What Older Americans Need to Know About Alzheimer's Disease

Lauren S. Schlesselman, PharmD
Published Online: Wednesday, January 1, 2003

What Is Alzheimer?s Disease?
Dementia is a disease of the brain.  It is a decline of mental functioning that continues to get worse and usually cannot be stopped. Alzheimer?s disease (AD) is the most common type of dementia. It accounts for 2/3  of all cases of dementia. AD can significantly affect a person?s over- all health. It can worsen other existing dis- eases such as heart disease, lung disease, or arthritis.  It also can lead  to  high rates of health care use. Thus, health  care can  be costly to  the individual as well as to the health care system.  In addition, the  care- giver (who may be a spouse, child, or grandchild) may suffer from stress and health problems from the burden of caring for someone with AD. It is important to remember that AD is not a part of normal aging. People at any age may have problems remembering where they placed their car keys or have trouble remembering a name. AD is dif-ferent, however.

How Common Is AD, and Who Is More Likely to Get It?
About 10 of 100 people aged 65 years or older have AD. This number goes up with  age.  Among  people  aged  85  years and older, approximately 35 of 100 have AD. A number of risk factors are associ- ated  with  this  disease.  The  most  com- mon are age, being a woman, and hav- ing a family history of AD.

What Causes AD?
No one knows exactly what causes AD. Various factors seem to come together in people who are likely to get it. These factors affect the processing of a brain protein, leading to the formation of plaques and tangles in the brain.

What Are the Signs and Symptoms of AD?
AD causes significant memory loss, which can interfere with daily life. In the beginning, AD involves problems such as forgetting job skills or recent conversations. More often, people with AD forget words or are confused about where they are or what time of day it is. AD also affects other mental functions, including learning, organizing, and planning. People with the disease have problems carrying out familiar activities such as cooking a meal, balancing a checkbook, or getting dressed. Patients may undergo a major change in personality (eg, becoming confused, suspicious, or afraid). They also may lose interest in activities or have sudden changes in mood or behavior.

How Is AD Diagnosed and Treated?
If you think that you or someone you know has any of the symptoms noted above, contact a doctor. Early detection and diagnosis of AD are very important. Although at present there is no cure, medicines can be used to treat the disease. These drugs include Aricept, Exelon, and Reminyl. They can lead to an improvement or stabilization of symptoms or to a slower decline than without treatment.

Does It Matter How Much of My Medication I Take?
It is very important to take the right dose of medicine to obtain the best result. Also, the benefits of the medication will show up only with continued use. If you should stop taking the medicine, you might have to start over at the lowest dose and work back up to the right dose. During that time, the benefits you previously got could be lost and never regained.

What Side Effects Should I Be Concerned About?
The most common side effects are nausea, vomiting, and diarrhea. These effects are usually mild and disappear after you have taken the medication for 1 to 2 weeks. They seldom force people to stop the medicine. Some people who have side effects with 1 drug can successfully change to another.

How Long Will I Have to Take the Drug?
Typically, a person with AD will have to take medication for a long time, since the disease is a slowly progressive disease.

When Should I Call My Physician?
You should call your doctor if you are experiencing side effects that are very bad and do not appear to go away.

When Should I Contact My Pharmacist?
You should ask your pharmacist if you have any questions about your medication?including when to take it, what you can take your medicine with, what over-the-counter drugs and herbs you should not take, and anything at all related to your medicines. It is very important that people with AD do not take other medications that have certain side effects. Your pharmacist can assist you in identifying drugs that should be avoided.

Practical Tips for Patients with Alzheimer?s Disease and Their Caregivers
? Find out about clinical trials of new drugs going on in your area.Taking part in such studies can have benefits.
? Become better educated about Alzheimer?s disease. This can reduce caregiver burden and stress.
? Identify and join a local support group. This can be very helpful, especially to the caregiver.
? Use memory tools to facilitate day-to-day functioning. For example, preparing ?to do? lists and organizing your home can make everyday life easier.
? Make use of the Internet. A very good resource is www.alzheimersdisease.com.



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