Mar 24, 2010

Alzheimer's I Want You to Know What I Know

People with Alzheimer's disease experience a rate of cognitive decline four times greater than those with no cognitive impairment.....
By Bob DeMarco
Alzheimer's Reading Room

Sometimes I write about how my mother went down hill fast, or did she? At 85 she was still walking long distances with me in New York. At 87 she couldn't walk a block. I found out later that she had stopped walking to the pool, she was bascially reduced to sitting around most of the day. Didn't know it. Nobody saw a problem.

I was living in New York and Reston, Va working away. The sound of my mother's feet and the way she complained constantly on the phone were already bothering me. These were new and different behaviors.

I thought something was wrong, but everyone seemed to think she was just "getting old". It seemed like a reasonable explanation, and I guess I was eager to accept this conclusion. I didn't have a clue about what was happening, so why not "old". It might have stayed that way if my stomach wasn't bothering me, and if I wasn't worried every time I thought about mom.

I know more now then I did back in those days. I now realize that my mother was deteriorating slowly over a long period of time. There were plenty of signs. Hindsight 20/20.

I continue to wonder about how things might have been. I wonder what if I had gotten my mother's memory tested the minute I felt concerned. I wonder if she had gotten on the combination of Aricept and Namenda early, what effect would they have had on my mother. Where would she be today?

I am never going to know the answers to those questions.

Now I spend time wondering how I can get the word out about mild cognitive impairment -- often the precursor to Alzheimer's dementia. The point at which a person starts to lose their memory faster than a person that is just getting "old".

The finding of the study below suggest that the memory and thinking abilities of person suffering from mild cognitive impairment declined two times as fast every year as the abilities of those without any cognitive problems. Thinking ability and memory in subjects with Alzheimer's disease declined four times as fast as in those without any cognitive problems.

"There persists the idea that some decline in memory is typical" with age. -- Robert Wilson

No doubt, memory does decline with age.

Here is my advice. If you have a parent or grandparent that starts to evidence new and different behaviors like meanness, worries about money, forgetfulness, gets lost while driving, or starts scrapping their feet on the ground -- get their memory checked.

If your stomach starts bothering you and you think there could be someone wrong with a parent or grandparent, don't assume they are getting old. Stomach bothering you? Pay attention. It is trying to tell you something -- get their memory checked.

If you have a parent or grandparent over 70 years of age -- get their memory checked every two years. People get physicals don't they? How about a brain physical? A memory test.

Alzheimer's dementia is ugly. You probably agree with that statement. But, if you haven't experienced Alzheimer's personally -- from the front row -- you can't imagine how ugly. No -- possible -- way.

There are treatments, not cures, available for Alzheimer's disease. They work very well for some people. We have people on this list that swear that the combination of Aricept and Namenda made a big difference in quality of life.

If you get worried about someone you love -- take action.

If its Alzheimer's, someone is going to have to assume the caregiver responsibility. The sooner you act the better the quality of life for the patient and the caregiver. The caregiver could be you.

Trust me, I know.

Cognition Declines Four Times Faster in People With Alzheimer’s Disease Than Those With No Dementia

People with Alzheimer’s disease experience a rate of cognitive decline four times greater than those with no dementia according to a new study by researchers at Rush University Medical Center in Chicago. The results of the study, which is only the second population-based study to quantify the rate of cognitive decline in Alzheimer’s disease, are published in the March 23, 2010 issue of the journal Neurology, the medical journal of the American Academy of Neurology.

“Knowledge about the progressive cognitive decline in Alzheimer’s disease is mainly based on studies of persons evaluated in clinical settings. In such studies, the full spectrum of the disease is unlikely to be represented,” said study author Robert S. Wilson, PhD, a neuropsychologist at the Rush Alzheimer’s Disease Center. “As a result, it has been difficult to securely determine the cognitive consequences of the disease and to test whether they vary in racial or ethnic subgroups of the population.”

Researchers at the Rush Alzheimer’s Disease Center and the Rush Institute for Healthy Aging set out to quantify the rates of cognitive decline in people who developed Alzheimer’s disease and its precursor, mild cognitive impairment.

The study followed 1,168 older adults. All were participants in the Chicago Health and Aging Project, a longitudinal cohort study of older white and black persons residing on the south side of Chicago. At the beginning of the study, participants did not have dementia. After a mean of five to six years, they had a detailed clinical evaluation and 614 persons were found to have no cognitive impairment, 395 had mild cognitive impairment, and 149 had Alzheimer’s disease. They then completed brief cognitive testing at 3-year intervals for a mean of five and half years.

In comparison to the no cognitive impairment group, the annual rate of cognitive decline was increased more than twofold in those with mild cognitive impairment and more than fourfold in those with Alzheimer’s disease. The results did not vary by race, sex, or age.

“This study is especially significant because half of the participants are African Americans. Most of what we know about Alzheimer’s disease is based on studies of Caucasians,” said Wilson. “Our study found no difference in how the disease played out in the two races.”

Study authors note that this is one of the few studies to look at a large population without the disease and track the disease progression as it is newly diagnosed. The results were similar to the only other study of its kind, which was completed over a decade ago.

“Part of understanding this disease is carefully quantifying what the consequences are in a defined population,” said Wilson. “Such knowledge is especially important now with the prevalence of Alzheimer’s disease expected to sharply increase by the middle of the 21st century.”

Other researchers involved with the study include Dr. Neelum Aggarwal, Dr. Lisa Barnes, Carlos Mendes de Leon, PhD; Liesi E. Hebert, ScD; and Dr. Denis Evans. The study was funded by the National Institute on Aging.

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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,300 articles with more than 9,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room