Overview

Alzheimer's Disease is a progressive neurological disease that results in the irreversible loss of nerve cells in the brain. The gradual loss of nerve cells eventually leads to impairment in memory, judgment and decision-making, orientation to physical surroundings, concentration and language. In addition, Alzheimer's disease can affect your ability to perform day-to-day tasks and can lead to changes in behavior and mood. These symptoms often interfere with social and work activities.

Stages

Alzheimer's disease affects people in different ways. Individuals will differ according to the symptoms that they experience and the way the disease progresses. However, the general course of the disease often is divided into stages (early, middle and late) based upon memory functioning, overall thinking ability, day-to-day abilities to care for yourself, and behavior. Long-term memory (e.g., childhood and early adulthood) is usually the least affected.

Early Diagnosis and Intervention

There is no cure for Alzheimer's disease, but there are important resources that can be of help to you and your family. The first step towards self care is to get a full diagnostic work-up to help rule out potentially reversible causes of memory loss (e.g., depression, reaction to medication, etc.). In addition, early diagnosis and intervention allows you to:

• Improve your understanding, and the understanding of those around you, about the changes that are taking place.
  
• Increase your knowledge and understanding of Alzheimer's disease and community resources.
  
• Become involved in planning for the future (e.g., financial and health care planning).
  
• Increase your awareness of local and national research projects.
  
• Stay up-to-date on progress being made with potential treatment options.
  
• Increase your awareness about safety issues and preventative health.
  

Early-Stage Symptoms

The following is a list of areas that may become increasingly difficult for you. The list is intended to help you identify potential areas of difficulty in order to plan for future changes, and to continue living your life to the fullest. You may begin noticing changes in the following areas:

• Memory for recent events. Examples: remembering appointments, details of a recent conversation, and names.
  
• Carrying out tasks with multiple steps. Examples: managing money and balancing your checkbook, taking medications, shopping and cooking.
  
• Decision-making and problem solving. Example: Making quick decisions when there is an emergency, such as responding to a flood in your home.
  
• Spatial ability and orientation. Examples: following a map or following directions, judging the distance of objects while driving, and feeling lost in familiar environments.
  
• Language. Examples: finding the right word, understanding what you have read, and writing letters.
  
• Behavior and/or mood. Examples: loss of interest in new projects, withdrawing in social situations, feelings of anxiety and depression. Keep in mind that symptoms of anxiety and depression are often quite treatable; speak with your physician if these feelings arise.
  

Transitions

Changes in your daily routine may be necessary in the early stages of Alzheimer's disease. Although there may come a time when you rely more on others for assistance in certain areas, you may want to stay actively involved in making decisions that affect your life. The following areas are usually addressed early on:

• Driving: Some states, have laws requiring physicians to report individuals with a diagnosis of Alzheimer's disease to the Department of Motor Vehicles. The intent is to insure that you and those around you are safe. If you continue driving, ongoing evaluation of your driving abilities and ongoing consultation with your physician are critical. It is also wise to pay attention to the suggestions of those close to you; they may recognize changes in your driving ability before they become apparent to you.
  
• In-home responsibilities: Household management may become increasingly difficult for you. Because you will experience changes in recent memory overtime, household tasks, such as cooking, may become safety risks.You may, for example, forget to turn off the stove. However, it may be possible to continue to participate in household activities with a minimal amount of assistance from another person. Some individuals choose to have family or friends assist in certain areas, and some individuals choose to hire help from outside the home.You may want to start discussing these options with those who are close to you.
  

Ways of Coping

• Educate yourself about the disease and resources in the community.

• Discuss your preferences with family members.

• Maintain an open mind and positive attitude—focus on your present abilities and avoid excessive worry about what might happen in the future. Know that there are many ways in which you can live a meaningful and productive life.

• Continue to explore ways to fulfill your needs for intimacy and closeness. The desire to have intimate and close relationships with others continues throughout the disease.

• Be patient with yourself.

• Exercise can contribute to good physical health and coordination, and can reduce stress and frustration. See your physician for an exercise program that will best fit your needs.

• Find productive ways to release anger and frustration—talk with a close friend, a counselor experienced in Alzheimer's disease, or join a support group especially for people with Alzheimer's.

• Use visible and/or accessible reminders—write notes to yourself, leave messages on your answering machine, or set the alarm on a watch as a reminder about an upcoming appointment.

• Engage yourself in meaningful activities—documenting your life story by creating a scrap book, a taped autobiography, or a journal can be a wonderful way to reflect upon your life and share yourself with those close to you.

• Know that you are not identified ONLY as a person with Alzheimer's disease—focus on the many and varied personal attributes and inner qualities that

• you have such as integrity, kindness, humor….

• Become an advocate for yourself and other individuals with Alzheimer's disease. Write letters and make phone calls to local and state representatives, assist community agencies in training staff and professionals about Alzheimer's disease, or become involved in a research program.

Research

Presently, researchers can not definitively say what causes Alzheimer's disease, and there is currently no cure. However, there has been considerable progress made in the field of Alzheimer's disease research in recent years. Two promising areas of research related to the treatment and cause of Alzheimer's disease include:

• Medications: While more information is needed, there are some medications that seem to delay the progression of the disease, or at least improve limited areas of functioning in a small percentage of individuals. To date, two drugs, Aricept and Cognex (tacrine) have been approved by the Food and Drug Administration (FDA). There are also a number of medications that are now in the testing phase and may be available in the near future. Agents such as Vitamin E also are being studied.
  
• Genetics Research: Discoveries in the field of genetics research can be helpful in assisting with diagnosis and addressing the complex factors that make individuals more susceptible to developing the disease.

Community Resources

• Support groups and counseling services: Support groups can be primarily discussion-oriented or can offer a variety of activities including outings and creative projects. Caregiver support groups are also available in the community for those individuals who are assisting you in some way.
  
• Volunteer programs: Volunteer workshops and community volunteer programs are now available in some areas.
  
• Artistic programs: Expressing yourself through work in clay, paint or photography, for example, may be very beneficial to you and can provide you with various opportunities for self-expression.
  
• Structured day programs: Adult day programs (both social and health oriented) provide activities such as art therapy, exercise, community outings and assistance with physical health needs.
  
• Professional Assistance: Take advantage of health care professionals who assist with maintaining physical strength and coordination, such as occupational therapists and physical therapists.
  
• Legal and financial assistance: Forming a durable power of attorney for health care and durable power of attorney for finances, for example, may be important initial steps.
  
• Care management: A care manager experienced in the field of Alzheimer's disease can provide education, assistance with transitions, emotional support and guidance in locating and coordinating community resources.