North Jefferson News, Gardendale, AL

June 24, 2009

Family members may be first to notice signs of dementia


Health Watch By Robert Sikes

The North Jefferson News




What do crossword puzzles, Sudoku and reading have in common?

Re-search has shown that these activities and other brain stimulating tasks can slow down the progression of dementia. Although the symptoms of dementia may be inevitable, mind stimulating tasks can help sharpen anyone’s memory.

Dementia can be described as the loss of mental skills that can affect your daily life. Usually it is progressive and develops over time.

Dementia is not a disease itself, but a compilation of symptoms including changes in mood, behavior, thinking ability and personality.

Lewy body dementia, vascular dementia and frontotemporal dementia are a few other diseases that are associated with dementia. Alzheimer’s disease is the most common form of dementia and has been found to cause 50-60 percent of all cases.

So what causes dementia? Most commonly, increasing age causes dementia. Five to eight percent of those over age 65 will develop some kind of dementia. The incidence doubles every five years above 65.

Studies have shown that more than half of Americans will develop symptoms of dementia when they reach their 80s.



Signs and symptoms

Family members are usually the first to notice cognitive changes of their loved ones. Cognitive changes that develop quickly should be dealt with immediately, as this may be a sign of a more serious condition. Gradual memory loss or forgetfulness may be a sign of normal aging, but a decrease in daily functioning should be reported to your physician. It may also be a good idea to take a family to a physician appointment to describe the changes they have noticed. This may be the only way the doctor can fully understand the symptoms.

Some of the warning signs of dementia include a decrease in:

• learning and retaining new information

• the ability to perform complex tasks (balancing a checkbook)

• handling problems appropriately

• finding their way around familiar places

• understanding and responding to situations and acting irritable or more suspicious than usual

The doctor can perform a few simple tests to determine the severity of memory loss. Memory loss is not the only symptom of dementia but it is the most common and most notable change in one’s behavior.

Risk factors for dementia include age, smoking, genetics/family history, atherosclerosis, high cholesterol and diabetes. Living a healthy lifestyle can reduce one’s risk factors. Maintaining normal glucose levels, cholesterol levels and blood pressure can reduce the risk. Strokes, head trauma, tumors and nutritional deficiencies can also lead to dementia.



Treatment

There are a few treatment options for patients with dementia, which include physical therapy and drug therapy.

Physical therapy may include the use of memory aids. The use of mnemonics, note taking and recording devices can be used to assist the patient and stimulate the brain in other ways. These activities can be useful in the early stages of dementia and can help to improve the patient’s quality of life.

As the disease progresses, care givers may be needed to help the patient maintain a quality of life that others may not be able to provide.

Currently, there are a few drugs on the market to treat Alzheimer’s disease and a few other types of dementia, but they only can slow the progression. A few of the drugs include Aricept, Exelon and Razadyne, which increase the amount of acetylcholine in the brain.

Acetylcholine is a neurotransmitter in the brain that helps to transmit signals across the nerve fibers. Increasing the amount of this neurotransmitter can help to improve the patient’s memory and brain function.

A fairly new drug, Namenda, works through a different pathway. Namenda works through a neurotransmitter called glutamate. Glutamate is also responsible for memory and learning. Namenda is indicated for moderate to severe Alzheimer’s disease.

Currently, there is a lot of research being done for Alzheimer’s disease. At one point there was a vaccine being developed, but it was discontinued due to its side effect profile.

Many studies are being done to find out the genetic causes of the disease and other studies are being done to find a drug that can prevent or halt the progression of Alzheimer’s disease.

Drug companies are currently researching drugs such as statins (cholesterol lowering drugs) to see if they can be use in the treatment of Alzheimer’s.

Robert Sikes is a Pharm D candidate at Samford University’s McWhorter School of Pharmacy and an intern at The Pharmacy in Mt. Olive. The Pharmacy can be reached at 631-1201.