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Q&A on Alzheimer’s Disease

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November 2, 2016

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Q. Are there any activities or lifestyle changes that are helpful for someone with Alzheimer’s disease?
A. Patients with Alzheimer’s and other types of dementia should be encouraged to increase their mental, physical and social activities. Lifestyle modification, following a healthy diet (e.g., Mediterranean diet), and regular physician care to lower cardiovascular risk may be beneficial. Safety issues, such as driving ability and conditions in the home, should be evaluated and modified, if necessary, to prevent injury.

Q. Where is the best place for someone with Alzheimer’s to live?
A. If it’s safe and possible, which depends on the person’s level of function and the availability of support, the best place for a person with Alzheimer’s to live is in a familiar environment such as their own home. It is important to keep everything constant to lessen the occurrence of disorientation and neurobehavioral problems such as agitation, psychosis and combativeness. The patient and his/her family are encouraged to discuss advance care planning with the patient’s primary care provider.

Q. What is Alzheimer’s disease?
A. Alzheimer’s disease is a neurodegenerative disorder commonly seen in older age. It is associated with an abnormal protein accumulation in the brain that damages brain cells, leading to cognitive symptoms including memory loss, difficulty with mental processing and skill-related tasks. Alzheimer’s is a gradual and progressive process and is the most common neurodegenerative disorder in the United States. Although Alzheimer’s rarely happens in the young, it increases with age, doubling in prevalence every 5 years after age 65.

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Q. What is the difference between Alzheimer’s disease and senile dementia?
Senile dementia is an outdated term used when associating aging with memory loss. It is a broad term that encompasses various types of dementia leading to memory loss, which include Alzheimer’s disease and a variety of brain disorders such as stroke, trauma and Parkinson’s disease.
It is important to distinguish normal aging from dementia. In normal aging, there is a slowing down of mental and bodily functions, but it’s not significant enough to cause functional impairment.

You may occasionally forget where you put the keys, where you parked the car, and other people’s names, but this memory loss is not severe enough to affect your ability to perform activities of daily living. Alzheimer’s disease causes impairment of memory, as well, but it also affects the areas of the brain involving executive function (ability to plan or solve problems), visuospatial skills (ability to navigate, locate the position of objects), and, in its more advanced stages, language and behavior.

Q. Does Alzheimer’s run in the family?
A. Alzheimer’s disease does run in some families, particularly in early onset dementia (less than 65 years of age), which represent 1 to 2% of all cases. For late onset dementia, there is a slight increase in risk if a relative was diagnosed past 65 years of age. Alzheimer’s is more common in women than in men, which can be explained by longer lifespan and other genetic, hormonal and societal factors.

Q. Is there a cure for Alzheimer’s?
A. There is no cure to date. Alzheimer’s medications such as donepezil, namenda, rivastigmine, or galantamine do not prevent, modify, or reverse the process but may help improve cognition, behavior, and the ability to perform daily tasks.

Paul Lleva, MD
Dr. Paul Lleva, a neurologist, is a Phelps Medical Associates physician and an assistant professor of neurology at New York Medical College. He is board certified in internal medicine, neurology and vascular neurology.

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