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Nov 3, 2011

Alzheimer’s A New Epidemic

Alzheimer’s disease is the most common cause of dementia in people over the age of 65.  Symptoms include memory loss; impaired judgment and decision-making capacity; a decline in the ability to perform activities of daily living; changes in behavior, mood, and personality; increasing dependence on caregivers.  A 2007 report released by the Alzheimer's Association estimated that there are 5.1 million people in the United States with Alzheimer’s disease.  And within another generation the number of people with Alzheimer’s disease will exceed 15 million.  Alzheimer’s is a leading cause of death after cardiovascular disease, cancer, and cerebrovascular disease.  Causes of death in Alzheimer’s patients include falls, severity of cognitive decline and function impairment, and the development of Parkinsonian signs.

 Alzheimer’s is the third most expensive disease after cardiovascular disease and cancer in terms of total costs.  In the outpatient population, approximately $18,000 is spent per patient per year for mild Alzheimer’s, with increased costs associated with disease progression and severity ($30,000 per patient per year in moderate stage and more than $36,000 per patient per year in the severe stage).  About 50% of the nursing home beds are occupied by Alzheimer’s patients costing on average of $60,000 a year (Neurology 67 2006).

Although age is by far the most important risk factor associated with the onset of Alzheimer’s, a number of other risk factors are also important such as female gender, low educational attainment, and head injury (usually associated with a loss of consciousness) appear to increase Alzheimer’s risk. Depression, particularly developing in late life, appears to be a prodromal symptom of Alzheimer’s and may precede memory deficits by several years.  Family history of dementia in first-degree relatives appears to increase the risk of developing Alzheimer’s slightly.  Recent evidence suggests that the same risk factors for cardiovascular disease may be important contributors to the risk of developing Alzheimer’s these include high blood pressure, high cholesterol, diabetes, and high homocysteine levels.  There are also several genes that are associated with Alzheimer’s.  This is why it can be hereditary. 

The most common symptoms of Alzheimer’s include memory impairment such as repetition; trouble remembering recent conversations, events, appointments; frequently misplacing items, deterioration of complex task performance; decreased ability to solve problems; difficulty with calculations; and impaired driving.  Many diseases are associated with memory loss such as hypothyroidism, hypoglycemia, depression, diabetes, chronic inflammation, Wilson’s disease, hemochromatosis, B12, vitamin D and antioxidant deficiency, menopause, alcoholism and heavy metal toxicity etc.  The list goes on.  Also, many drugs can cause memory loss.

It is important to treat memory loss at the early stages and try to identify the cause of the problem.  A complete lab work up is necessary to help identify the cause.  There are many nutritional and amino acid deficiencies related to memory loss, blood sugar problems, hormonal issues, alcohol, drug and heavy metal toxicity.  The list goes on again this is why a thorough work-up is important.  Each patient should be examined individually.  Unfortunately the drugs used to treat Alzheimer’s are not very effective and tend to have a lot of side effects.

Certain activities have been associated with improved cognitive function and can prevent the onset of Alzheimer’s these include exercise, exposure to classical music, social engagement, playing a musical instrument, reading and bingo. The earlier these activities are started in life the better. 

Caring for an Alzheimer’s family member is very stressful for the care giver. Family caregivers are also at risk for depression, anxiety, and physical illness. Caregiver depression and decline in health may affect his or her ability to adequately provide care for the patient and increases the likelihood of premature institutionalization for the patient.  Therefore, taking care of the caregiver is just as important as taking care of the patient.

Studies show that Alzheimer’s may reach epidemic proportions in twenty years.  The goal is to get early diagnosis and treatment for memory loss so one can delay progression of the disease, improve function and reduce caregiver burden. Health problems should not be ignored.  Many times they can be treated easily at the early stages of the disease. 

Dr. Deborah Wiancek is a naturopathic physician specializing in natural medicine at the Riverwalk Natural Health Clinic in Edwards, CO.  She can be reached at 970-926-7606, Wiancek@healthref.com or www.healthref.com.