickly chages occur, vary from person to person. On the average, people live from 8-10 years after they are diagnosed, though some may live with AD for as many as 20 years.

AD is categorized in 3 main stages: mild; moderate; and, severe. Each stage has unique characteristics.

• MILD - People with mild AD may appear to be healthy, but they actually have trouble making sense of their surroundings. Mild AD is often mistaken for normal aging and family members are often slow to realize the person's problems result from AD.
• MODERATE - At this stage, the degeneration of the brain worsens and spreads to other areas that control language, reasoning, sensory processing and thought. The signs of the disease become more pronounced and behavioral problems often occur.
• SEVERE - Damage to the brain's nerve cells is widespread in severe stages and people may lose motor coordination, the ability to walk, speak, feed themselves and recognize others. Typically at this stage, full-time care is required.

The first symptoms of AD can be confused with normal aging, but AD is not a normal part of aging and involves parts of the brain that control thought, memory and language. In the early stage, people may have trouble remembering recent events, activities or the names of familiar people and places. Such difficulties are bothersome, but usually the are not serious enough to cause alarm. However, as the disease progresses, symptoms are more noticeable and become serious enough to cause people with AD or their family member to seek medical assistance.

No treatment can stop AD. However, some people in the early and middle stages benefit from Aricept, Excelon, and Razadyne which may help some symptoms from becoming worse for a limited period of time. Namenda is used to treat moderate to severe AD. Some medications can help to control behavior symptoms of AD such as sleeplessness, agitation, wandering, anxiety and depression.

Dementia is a pattern of mental decline caused by different diseases or conditions. The most common is Alzheimer's Disease which accounts for 50-55% of all dementia in persons over the age of 65. The second most common form of dementia is vascular dementia and generally affects people between the ages of 60 and 75. It is a degernative cerebrovascular disease that leads to progressive decline in memory and cognitive functioning. It occurs when the blood supply carrying oxygen and nutrients to the brain is interrupted by a blocked or diseased vascular system.

The changes in the brain caused by AD can lead to unpredictable behavior and thoughts. Persons with AD do not purposefully become more childish, irrational, stubborn, suspicious or angy. Many behavioral episodes are due to the person's inability to make his or her needs known verbally. Family members can only guess and change their expectations accordingly. Imagine being unable to recognize familiar surroundings or recall your normal daily routines and the embarrassment of needing others to take care of you. Behaviors that we call "problems" are often attempts to get very basic needs met and for reassurance, safety and love. In some cases, behavioral problems like delusions or physical aggressiveness can be treated with anti-anxietants or anti-psychotic drugs.

Mental impairment or dementia makes driving more dangerous and more frustrating. AD can cause delayed reactions to sudden or confusing situations on the road. If someone is finding driving more difficult than before, watch for signs of unsafe driving and reassess the risk factors. Many small warnings of unsafe driving can add up to a difficult decision to stop someone from driving. Warning signs to watch for include:

• Abrupt lane changes, braking or acceleration;
• New dents or scrapes on the car or on fences, mailboxes, garage doors and curbs;
• Failure to use a turn signal, or keeping the signal on without changing lanes;
• Drifting into other lanes;
• Missing familiar highway exits;
• Trouble reading signs or following directions to get somewhere;
• Feeling nervous or fearful while driving;
• Getting lost more often;
• Trouble paying attention to signals, road signs or pedestrians; and,
• Slow reactions to changes in the driving environment.

There are many, many websites that have information about research on AD and clinical trials. The following websites are highly reputable, very thorough and a good place to start reading about clinical drug trials.

The Fisher Center for Alzheimer's Research Foundation

The Alzheimer's Association Safe Return^® is a nationwide identification, support and enrollment program that provides assistance when a person with AD or other dementia wanders and becomes lost locally or far from home. This program works 24 hours a day, 365 days a year. One phone call immediately activates a community support network to reunite the lost person with family or caregiver. To enroll online, go to www.alz.org or in Connecticut call the Alzheimers Association at 860-828-2828 or at their hotline 800-356-5500.

The Alzheimer's Resource Center of Connecticut provides a range of community services designed specifically for families caring at home for a loved one with AD or other dementia. While our primary service area is Connecticut, we have also reached out to families in Massachusetts, Rhode Island and New York who have heard about the extraordinary level of care and support services we provide to families struggling to cope with AD.

Nationally, there are organizations dedicated to providing support to family caregivers.

1. Family Caregiver Alliance/National Center on Caregiving www.caregiver.org
2. National Family Caregivers Association
   www.thefamilycaregiver.org
   1-800-896-3650
3. National Respite Network and Resource Center
   www.archrespite.org
   1-919-490-5577 X 222
4. Well Spouse Association
   www.wellspouse.org
   1-800-838-0879
5. C-Mac Informational Services/Caregiver News (For Alzheimer's-Type Dementia Caregivers)
   www.caregivernews.org