Understanding Alzheimer’s Disease: Frequently Asked Questions About Alzheimer’s Disease
Print out these questions and answers to discuss with your health care provider.
1. Are there any medications that someone with Alzheimer’s disease should avoid?
A person with Alzheimer’s disease may be taking medicines to treat symptoms of the disease, as well as other health problems. However, when a person takes many medications there is an increased risk of having an adverse reaction, including confusion, agitation, sleepiness, or sleeplessness, mood swings, memory problems and/or stomach upset.
While it may become necessary for a person to take medicine to treat the behavioral symptoms that sometimes occur in Alzheimer’s disease -- such as hallucinations or aggressive behavior -- some of these medications can worsen other symptoms of the disease. For example:
It is important to discuss the pros and cons of these treatment options with your doctor before making a decision regarding medication. In addition, it is important to consider the possible side effects of over-the-counter medication, including cough and cold remedies, and sleep medicines. These drugs may also react with other medications taken by the person with Alzheimer’s disease. It is best to consult your doctor before using any over-the-counter medication.
2. I’m thinking about taking a trip with my father, who has Alzheimer’s disease. Is there anything special I should do?
The most important things to do when traveling with someone with Alzheimer’s disease are to plan ahead and try to anticipate the person’s needs, so you’ll be ready for any changes or problems. As you plan, be sure to consider the stage of the person’s illness and any behaviors that may be affected by traveling away from home. You may want to try taking a short trip to see how your loved one reacts to traveling. Here are a few other tips to consider:
3. I’m having trouble getting my loved one to eat. What can I do?
Good nutrition is important for people with Alzheimer’s disease. In fact, poor nutrition can worsen some symptoms of dementia. Loss of appetite is common in Alzheimer’s disease; loss of appetite can also occur with commonly used treatments for Alzheimer’s disease. To get your loved one to eat, try some of the following:
4. My mother has Alzheimer’s disease, and I’ve noticed she is getting more confused. How can I help her?
There are several things you can try to help a person who is confused:
5. Is there anything I can do to help my mother preserve what memory she has left?
Losing cherished memories is one of the devastating consequences of Alzheimer’s disease. Some medications used to treat Alzheimer’s disease may help slow down memory loss and there are some techniques you can use to help enhance what memory exists.
6. Can ginkgo biloba cure Alzheimer’s disease?
A recent carefully controlled study of ginkgo biloba in Alzheimer disease showed no significant benefit of the drug in preventing or treating memory loss. Some questions remained unanswered, and the issue cannot be considered closed.
7. Is exercise recommended for someone with Alzheimer’s disease?
Exercise offers many benefits for people with Alzheimer’s disease. The major benefits include improved strength, endurance, and heart fitness. Exercise can also increase energy, and improve mood and sleep. Exercise also helps people with Alzheimer’s disease preserve motor skills and improve balance, which in turn, can help prevent serious injury from falls. Further, exercise can help improve mental function.
The type and intensity of exercise appropriate for someone with Alzheimer’s disease depends on the person’s degree of impairment. People in the early stages of the disease may enjoy exercises such as walking, bowling, dancing, golf, and swimming, although supervision may be necessary. Greater supervision may be required as the disease progresses. Activities that could lead to injury should be avoided.
It is important to talk to the person’s doctor before beginning any exercise program. There may be other factors -- such as bone disease, a heart condition, or balance problems -- that could limit or restrict activity.
8. What is "sundown syndrome?"
Sundown syndrome -- also called sundowning or sunsetting -- is a behavior common in people with Alzheimer’s disease. It describes the confusion, anxiety, agitation, or disorientation that often occur at dusk and into the evening hours. The episodes may last a few hours or throughout the night.
While the exact cause of sundown syndrome is not known, experts believe there are several contributing factors. These include physical and mental exhaustion (after a long day), and a shift in the "internal body clock" caused by the change from daylight to dark. Some people with Alzheimer’s disease have trouble sleeping at night, which may contribute to their disorientation. Medication that can cause agitation or confusion also may contribute to this syndrome.
Sundown syndrome can be draining for the person with Alzheimer’s disease and his or her caregivers. Here are some suggestions for helping a loved one with sundown syndrome cope:
9. When will the new Alzheimer’s disease vaccine be available?
Several types of vaccines are being studied and may be available in clinical trials. They are several years away from approval.
10. Does the desire for sex diminish or totally disappear in people with early or mid-stage Alzheimer’s disease?
Sexuality has been little studied in Alzheimer’s disease. However, many individuals with Alzheimer’s disease have mood disorders such as depression, which can cause sexual problems. In addition, medications used to treat depression can also cause sexual problems. Many persons with dementia also have decreased motivation that affects much of their lives, such as their interest in their appearance, clothes, friends, etc., and may affect their sexual function as well. A few have increased sexual drive.
If you are concerned about your partner’s sexuality, try the following recommendations:
11. Is Alzheimer’s disease inherited?
Yes, there are important genetic influences in Alzheimer’s disease. Early-onset (before age 60) Alzheimer’s disease has a genetic predisposition. If you have a first-degree relative with Alzheimer’s disease, you are 4 to 10 times more likely to develop Alzheimer’s disease than someone who has no family history of the disease. Recent research indicates that the risk is higher for people who have a mother with Alzheimer’s disease than for those who have a father or no parent with the disease.
Mutations in one of three genes that can be inherited from parents seem to explain many causes of early-onset Alzheimer’s. These genes are APP, PSEN1, and PSEN2. An alteration of any of these genes leads to excess production of amyloid beta peptide in the brain, which accumulates to form the amyloid plaques in the brain that are characteristic of Alzheimer’s disease.
Early-onset Alzheimer’s disease is much rarer than late-onset Alzheimer’s disease. The cause of late-onset Alzheimer’s disease (after age 65) is not entirely clear but variants in the ApoE gene are implicated, along with lifestyle and environmental factors. Inheriting one copy of the ApoE gene variant increases the risk of late-onset Alzheimer’s, inheriting two copies further increases the risk.
More recently, several other gene variants have been identified as possible risk factors for late-onset Alzheimer’s disease. These are variants of the genes CR1, CLU, PICALM, BIN1, EPHA1, MS4A, CD2AP, and CD3. Some of these genes play roles in inflammation, lipid transport, and the movement of proteins within cells, which could be important pathways for development of Alzheimer’s.
In most cases of late-onset Alzheimer’s, however, the major risk factor is older age. After age 75, the risk of Alzheimer’s disease increases substantially.
12. What can I do to avoid Alzheimer’s disease?
You can take several steps to reduce your risk of getting Alzheimer’s, even if you inherit the genes responsible for the disease. Some of the risk factors for cardiovascular disease also increase the risk of developing Alzheimer’s. Therefore, physical activity and maintaining a healthy weight, blood pressure, and cholesterol level, as well as avoiding diabetes, can go a long way to prevent the disease. People who have diets that contain a lot of fish, vegetables, and fruits as opposed to red meat, processed meat, fat, and sugar also have a lower incidence of Alzheimer’s disease. Higher levels of education appear to reduce the likelihood of later development of Alzheimer’s.
Alzheimer’s Association. www.alz.org/index.asp Accessed 8/18/2011
National Institute on Aging. Alzheimer’s Disease Education and Referral Center. www.nia.nih.gov/Alzheimers/ Accessed 8/18/2011
Alzheimer’s Association. New York City Chapter. www.alznyc.org/caregivers/sundowning.asp Accessed 8/18/2011
National Center for Complementary and Alternative Medicine. Gingko Biloba. http://nccam.nih.gov/health/ginkgo/ Accessed 8/18/2011
Alzheimer’s Foundation of America. www.alzfdn.org/ Accessed 8/18/2011
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