Question: What is one thing all four of these have in common?

Answer: They are all among the top 10 leading causes of death in America.


Question: How is Alzheimer’s different from the other three?

Answer: It is the only one of the top 10 causes of death in America that cannot be prevented or cured and for which there is no reliable way to slow its progression.

That sobering information comes from the Alzheimer’s Association. And although I lost a parent to Alzheimer’s and have another family member who now struggles with the disease, it is something I had never thought about – a cause of death that we seem powerless to prevent.

Nationally, the Alzheimer’s Association estimates that 5.2 million Americans have Alzheimer’s, including 200,000 with an early-onset form of the disease. The Association also estimates that by 2024, an estimated 7.1 million people over the age of 65 will have the disease – that’s a 40 percent increase. And unless science finds a way to treat, prevent or cure this devastating condition, the Alzheimer’s Association predicts that by 2050, the number may have nearly tripled to 13.8 million people.


A slow downward spiral

In the past, forgetfulness and loss of mental acuity were considered an inevitable part of aging. Now there is a growing realization that dementia – whether caused by Alzheimer’s or another condition – is not just a part of growing older.


According to the Mayo Clinic, dementia is not a specific disease, but a group of symptoms that interfere with daily living by affecting thinking and social skills. While there are many causes for dementia, Alzheimer’s is the most common. Memory loss is usually part of dementia, but memory loss by itself doesn’t mean a patient has dementia. For someone to be diagnosed with dementia, there have to be multiple problems, such as memory loss, impaired language or judgement or impaired ability to do routine tasks. This can mean an inability to pay bills or drive in familiar neighborhoods without getting lost.

To watch a friend or family member struggle with Alzheimer’s is to watch a slow decline. The Mayo Clinic says this decline usually takes seven to 10 years. The disease affects different parts of the brain with growing severity – causing problems with memory, language, reasoning and often leading to agitation and fearfulness. It’s the reverse of watching a child develop new skills, as you watch one simple skill after another slip away.


But what are the warning signs for which you should be aware? The Mayo Clinic has quite a long list of changes that could indicate dementia. These range from things like failure to keep up with daily routines of bathing and grooming to deterioration in housekeeping or unexplained weight loss. Forgetting common words can be another clue. And getting lost while trying to drive to the neighborhood grocery store can be another red flag.

If you are worried about behaviors like these in a family member or a friend, it’s a good idea to schedule a doctor visit and go along to have an honest conversation about the changes you are seeing.


Where do we go from here?

Once you get the results of the physician’s tests you may have  more questions than answers.

“The American Journal of Psychiatry” has published a Global Deterioration Scale, or GDS. According to the GDS, people with mild memory loss or people who are functioning normally, although others around them may be aware of their decline, can usually continue to live independently. People with early dementia may be able to live independently with the assistance of family or caregivers. By the time someone has progressed to moderate dementia, independent living is not an option. In this phase, people cannot recall things that they have known for years – like their phone number or address – and may be disoriented as to date or time of year.

By the time someone progresses to moderately severe dementia, he or she will have little ability to recall recent events in his or her life and will require help with what are known as “activities of daily living,” which including bathing, dressing and eating. In severe dementia, someone may no longer be able to recall and use language, be incontinent and lose the ability to walk.

Helping while you can

At this time of the year, we want to be around the people we love. And this can be a hard time both for those who care for loved ones with dementia and for those who suffer from it. You may find the holidays more rewarding if you follow these suggestions from the Mayo Clinic:

If you are the caregiver, adjust your expectations for the holiday

If your family member is still living at home, make holiday preparations together when you can. This can mean opening greeting cards together or helping with simple steps such as measuring flour when baking

Keep decorations simple – avoid lighted candles or flashing lights as these can be a distraction to someone with dementia. Also avoid decorations that look like edible treats – such as garlands made to look like candy or fruit

If your family member or friend lives in an assisted living facility, it may be best to celebrate the holiday at the facility. Familiar surroundings are best for someone with dementia, and a visit home – although it can sound like a good idea – may be upsetting

Limit guests to small groups, two or three people at a time. Larger groups can be confusing

Schedule visits at the time of day when he or she is at his or her best, usually the morning or noontime


Remember that although dementia affects memory and behavior, all of the emotions that make us human are still there. People with Alzheimer’s and other forms of dementia will still feel happy, sad and anxious. You can help them by not dismissing their feelings. They may still remember the past clearly, and you should take the time to talk with them about their memories. During the holidays you can have some very special memories to reflect on, and hopefully together you can focus on what is still shared instead of what is lost.


Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines.

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