“Lunch With Your Doctor”

Understanding and Recognizing Alzheimer’s disease:
Senior Moments or Something More Serious


Saint Mary’s Regional Health System’s Vintage Club held their final luncheon for 2008 on Wednesday, December 10. Over 95 members and guests from Pope and surrounding counties attended. James Smith, M.D., an Internal Medicine physician with Millard Henry Clinic, was the featured speaker. Dr. Smith presented information regarding the subject of “Dementia and Alzheimer’s disease”. Smith’s presentation focused on an individual’s risk factors, different warning signs and ways to help keep the mind sharp. The floor was open for questions during and after Smith’s presentation.

Occasional lapses in memory as one ages are common and are sometimes referred to by many as “Senior Moments”. One may discount the once-in-a-while occurrence of forgetting where the car is parked or the name of someone rarely seen. But, when recognizing normal people or objects becomes difficult or serious memory loss occurs, a visit to one’s doctor is recommended.

Dementia is a general term most commonly referred to as the loss of intellectual abilities or memory skills that affect daily life. Alzheimer’s disease is the most common form of dementia in the elderly. This progressive disease destroys brain cells, which causes problems with daily activities, language skills, the ability to work, continuing hobbies or other activities, the ability to attain memories or build new ones and maintaining a normal social life.

Currently, there are nearly 5 million Americans living with the disease. Alzheimer’s is usually diagnosed in individuals 65 and older is ranked as the sixth leading cause of death in the United States. Little information is known regarding this degenerative disease. According to the Alzheimer’s Association, most of what is known has been uncovered in the last 15 years.

Scientists do not know the cause of Alzheimer’s and so far there is no cure; however progress has been made and treatments are available to help improve the quality of life for someone living with Alzheimer’s. A worldwide research effort is underway in discovering better ways of treating the disease, delaying its onset and even preventing it from developing. Some studies have shown that exercising the mind and learning new skills will help increase brain health among seniors. Playing cards or other games or taking a class are great ways to increase memory skills and strengthen the brain.

Like everything else in the body, the brain changes as we age. Slowed thinking or occasional memory lapses are normal; however, serious memory loss, confusion or severe noticeable changes should be evaluated. These changes could be a sign of failing brain cells. “In age-appropriate memory loss, the memory will eventually come back, but with dementia, that memory is more than likely unattainable” said Dr. Smith.

There are over 100 billion nerve cells in the brain communicating and controlling every bodily function. Alzheimer’s disease halts the functioning of some cells. When communication between the different networks in the brain is interrupted, normal functions cannot be achieved. The interruption will eventually spread and cells will eventually die. Plaques and tangles are two abnormal structures found in the brain and are thought to be the cause of the damage which kills nerve cells.

Plaques build up between the nerve cells and tangles form inside the dying cell. These structures do develop as most people age, but Alzheimer’s patients tend to develop more. While their role is not completely understood, some researchers believe that these structures block communication between the cells and disrupt activity which maintains the cell.

While no single reason has been identified to cause the failure of brain cells, certain fixed and non-fixed risk factors have been determined to increase the likeliness of developing this disease.

These risk factors include:
Age – increasing age is the greatest risk factor
Family History – an immediate family member who has been diagnosed; the risk increases if more than one family member is diagnosed
Genetics – Researchers know that genes are involved; the Alzheimer’s gene has been found in the two categories of genes that play a role in determining whether or not a person could develop the disease.

Non-fixed risk factors:
Head Injury- There appears to be a strong link between a severe head injury and the development of Alzheimer’s.
Heart-head connection – Brain health is linked to heart health. High blood pressure, heart disease, stroke, diabetes and high cholesterol damage the heart and blood vessels which supply blood to the head.
General healthy aging – An overall healthy lifestyle such as maintaining a healthy weight, avoiding tobacco, maintaining a social life and exercise may help keep the brain healthy.

Warning Signs
As people age, forgetfulness can become quite apparent and it affects each individual differently. Mild forgetfulness can be inconvenient, especially for those used to being independent, but it’s nothing to be concerned about. As stated before, exercising the mind will help keep the mind sharp as one gets older. Other ways to help maintain a sharp memory are remaining social, having a hobby, exercising and maintaining a healthy diet.

But, sometimes memory loss isn’t just getting older; it could be the onset of Alzheimer’s disease. There are no clear cut lines separating normal changes from warning signs. So, it’s always a good idea to consult with a primary care physician if normal activity or function level seems to be changing.
Here are some warning signs to watch out for:
Memory Loss – The forgetting of recently learned information is the most common early sign. A person may begin to forget more often and is unable to recall information later or may ask the same question or repeat the same story over and over.

Difficulty performing familiar tasks – The ability to perform or complete everyday tasks, such as, preparing a full meal, playing a game or making a telephone call.

Problems with language – The forgetting of simple words or the substitution of unusual ones often make a conversation or reading a letter from them hard to understand.

Disorientation to time and place – Becoming lost in familiar areas, forgetting where they live or how they might have gotten there is another sign of the Alzheimer’s disease.

Poor and decreased judgment – Giving away large sums of money, dressing inappropriately for outside temperatures or neglecting to keep proper hygiene.

Problems with abstract thinking – The inability to perform complex mental tasks.

Misplacing items – The storage or placement in odd or unusual places, for example, an iron in the freezer.

Changes in mood or behavior – Unprovoked rapid mood swings.

Changes in personality – Changes can be dramatic and one may become extremely erratic, confused, suspicious or fearful.

Loss of initiative – Changes in ambition such as sleeping long hours during the day or watching T.V. for hours.
Paying attention to possible warning signs is the first and best step to diagnosing Alzheimer’s. If someone has just one or several of the listed symptoms, consulting a physician is the next step. A more thorough examination by a medical specialist trained in the evaluation of memory disorders or a visit to a neurologist may be suggested later.

Alzheimer’s disease can come without warning and can be very hard for families to cope with. Finding a good support group or family counselor might help with the transition period after a loved one has been diagnosed. Staying healthy both mentally and physically is one of the best ways to help prevent the onset of Alzheimer’s disease. Pay close attention and watch for warning signs. Vast amounts of research are being done in the fight against Alzheimer’s disease, and as Smith stated, “I think the future is optimistic.” For questions regarding certain risk factors for oneself or a loved one, talk to a primary care physician.

Dr. Smith is a member of the medical staff at Saint Mary’s Regional Health System and is one of five Internal Medicine physicians with Millard Henry Clinic. Dr. Smith’s office is located at 101 Skyline Drive in Russellville. To make an appointment with Dr. Smith, please call 890-2421.
For more information about the Vintage Club or to inquire about upcoming events and luncheons, please contact the Saint Mary’s Community Relations office at 964-9355.