16 Dec

Late Stage Alzheimerʼs Disease: The Opportunity for a Wonderful Experience

Springtime means gardening and Home Depot was my destination for flowers one beautiful afternoon. As I was making my selection, I was surprised to see Jane, my Alzheimerʼs patient, and her daughter, Sue, walk up. After greetings, I watched with admiration as Sue helped her mom choose an array of plants. Although Jane could not have told you what she was doing, she was smiling, holding hands, and having a wonderful time. What a sweet and beautiful reflection of love.

Tears came to my eyes as I recalled my first meeting with Jane. She was surrounded by hospital techs as a nurse injected a calming medication. Jane was screaming and cursing, knowing without a doubt, our staff wanted to kill her. Her admission to our advanced stage Alzheimerʼs unit was precipitated by the verbal and physical assaults she had inflicted upon her caretakers at home. No one could have imagined just ten years before she was a sophisticated Southern woman and a kind, caring mother of five and grandmother of ten. Alzheimerʼs Disease had robbed her of her dignity and was cheating her of relationship with her family. My tears were of joy watching my restored patient intimately relate to her daughter.

What happened in the hospital to produce such an incredible transformation? Jane underwent the same treatment process I have used to transform hundreds of late stage Alzheimerʼs patients. Infections were treated. Harmful medications were discontinued. Medications to restore sleep and energy were prescribed. A slow titration of safe nonaddicting calming medications were daily adjusted until Jane was alert, calm and happy during the day. Three years after her hospitalization, Jane is still enjoying wonderful experiences with Sue.

14 Dec

How do you diagnose early Alzheimer’s Disease?

Early Alzheimer’s Disease results from aging of your brain and the loss of cells, and most commonly begins in the memory section of your brain. Early Alzheimer’s Disease can be easily hidden by the suffering person and typically is missed by the average physician. People with early Alzheimer’s Disease are not usually examined by Alzheimer’s specialist. My referrals tend to be patients with more advanced stage disease; therefore, primary care physicians are in the best position to identify early AD but typically fail to do so.

Why are primary care physicians failing to aggressively screen for Alzheimer’s Disease? And why would a person want to hide early memory loss and avoid a diagnosis of Alzheimer’s Disease? The answer to these questions is the same. Most people, including doctors, perceive Alzheimer’s Disease as a disease that attacks old people with minimal options available for prevention or treatment. Why pursue early discovery of a disabling disease if there is nothing you can do about it? In reality, much can be done. Current research strongly supports multiple interventions that reduce your risk of Alzheimer’s Disease as well as aggressive medical intervention to slow down the progression of memory loss and significantly delay the onset of disability.

Critical to the success of medical intervention is early diagnosis and treatment. The memory loss of Alzheimer’s Disease is a result of brain cell loss. Aging is the major contributor to brain cell loss. As we age, we lose brain cells and our brain shrinks. We have a reservoir of cells, an excess amount, we can lose before we lose memory. How fast we lose our reservoir is influenced by multiple factors, many of which you can impact; however, everyone who lives long enough, ultimately loses his reservoir and experiences the early memory loss of Alzheimer’s Disease. The earlier you identify Alzheimer’s Disease, the more memory cells you have to treat, the more effective the medical treatment.

Diagnosis of early Alzheimer’s Disease requires identifying a deficit in short term memory combined with at least one other cognitive deficit.

The Mini-Cog is a very simple and effective test for early Alzheimer’s Disease. It is 90% sensitive and 90% specific for Alzheimer’s Disease, meaning out of 100 patients with Alzheimer’s Disease, the Mini-Cog will identify at least 90. Three steps are required for the test: Immediate recall of 3 items, 1 minute recall of the same 3 items, and a clock drawing. During the one minute interval between recall, the person being tested should be distracted with simple cognitive exercise such as spelling “WORLD” in reverse, repeating five numbers forward and reverse, and assessing similarities.

To learn more, watch this video:

If you have a positive Mini-cog exam, it is highly likely you have early Alzheimer’s Disease. On the other hand, a negative Mini-cog does not rule out Alzheimer’s Disease. You should be screened annually starting at 65 years of age and earlier if you have a family history of Alzheimer’s Disease or multiple risk factors. Most importantly, remember that early diagnosis is good thing. If you live long enough you will experience the memory loss of Alzheimer’s Disease. If you start treatment early, you will definitely prolong the quality of your life and possibly avoid disability.

14 Dec

How do you know when you have Alzheimer’s Disease?

For decades, the official and technical diagnosis of Alzheimer’s Disease required disability, meaning a patient was not diagnosed with Alzheimer’s Disease unless the cognitive loss was so great that that he or she was unable to function in life.

The very unfortunate outcome of the disability criteria is that doctors are reluctant to start treatment until “they are sure” it is Alzheimer’s Disease, thus limiting treatment to advanced Alzheimer’s Disease where it is least effective.

The new perspective is Alzheimer’s Disease starts years before disability, and early diagnosis and treatment are the foundation to reducing suffering and prolonging quality of life.

14 Dec

Is my memory loss Alzheimer’s Disease?

As a medical doctor who specializes in Alzheimer’s Disease, I am asked this question often. It is amazing and sad how uninformed most people are about an illness which is currently affecting tens of millions of people worldwide and, by some estimates, headed for 1 billion. For the last ten years and until the end of my career, my mission is to inform, educate and offer solutions to the suffering of Alzheimer’s Disease.