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Oldtimers…It’s
No Joke
By Dianne Pettis, CRNP
The Truth Contributor
Joking that “I must
have ‘Oldtimers,’” used to seem funny to me, until I began
to observe the effects of Alzheimer’s Dementia in my own
family. It’s sad to see the physical and mental decline in
once very vibrant and independent people. It’s also sad to
see the stress-related illnesses affecting those who care
for their loved ones.
Dementia is a
general term for loss of memory caused by physical changes
in the brain and death of nerve cells, resulting in the
brain not being able to function properly.
There are 10 types of
Dementia; four of which I’ll highlight here. Alzheimer’s
Disease is the most common of the dementias – 60-80 percent
of cases. One in nine people over age 65 has Alzheimer’s;
one-third of the population over age 85 has it, and two in
three are women.
Alzheimer’s is the sixth
leading cause of death in the United States. It is a slowly
progressive brain disease that begins well before a person
actually has any symptoms. The changes in the brain are due
to plaques and twisted strands of proteins that are
deposited in the brain, nerve cell damage, and death of
brain tissue.
Symptoms include
difficulty remembering recent events, names, or
conversations; and depression. Later, as brain cell changes
progress, and cells die; a person has problems speaking and
swallowing, displays poor judgement, disorientation,
confusion and has problems walking. Ultimately, the brain
can no longer control life processes, leading to death.
The manifestation of
Alzheimer’s symptoms is divided into stages. The stages and
symptoms affect people differently. The rate of the decline
in health varies from person to person, but all symptoms
will worsen over time. Once a diagnosis of Alzheimer’s
Disease is made; the average life expectancy is four to
eight years. The stages are Early (mild), Middle
(moderate), and Late (severe). In the mild stage, a person
is still able to live and work independently, but they may
notice little memory lapses…forgetfulness. They may
frequently lose things, and find it difficult to
concentrate. They not only notice these things, but family
and friends now begin to take notice also.
The Middle Stage is
the longest stage. Thinking and memory challenges progress.
There is more forgetfulness even for more familiar and
personal things, such as address, and information about
their life and history. There is more confusion about
activities of daily living, what to wear, how to pay bills,
and orientation to time or place. Physically, there tend to
be changes in sleep, bowel, bladder, and hygiene patterns.
During this stage, the person will need more care and
observation.
Severe Alzheimer’s is
the final stage of this disease. People will definitely
require around-the-clock care because they can no longer
respond to their environment or those around them.
Communication becomes difficult, as does controlling
movement. Eventually, everything needs to be done for the
person. They are also more susceptible to infections.
Eventually death occurs due to the progressive damage to
vital brain tissue.
The next most common
dementia is Vascular or Post-Stroke Dementia. Ten percent
of cases are of this type. With this type, there is blood
vessel blockage and damage usually after a stroke. These
changes are seen on brain imaging. Initially there is
impaired judgement, and decreasing ability to make
decisions, plan, or organize. The size of the injury,
location, and number of the injuries determine the functions
that are affected.
Lewy Bodies; another
cause of dementia, are clumps of alpha-synuclein protein.
There is memory loss and thinking difficulty as seen in
Alzheimer’s, but people are more likely to have earlier
symptoms such as sleep disturbances, slowness, imbalance
with walking, and hallucinations. With Mixed Dementia – the
fourth most common dementia, the brain changes are linked to
more than one type of dementia all occurring at the same
time. The more common combinations are Alzheimer’s +
Vascular Dementia, Alzheimer’s + Lewy Bodies, and
occasionally Alzheimer’s + Lewy Bodies + Vascular Dementia.
The other six types of dementia are Parkinson’s Disease,
Frontotemporal Dementia, Creutzfeldt-Jacob Disease, Normal
Pressure Hydrocephalus, Huntington’s Disease, and
Wernicke-Korsakoff Syndrome.
If you are concerned
about yourself or others, the first step is to consult your
primary care provider (PCP). There should be a thorough
medical history and physical exam that includes bloodwork, a
mental status evaluation, and a neurological exam.
Sometimes there are diseases and conditions that can cause
similar dementia symptoms. Based on exam results, the PCP
may order brain imaging with an MRI, or CT scan.
Care givers need a
tremendous amount of help and support. Contact local
community organizations and the Alzheimer’s Associations for
resources for caregivers and loved ones.
Dianne Hart Pettis, CRNP |
