Since I’ve been a consumer journalist
for many years, I’ve written a number of articles about memory mistakes after
40.
What I learned is that it’s typical for
busy people to begin making memory errors around age 40. What is recommended is
that people stay active and engage in activities that stimulate the brain, such
as games, puzzles, and learning a foreign language.
However, a survey by the Alzheimer’s Foundation
of America adds some new information.
Delayed diagnosis
Many caregivers mistakenly interpret
certain behaviors as a normal part of aging rather than as symptoms of
Alzheimer’s disease or another dementia. As a result, the diagnosis of a loved
one’s Alzheimer’s could be delayed.
A survey conducted by Harris
Interactive of relatives and friends who care for people with dementia examined
how behavioral symptoms compare to cognitive symptoms in their impact on
diagnosis, disease management, caregivers’ well being, and other issues.
Cognitive symptoms are symptoms such as memory loss and confusion.
Respondents report the most frequent
behaviors, exhibited daily to about once a week, are irritability, late-day
confusion, anxiety, and sleeplessness.
Symptom management
Only 14 percent of respondents thought
they’re managing the person’s behavioral symptoms better than their cognitive
ones. And the survey showed that healthcare professionals are suggesting a
multi-pronged treatment for behavioral symptoms, including non-drug interventions.
“The survey findings sound another loud
wake-up call that we must address this public health crisis, and reinforce that
education and early detection must be among the nation’s key strategies in
tackling it,” Eric J. Hall, foundation president and CEO, said in a statement.
Two-thirds of respondents who provided
care prior to diagnosis believed their loved one’s behaviors were “just a
normal part of aging,” according to the survey. Sixty-seven percent said these
thoughts delayed getting a diagnosis.
Often cognitive symptoms, 40 percent,
or a combination of cognitive and behavioral symptoms, 40 percent, triggered a
doctor’s visit, outweighing behaviors, 12 percent, as a factor.
Behavorial symptoms
To cope with behavioral challenges, 80 percent of caregivers
report that the healthcare provider suggested medication:
- A prescribed name brand drug, 67 percent, or a generic
version, 30 percent, specifically for Alzheimer’s disease or dementia, or;
- Medications to treat behaviors, 26 percent, such as
anti-depressants, 45 percent; anti-anxiety medications, 28 percent;
antipsychotics, 21 percent; and mood stabilizers, 12 percent.
While the U.S. Food and Drug Administration hasn’t approved
any medications to specifically treat the behavioral symptoms of dementia,
doctors are permitted to prescribe a drug for a different illness than what the
FDA has approved it for, known as off-label use.
The survey also showed that 82 percent
of physicians and 92 percent of social workers suggested behavioral
modifications, environmental changes, and other non-drug interventions, such as
communication techniques, support groups, reducing noise and clutter, and
activities like music and artwork.
“Behavioral treatments are the treatment of choice,” said Jacobo Mintzer,
M.D., chairman of foundation’s Medical and Scientific Advisory Board and
Alzheimer’s researcher.
What do caregivers find works best for
behavioral symptoms?
- About one-third of respondents believe
non-drug options help “a lot,” especially sticking
to routines, 53 percent.
- Among individuals with dementia taking
at least one medication, 47 percent of caregivers say medications to treat
specific behaviors help a lot – more than double those, 21 percent, who say an
Alzheimer’s-specific drug medication helps a lot.
While nearly half of caregivers say
they manage both classes of symptoms equally well, fewer think they’re coping
well with more severe behaviors: irritability, anger, inappropriate sexual
behavior, aggression, personality changes, and paranoia and/or suspiciousness.
Aggression, 59 percent, and fear of self-harm
to the diagnosed person, 54 percent, or injury to other family members, 48 percent,
would be the most likely reasons for long-term care placement of loved ones.
Women, 35 percent, are less likely than men, 48 percent, to feel they can
handle aggressive behavior.
The behaviors by people with dementia
are triggered most often by frustration followed by unfamiliar surroundings and
a “desire to go home,” the majority of caregivers said in the survey.
Caregivers
Concerning the impact on their lives,
caregivers are rocked by both behavior and cognitive symptoms, with each equally
impairing their own health – causing fatigue and difficulty sleeping – as well
as limiting their social and work lives.
Alzheimer's disease statistics
About 5.1 million Americans are living
with Alzheimer’s disease, and, with advanced age posing the greatest risk, the
incidence is expected to skyrocket as the nation’s population ages. It's a big issue facing baby boomers.
Informal caregivers provide more than
80 percent of all long-term care services at a market value of $450 billion
annually.
