hn a high school student is writing a paper on alzheimers disease
he emailed me a list of excellent questions
which i answered
i must apologize for using caps and punctuation
What is the cause of Alzheimer's?
1% of the cases are genetic. The person inherits a dominant gene that makes them get Alzheimer’s.
25% of the patients inherit a gene called apoe 4 that makes them have a higher risk of getting the disease.
Health issues like blood pressure, cholesterol, diabetes, obesity, diet, sleep disorders, lack of exercise, anxiety, stress, depression all can contribute to Alzheimer’s.
The true cause for most cases aren't really known.
All patients with Alzheimer’s Disease develop accumulation of a protein called beta amyloid which forms plaques in the brain. This leads to brain cell destruction. Later a protein called tau becomes damaged. It unwinds, forms tangles which get deposited in the brain leading to inflammation and brain cell destruction.
What is the most affected part of the brain with this disease?
Alzheimer’s Disease starts in the area of the brain called the hippocampus. This is where short term memory is processed. Thus the first symptoms of Alzheimer’s Disease is the loss of short term memory. Then as the disease progresses, it spreads throughout the brain.
What is the average life span with the disease?
It varies from patient to patient. It can be as short as 3 years or as long as 15-20 years. If i was pick an average time i would say 7 years.
What are the stages of this disease?
PreAlzheimer’s or Prodromal Alzheimer’s-there is brain cell destruction occurring but the memory hasn't been affected yet
Mild Cognitive Impairment due to Alzheimer’s-there is short term memory loss but the patient is fairly functional. This is my diagnosis. I am in the early part of this stage.
Alzheimer's Disease-there are more symptoms than short term memory. Patients functions are affected like walking, dressing self, eating, talking, driving etc.
Some break Alzheimer’s down into mild, moderate, severe or early, mid, late
The Alzheimer's Association has a staging system you can find at this link
What are the treatment options if you have it?
There is no treatment or cure for Alzheimer's.
There are medications like aricept (donepezil) that may slow down symptoms but they don't affect the progression of the disease.
my mother, my younger brother, my older brother and i took or take this medicine.
It may help to be aggressive about taking care of your health doing healthy things like controlling your blood pressure, cholesterol and diabetes, getting adequate sleep, maintaining a normal weight, exercising, getting a normal sleep each night, controlling anxiety, depression and stress, and staying active mentally.
These may slow down the symptoms.
Doing these all your life may actually prevent or delay the onset of Alzheimer's Disease.
There are new treatment research studies that are ongoing that my end up slowing down or if we are lucky prevent the disease.
I will be starting infusions next week in one of these studies.
Here is an article from forbes magazine on the aducanumab study
Is there a way to prevent this disease? If so what?
See the paragraph above.
What can loved ones do to help someone with Alzheimer's?
Be there for them. Talk to them like you would normally. Make sure they don't do things that can harm themselves like drive when they shouldn't anymore or wander off.
If you become the caregiver it's always important to take care of yourself. That's something a lot of caregivers forget to do
After studying and knowing how the disease affects the body how does it feel to know you have it?
It has been a gradual process for me. It was overwhelming when i was first told i had memory issues when i volunteered to be in an Alzheimer's research study. Since then i have had more studies done like labs and genetic tests and spinal taps for the amyloid and tau levels and more recently an amyvid pet scan of the brain for the amyloid.
All the tests have been positive so far. I dont have the dominant gene but do carry a double version of the apoe 4 gene which increases my risk by 10-15 times.
Each test as it comes in represents a down time emotionally but i quickly recover. This last test the amyvid scan makes it more certain that i have Alzheimer's Disease.
Lucky for me is it qualifies be for a new treatment study that shows promise called the aducanumab study. I will start next week getting a monthly infusion for 5 years of the aducanumab antibody which attacks and removes the amyloid from the brain. It appears it may delay the disease.
By knowing my diagnosis early it has allowed my wife and i time to accept the diagnosis and allows us time to prepare for our future.
I do not get depressed or sad about have this diagnosis. I have accepted it and have moved on with my life doing what i can to slow it down or stop it but enjoying life while i can.
What can you tell others that may have the disease?
Make sure you have had a good diagnostic workup to include all the medical tests that are available as this makes it more certain of your diagnosis.
Take care of your health doing all the healthy things mentioned above.
Stay busy mentally, physically, and socially as long as you can.
Extract all you can out of every day while your memory is intact.
Be prepared with a will, a power of attorney, a medical power of attorney, a living will, and consider doing a funeral outline. These can make life easier for your loved ones when you can no longer make decisions for yourself.
Dewayne Nash MD, retired physician, Alzheimer’s advocate, Alzheimer’s lecturer, Alzheimer’s patient