Alzheimer's Disease (AD) is a progressive, age-related brain disease that impairs thinking and behavior.
An estimated 2.5 million American adults are affected. AD is the most common form of dementing illness,
which causes declines in intellectual functions and in the ability to perform routine activities.
AD usually has a gradual onset. Problems remembering recent events and difficulty performing familiar
tasks are early symptoms. Additionally, the Alzheimer patient also may experience confusion, personality
change, behavior change, impaired judgment, and difficulty finding words, finishing thoughts, or following
directions. How quickly these changes occur varies from person to person, but the disease eventually
leaves its victims totally unable to care for themselves.
Symptoms Of Alzheimer's Disease
Alzheimer's Disease is a dementing illness. Dementia involves loss of memory and loss of intellectual abilities severe enough to interfere with routine work or social activities. These symptoms may occur in middle-aged and older adults. They include:
These symptoms typically cause problems in everyday activities and they may be recognizable in the following ways:
The overall result is a noticeable decline in personal activities or work performance.
Can Other Conditions Produce The Same Symptoms?
Yes. More than sixty other disorders have symptoms similar to Alzheimer's Disease, so one must not assume that someone has AD just from the signs mentioned earlier.
Among the other most common causes of dementia symptoms are: stroke, depression, drug intoxication,
thyroid disease, nutritional deficiencies, AIDS, tumors, head trauma, subdural hematoma, and normal
In addition, there are the "related disorders" that also cause dementia: Huntingdon's disease,
Parkinson's disease and Creutzfeldt-Jakob disease.
That many of the conditions that produce similar symptoms to AD are treatable emphasizes the importance
of a complete medical assessment for patients experiencing dementia symptoms. Reversible causes of
dementia symptoms can be depression, nutritional and vitamin deficiencies, drug interaction, thyroid
imbalances, infections, blood chemistry imbalances, tumor, blood clots, normal pressure hydrocephalus,
and excessive pressure in the brain from spinal fluid. In contrast, there is no effective treatment for
Alzheimer's Disease at this time. If a diagnosis of Alzheimer's Disease is assumed without adequate
evaluation, the patient with a treatable condition could be deprived of treatment.
What Is "Normal" Memory Loss
At some time, everyone forgets the name of an acquaintance, or where s/he parked the car or put his/her keys. Everyone forgets things as s/he goes about daily activities. Usually, we don't think anything of such brief memory lapses. Often, what has been forgotten is something of little importance and eventually the information is remembered.
Although most of us expect our bodies and our reflexes to slow down with age, physicians now recognize
that many healthy individuals are also less able to remember certain types of information as they get older.
Health care professionals use the term "age-associated memory impairment" (AAMI) to describe minor
memory difficulties that come with age.
AAMI is neither progressive nor disabling, whereas some dementias are both. AAMI is often most
noticeable when the person is under pressure. Often when s/he relaxes, s/he can usually recall the
forgotten material without difficulty.
No "treatment" for age-associated memory loss has been developed. However, writing reminders, making
lists, repeating messages or names out loud, and allowing more time to remember names may be helpful.
In addition to AAMI, minor memory difficulties may be caused by distractions, fatigue, grief, depressions,
stress, illness, medication, alcohol, vision or hearing loss, lack of concentration, or an attempt to remember
too many details at once.
In general, it may be beneficial to cut back on alcohol, eat well-balanced meals, and make sure that
medications are being taken as prescribed and are not themselves causing problems.
How can you tell if memory loss is more serious than AAMI? How can you tell if it is dementia?
Dementia is progressive. AAMI may remain unchanged for years. Most individuals with AAMI can
compensate for memory loss with reminders and notes. However, memory loss associated with dementia
will begin to interfere with the normal activities of daily life. In addition, dementia will affect more than
For instance, Alzheimer's Disease affects the ability to use words, work with numbers, solve problems,
and use reasoning and judgment. Alzheimer's Disease also may result in changes in mood and
When "forgetfulness" starts to affect the ability to carry on daily activities, it is cause for concern. Even
in advanced old age, memory loss that interferes with everyday life is not normal. It may indicate a form
of dementia, and the individual should undergo a complete evaluation to find out the cause.
Testing For Alzheimer's Disease
There is no single diagnostic test for Alzheimer's Disease. However, a complete medical and neurologic evaluation is strongly recommended to account for any dementia symptoms that appear.
A complete evaluation should include:
The last category of tests is used to exclude such causes of dementia as vitamin deficiency, thyroid
disease, and chronic infections, such as syphilis, depressive syndrome, brain tumors, circulatory disease,
hydrocephalus, subdural hematoma, and multi-infarct dementia.
None of these tests alone can make a diagnosis of AD. They are useful only when their findings are
considered together and they can be used to identify or eliminate other potential causes of dementia.
The only way to confirm a diagnosis of Alzheimer's Disease is to examine brain tissue under a microscope,
such as in an autopsy.
Obtaining A Medical Assessment
A good place to start is with the family doctor. A geriatrician or an internist also can begin the diagnostic process. Any of those doctors may then consult with or refer to a neurologist, psychiatrist, or specialized Alzheimer diagnostic center.
Because of the seriousness of Alzheimer's Disease, a second opinion is appropriate if there are any
doubts about the diagnosis. In some patients it is difficult to tell from a single testing whether there has
been any decline. Re-testing is then recommended to provide comparisons that will show if there has
been decline of memory and other skills and abilities. Re-testing is also recommended in cases where
the patient experiences symptoms that are not clearly defined.
You probably have many questions about what can be done to protect the future security of an Alzheimer patient and his/her family. You should feel reassured knowing that, before the full decline of mental capacity, the Alzheimer patient will be able to make decisions about the future management of his/her life and assets through careful ncial and legal planning.
It is beneficial for the Alzheimer patient and his/her family to devise a plan that meets their needs and
desires as soon as possible. Whether the patient him/herself or his/her concerned caregiver(s) are to
assume this task, professional financial and/or legal advice will be required. If your elder is diagnosed
with AD, you'll need to find a competent, concerned professional to answer any questions to your
satisfaction. Remember, laws vary from state to state as do the needs of each person and family. With
help and proper guidance, you should be able to make the choices that will best protect your circumstances.
You are probably wondering where to start. You should begin by collecting any legal and financial
documents that are the property or concern of the Alzheimer patient. This includes prior tax returns,
information on insurance policies, mortgages, bank accounts, and other financial investments, as well as
previously executed wills and trusts. Descriptions of employee benefits to which the patient may be
eligible will also be important when planning an estate. With these documents in hand, you are now
ready to seek professional legal or financial advice.
Patient And Family Relationships
Planning the future for a patient with AD can be a disturbing process for the individual and his loved ones. While it is important to designate an appropriate person early to assume legal responsibilities, it should be understood by all that the patient will only need to give up those responsibilities that he can no longer effectively handle. Even after there has been significant impairment, keeping the patient abreast of important decisions will help to ease his mind that things are being done the way he would have chosen. Very often a family meeting with the patient's physician, counselor, clergyman, or legal advisor can help to open communications among family members.
Finding Legal Help
Resources For More Information
For more information about Alzheimer's Disease, write the Alzheimer's Disease and Related Disorders Association, 70 E. Lake Street, Chicago, IL 60601-5997. Or, call 312-853-3060 or 1-800-621-0379.
Mace, Nancy, and Peter Rabins, M.D.
O'Connor, Kathleen, and Joyce Prothero.
Ronch, Judah L.
For more information or a list of other Heritage Planning educational materials on helping your parents, contact:
Richard Smith or Roger Erickson