Alzheimer’s disease is a degenerative cognitive brain disorder that causes a loss in memory, thinking ability, and reasoning. It is a fairly common disease that usually affects the elderly population although cases of early-onset Alzheimer’s also occur in populations under 65 years of age. Five hundred thousand cases are added yearly, and it is the most common form of dementia, accounting for sixty to eighty percent of all cases. Alzheimer’s disease is progressive, and worsens with time; Alzheimer’s disease has no current cure, though there are treatments for the symptoms, and research is being conducted to prevent the development of the disease.
Women make up over sixty percent of Alzheimer’s disease patients, and one in three seniors living with dementia or Alzheimer’s will die from it.. Only forty-five percent of caregivers report and properly diagnose cases of Alzheimer’s disease, which limits the progression toward discovering more efficient treatment and ultimately hinders the race for a cure.
Carolina Partners provider Ellen Minier, PMHNP-BC shares three of the most challenging aspects of treating Alzheimer’s patients that caregivers face. First, patients will often become dehydrated or malnourished because they can forget to eat or drink. This leads to medical comorbidities such as urinary tract infections, increased weakness, fatigue, and dizziness–which lend themselves to frequent falls and exacerbation of dementia symptoms. Secondly, challenges that caregivers face that are often not discussed are caregiver fatigue, anxiety, and depression when they are trying to manage a patient’s illness with minimal support and lack of community resources. Lastly, Minier points to behavioral changes that may occur in the early stages of dementia, such as the patient cursing, becoming combative, or developing sexually inappropriate behaviors. Because of the stigma attached to these behaviors, it is something that caregivers are afraid to discuss.
She notes also that treatment can often be difficult, as many primary care physicians do not have the experience with this type of patient. Often, the patient will suffer evening agitation or insomnia, go to their primary care physician, and receive a prescription for benzodiazepines. Minier says, “It is common for this type of medication to make dementia symptoms worse instead of better, often leading to increasing agitation and lowering inhibition of the patient, as well as increased risk for somnolence and falls.”
Minier offers some recommendations for anyone who suspects that they or a loved one may be developing Alzheimer’s, noting that early detection and referral to neuropsychiatric services are both crucial parts of receiving a proper diagnosis. She says, “I recommend that if it is noticed by a family member that there is a change in behavior or memory difficulties, however subtle it may be, go to a neuropsychiatric clinic and get proper testing done. Have medications managed by a psychiatric provider with experience. Make sure the caregiver also has resources and support for the long journey ahead.”
Alzheimer’s studies and the vast majority of what medical professionals know today have only been discovered in the last 15 years. The fact that most of what is known is fairly new information means that there are still a lot of mystery and unknown factors contributing to the disease, the progression of the disease, and the underlying causes. As the doctors discover more about Alzheimer’s and there are more well-documented case studies, hopefully there will be more effective treatments available to patients dealing with this disease.