Alzheimer’s Disease – Signs of Dementia

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Sally Smith:  Welcome to Age to Age.  I’m Sally Smith.  Let’s talk.  We have with us, today, Fran Emerson, who is the head of the Alzheimer’s Association in our area, and has a vast amount of experience in dealing with people with Alzheimer’s and dementia.  Fran, one of the things you have said, that I respect, is that to really be an effective caregiver of someone with Alzheimer’s, you need to not only understand the person and their personal habits, and personality, but also keep in mind the basics of the disease:  you understand the disease, you understand the person, you’re a detective trying to help, to find a happy solution to any problems that arise.


When you say, know the disease, just the basic overview, we know that the region controlling temper and personality is vastly changed in Alzheimer’s patients.  What are the basic signs of dementia?


Fran Emerson:  I think if you look at those two things, personality and temper, all parts of brain, of course, are being affected by this illness, but, you know, you may observe your loved one suddenly displaying behaviors or doing something totally out of the ordinary that you wouldn’t normally associate with your mother or father, or you spouse.  Often these are little clues that something serious may be happening with the brain.  What is happening, essentially, is that the amyloid plaques and tangles, that we know are associated with Alzheimer’s disease, are attaching themselves and affecting the neurons, or brain cells, and, one by one, brain cells are dying, and different parts of the brain are atrophying and ceasing to function. 


A lot of the skills that you learn, like social behavior and developing skills, are slowly being unlearned.  So, you know, I hear people say, you know, my mother was always so proper, so beautifully engaged with other people in social connections, and now she’s using language that I’ve never heard a sailor use on the wharf front.  They’re shocked.  They’re saddened.  They’re frightened about this change.


But, getting back to the disease, it’s not the person’s fault.  That person is not behaving in that manner intentionally.  It is because those parts of the brain, controlling those functions, are being affected.  It’s a physical phenomenon.  And, that’s understanding the disease; that’s understanding why this is happening. 


Sally Smith:  Well, if you were someone who had some of these changes occurring, say you were a person who began to suspect that you, personally, were developing some form of Alzheimer’s or dementia, what would you recommend doing?  Would you get analyzed as to whether it is dementia or, actually, Alzheimer’s?  I know that Alzheimer’s is one form of dementia, and there are many forms of dementia.  Is that the route that you would go if you truly suspected, I mean, you repeatedly couldn’t find your car in the parking lot?  What steps would you take?


Fran Emerson:  I would always recommend getting an early diagnosis.  If I truly felt that I was experiencing some changes and challenges that were sudden and persistent, I would go and get checked.  I would go and have a mini-mental, the mini-mental state exam.  Many of us have heard about that.  I would get an appointment with a neurologist and get a diagnosis.  We do know that early diagnosis and early treatment can sustain someone on a higher level of cognitive functioning than if they were not diagnosed and treated early.  I think that’s really important.  And, you know, it may not be anything serious.  It may be that some other stuff that is happening, physically, with you can cause you to have a temporary dementing episode that can be treated.


Sally Smith:  Well, with the early diagnosis, as you say, I heard you mention a friend that had an early diagnosis and was very optimistic, very proactive, and has really outlived her expectations of not being too demented to enjoy and have a productive life.  Is this happening more and more?  Do you see this more and more, that early positive action make a difference?


Fran Emerson:  Yes.  And I think the news is spreading.  I think the news is spreading that the earlier we catch this, the earlier it’s treated, the better.  We can’t fix it, you know.  We have to make that clear.  This is not a fixable disease, yet.  I, personally, believe that it will be in the future.  But we can’t fix it, so get an early diagnosis.  I’ve seen some people function pretty well for some years, in the early to early mid-stage of this illness.


Sally Smith:  Do you have any recommendations, say it were you, and you have all these years of experience, would there be certain techniques or strategies, little things you would tell yourself each day to kind of get yourself on the right track?  Like, would you go out and volunteer for other people, or become more active in your church, get more involved with support groups?  Are there certain techniques or mindsets that help people be the early achievers in this battle?  I’m sure everybody that develops this wants to be one of the ones that survives happily the longest, in a healthy way.  Are there certain things that those people are doing, other than just medication, that you find are key to their success?


Fran Emerson:  Yes.  And there are some great examples of those, people who, first of all, have a positive attitude.  It’s really frightening, and it’s easy to get depressed and kind of give up and withdraw.  And we know that situation, actually, will lead an individual into a faster decline.  Keep active.  Keep socially connected.  That’s really important.  Exercise is really important.  Everything that you can do to stimulate your body, your heart and, consequently, your brain is going to keep you functioning longer.  They’ve done research to show that this is so.  So, keep connected, volunteer.  There are a lot of people who are involved in support groups, which are hugely empowering to family caregivers to help them on this journey of caregiving.  So, yes, stay connected, keep involved.  There’s a certain amount of truth in that old saying, if you don’t use it, you lose it.  Even at the beginning of this disease, you can help keep yourself going by using it.


Sally Smith:  Wow, valuable advice.  Fran, thank you so much.  It’s so wonderful to have you with us again today.  Thanks to all our listeners too for joining us, and we welcome your suggestions.  This is Sally Smith, Age to Age, saying good-bye and wishing you courage and joy on your own journey.  We are all connected. 


If you enjoy listening to Sally Smith, you can buy her book, The Circle.  It’s the story of how she personally responded to her mother’s journey with Alzheimer’s disease.  It’s a wonderful gift of hope for anyone with a parent with dementia.  Just click on Sally Smith’s name under the Health Professionals tab on the Podcast home page.  All profits support research at the Center on Aging.  Thanks.

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