Alzheimer's: Treatment and Coping, Nutrition, and Important Medical Information

Different types of dementia are common in older ages and significantly affect the elderly population. The most common cause of dementia is Alzheimer's disease.

What is Alzheimer's?

Alzheimer's is a degenerative brain disease that mainly affects people over the age of 65, although it can appear in younger individuals. In this disease, a protein called amyloid accumulates in brain tissue, while inside nerve cells, a protein called tau accumulates. This accumulation creates a degenerative process that leads to the death of existing nerve cells in the brain. The process is gradual and causes impairments in functioning and cognitive abilities, including memory, information processing, learning, language, planning, orientation, and more.

Alzheimer's disease develops over many years, typically lasting 8-10 years. Although considered terminal, the causes of death are indirect consequences of the disease, such as pressure sores from immobility, infections developed due to the disease, and the patient's lack of function.

Symptoms of the Disease

The disease is typically divided into three main stages. In the initial stage, cognitive abilities begin to decline, showing difficulties in handling complex tasks such as time management and financial management; memory problems like short-term memory loss, disorientation, forgetting names or specific words, and misplacing objects. Mood and behavior changes may also occur, such as confusion, lack of interest in social activities, mild aggression, and tendency towards depression.

In the second stage, symptoms worsen. Cognitive abilities are more impaired, and there is noticeable difficulty concentrating, decision-making challenges, inability to perform simple calculations, disorientation, even in familiar places, and other such issues. Short-term memory gradually disappears, making it hard for patients to process new memories or learn new things, while long-term memory remains. Behavior also becomes more extreme, characterized by mood swings, suspicion, paranoia, hallucinations, sleep disturbances, and a lack of interest even in close people, leading to wandering without purpose.

In the third and most severe stage, cognitive abilities and memory are entirely erased. The patient becomes entirely passive and indifferent to their surroundings and can no longer recognize close people or objects.

How is Alzheimer's Diagnosed?

There are various warning signs that may indicate the early development of the disease. It's important to pay attention to symptoms, as early identification of the disease is crucial. Although Alzheimer's has no cure and cannot be prevented, its progression can be delayed, especially if treatment starts early in the disease's development.

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Sometimes, the individual themselves senses difficulties with memory or functioning. However, often the patient may not notice the symptoms, but those around them notice changes in mood or functional abilities.

Here are some symptoms to watch for:

• Difficulty retrieving a word during conversation
• Reduction in vocabulary or avoiding conversation
• Forgetting recent events or occurrences
• Forgetting details that interfere with daily functioning, like phone numbers or names of acquaintances, without recalling them later
• Difficulty performing regular daily tasks, like forgetting food in the oven or being unable to make a familiar recipe
• Misplacing objects in inappropriate places, such as putting the iron in the fridge or milk in the wardrobe.
• Reduction in planning ability and problem-solving skills
• Difficulty with orientation, even in relatively familiar places
• Frequent confusion, disorientation of date or time
• Mood or personality style changes
• Tendency towards impatience or irritability not previously observed
• Avoidance of social activity

It's important to note that these symptoms can occasionally occur in healthy individuals. However, if you notice 3-4 symptoms from the list occurring frequently, it's cause for concern and requires testing.

Alzheimer's Diagnosis

The diagnosis of Alzheimer's disease is divided into three:

Diagnosis of Cognitive Deficits – Through tests examining memory, orientation, language, thinking ability, and more.

Brain Imaging – CT, MRI, and other tests, as well as blood tests and additional exams, aim to ensure no other factor is causing the symptoms, such as vitamin B12 deficiency or heart diseases.

Psychiatric Evaluation – Essential because severe depression can manifest similarly to Alzheimer's. Depression can be treated or significantly improved, whereas Alzheimer's is irreversible. Additionally, Alzheimer's patients may develop behavioral disturbances that can harm the patient or those around them, hence early intervention is crucial.

How to Cope with the Disease?

Alzheimer's patients need comprehensive care and close supervision from a certain stage of the disease's progression.

There are medicinal treatments given to patients to delay the disease's progression, but as mentioned, they do not completely prevent it, and sooner or later, the patient's condition will deteriorate.

There are also medications aimed at the common behavioral problems in the disease, occasionally anti-psychotic drugs, which help in the early stages when the patient is still aware of their condition.

Besides medication, close supervision is needed to prevent self-harm by the patient. Eventually, physiotherapy is necessary to maintain the patient's mobility for as long as possible; occupational therapy; dermatological monitoring to prevent pressure sores and infections, etc.

Currently, there is increased awareness of treating the patient's family as well. The primary burden of care falls on the spouse or children, and research shows that family members of Alzheimer's patients are more likely to suffer from physical and mental illnesses. Therefore, it is important to provide significant support to family members, supplying them with as much information as possible about the patient's condition, various forms of assistance, and emotional support.

From the family's perspective, the best way to cope with a close relative's illness is to understand the disease. Understand the origins of different behaviors, and accept that when an Alzheimer's patient suffers from hallucinations, for example, they indeed "see" and "hear" these hallucinations. There is no point in trying to convince them the hallucinations are not real; it's better to "go along" with them and respond to their words as reality, with patience, respect, and love.

Improving Memory - Rabbi Eyal Ungar