Forget your keys again?

By Ken Hepburn, Ph.D.
(May 5, 2002; Reviewed Nov. 15, 2005)

Misplaced your keys? Can't remember names? Find yourself joking about "having a senior moment?" Are you secretly worrying about Alzheimer's disease? Don't worry; those minor memory lapses are not likely signs of Alzheimer's.

Alzheimer's is more serious; it and 70-some other diseases gradually destroy all thinking abilities, undermining the ability to organize the day, envision tomorrow, even interpret what one sees. Alzheimer's and other dementing diseases affect about 100,000 Minnesotans and that number is growing. We have more people living to 80 and beyond than ever before. While only 10 percent of people over the age of 65 will suffer from dementia, among people 85 and older, somewhere between 35 and 50 percent will have it.

Suspect Alzheimer's when an older person who could do a complex task now cannot. Someone who always managed the taxes now messes up. One who cooked elaborate meals for a dozen people refuses to try. Another, once eager to travel, suddenly feels uncomfortable in new environments. Then it's time to see a physician for an evaluation. Explain the concern about possible Alzheimer's and make sure that concern has been heard.

Health professionals, patients, and families should know, though, that depression mimics dementia. In both, a person has little zest, doesn't enjoy things he or she used to like, seems distracted, has trouble with sleep, and isn't thinking very clearly. If it's depression, drugs or therapy can help. If it's both depression and dementia, a person could be relieved of the burden of overlying depression, which might reduce a person's symptoms overall.

If Alzheimer's or dementia is diagnosed, this person's health problem becomes a family issue, because they provide most of the care. Typically, one family member assumes the principal caregiving role. Although admitting that this disease is occurring can be emotionally hard on everyone, families that pull together to help with care yet also to continue to be families in spite of the disease can find meaning and reward in the situation.

 Being an effective caregiver calls for knowledge and skills. Being a loving spouse or child provides motivation, but the task requires more. A caregiver needs to read books, go to education programs, and talk to health care professionals. Keep in mind that primary caregivers also are more susceptible to physical and emotional problems, are often socially isolated, and may, at times, become financially strapped. Taking care of family members suffering from Alzheimer's is especially hard because we expect people to behave rationally and that's exactly the way that people with dementia don't behave because they can't.

Although my colleague Karen Hsiao Ashe and other researchers are testing antioxidants and other therapies to stop or reverse dementia, a cure for Alzheimer's is not in sight yet. There are some drugs on the market now, and they do help, a little.

Unfortunately, many insurance companies don't pay for these drugs; the out-of-pocket expense can run more than $100 a month. A family has to balance whether to spend that money on drugs which have a bit of an effect, or to bring some help into the home or use a day-care center a couple of times a month. With Alzheimer's, there are no easy answers.