Alzheimer’s Disease & Medication Doctor in Mursfreeboro, TN
Helton Family Medicine, a Mursfreeboro Family Doctor helps individuals who are struggling with Alzheimer’s Disease find long-term recovery. Located in Mursfreeboro, TN, Helton Family is the leader in mental health care.
Alzheimer’s disease is a permanent, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out even the simplest day to day routines and tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. This however varies, but experts suggest that more than 5.5 million Americans may have Alzheimer’s.
Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.
Scientists believe that in the majority, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.
Although the causes of Alzheimer’s aren’t yet fully understood up to this day, its effect on the brain is clear. This disease damages and kills brain cells. A brain affected by Alzheimer’s disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain.
Increasing age is the greatest known risk factor for Alzheimer’s. This diseases is not a part of normal aging, but the risk increases greatly by mid 60’s. The rate of dementia doubles every decade after age 60.
People with rare genetic changes linked to early-onset Alzheimer’s begin experiencing symptoms as early as their 30s.
Family history and genetics
The risk of developing Alzheimer’s appears to be higher if a first-degree relative ( your parent or sibling) has the disease. Scientists have identified mutations in three genes that virtually guarantee a person who inherits them will develop Alzheimer’s. But these mutations account for less than 5 percent of Alzheimer’s disease.
Most genetic mechanisms of Alzheimer’s among families remain largely unexplained. The strongest risk gene researchers have found so far is apolipoprotein e4 (APoE4), though not everyone with this gene goes on to develop Alzheimer’s disease. Other risk genes have been identified but not conclusively confirmed.
Many people with Down syndrome develop Alzheimer’s disease. Signs and symptoms of Alzheimer’s tend to appear 10 to 20 years earlier in people with Down syndrome than they do for the general population. A gene contained in the extra chromosome that causes Down syndrome significantly increases the risk of Alzheimer’s disease.
Women seem to be more likely than are men to develop Alzheimer’s disease, in part because they live longer.
Mild cognitive impairment
People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia.
Those with MCI have an increased risk of later developing dementia. Taking action to develop a healthy lifestyle and strategies to compensate for memory loss at this stage may help delay or prevent the progression to dementia.
Past head trauma
People who’ve had a severe head trauma seem to have a greater risk of Alzheimer’s disease.
Lifestyle and heart health
There’s no lifestyle factor that has absolutely shown to reduce your risk of Alzheimer’s disease.
However, some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include:
- Lack of exercise
- Smoking or exposure to secondhand smoke
- High blood pressure
- High blood cholesterol
- Poorly controlled type 2 diabetes
- A diet lacking in fruits and vegetables
These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain.
Lifelong learning and social engagement
Studies have found an association between lifelong involvement in mentally and socially stimulating activities and a reduced risk of Alzheimer’s disease. Low education levels — less than a high school education — appear to be a risk factor for Alzheimer’s disease.
Mild forgetfulness can be a normal part of aging. If you have trouble remembering someone’s name but remembers later, that’s not a serious memory problem.
But if memory problems are seriously affecting your daily life, where you cant function because of it, they could be early signs of Alzheimer’s disease. While the number of symptoms you have and how strong they are vary, it’s important to identify the early signs. You need to ask yourself some tough questions.
This is the most common symptom. Do you easily forget information you just learned? Do you lose track of important dates, names, and events? Do you forget big things even happened? Do you ask for the same information over and over? Do you rely heavily on memory aids like Post-it notes or reminders on your smartphone?
Trouble planning and problem solving
Do you have trouble making plans and sticking to them? Is it tricky to follow a recipe, even one you’ve used many times? Is it hard to concentrate on detailed tasks, especially if they involve numbers? For example, can you keep track of your bills and balance your checkbook?
Daily tasks are a challenge
Even familiar things can become hard. Do you have trouble driving to a location you go to often? Can you complete an ordinary task at work? Do you forget the rules of your favorite game?
Times and places are confusing
Can you fully grasp something that’s not happening right now? Are you disoriented? Do you get lost easily? Do you forget where you are? Do you remember how you got there?
Changes in vision
Is it harder to read the words on the page? Do you have trouble judging distance? Can you tell colors apart? This is important because it can affect your driving.
Words and conversations are frustrating
Conversations can be a struggle. Do you avoid joining in? Are you able to follow along? Do you suddenly stop in the middle of a discussion because you don’t know what to say? Do you keep repeating yourself?
You lose things
Everyone misplaces things from time to time, but can you retrace your steps to find them again? Do you put things in unusual places, like your watch in the refrigerator? Do you accuse people of taking things?
Lapse in judgment
Have you made poor decisions lately? Do you make mistakes with money, like giving it away when you normally wouldn’t?
Are you showering as often? Do you take less care of yourself? Do you dress for the wrong weather?
Are you scaling back on projects at work? Are you less involved with your favorite hobbies? Do you lack motivation? Do you find yourself watching television or sleeping more than usual?
Do you get upset more easily? Do you feel depressed, scared, or anxious? Are you suspicious of people?
Having one or two of these symptoms occasionally occur in your life does not necessarily say that you have Alzheimer’s Disease. Diagnosis of this disease comes through a series of test involving the frequency of the symptoms showing up or if its lingering for quite some time.
Current Alzheimer’s medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:
Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication by providing a neurotransmitter (acetylcholine) that is depleted in the brain by Alzheimer’s disease. The improvement is modest. Cholinesterase inhibitors can improve neuropsychiatric symptoms, such as agitation or depression, as well.
Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea, loss of appetite and sleep disturbances. In people with cardiac conduction disorders, serious side effects may include a slow heart rate and heart block.
Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer’s disease. It’s sometimes used in combination with a cholinesterase inhibitor. Side effects may include constipation, dizziness and headache.
Sometimes other medications such as antidepressants are used to help control the behavioral symptoms associated with Alzheimer’s disease. But some medications should only be used with great caution. For example, some common sleep medications — zolpidem (Ambien), eszopiclone (Lunesta) and others — may increase confusion and the risk of falls.
Anti-anxiety medications — clonazepam (Klonopin) and lorazepam (Ativan) — increase the risk of falls, confusion and dizziness. Always check with your doctor before taking any new medications.
Creating a safe and supportive environment
Adapting the living situation to the needs of a person with Alzheimer’s is an important part of any treatment plan. For someone with Alzheimer’s, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.
You can take these steps to support a person’s sense of well-being and continued ability to function:
Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don’t become lost.
See if your doctor can simplify your medication regimen to once-daily dosing, and arrange for your finances to be on automatic payment and automatic deposit.
Develop the habit of carrying a mobile phone with location capability so that you can call in case you are lost or confused and people can track your location via the phone. Also, program important phone numbers into your phone, so you don’t have to try to recall them.
Make sure regular appointments are on the same day at the same time as much as possible.
Use a calendar or whiteboard in the home to track daily schedules. Build the habit of checking off completed items so that you can be sure they were completed.
Remove excess furniture, clutter and throw rugs.
Install sturdy handrails on stairways and in bathrooms.
Ensure that shoes and slippers are comfortable and provide good traction.
Reduce the number of mirrors. People with Alzheimer’s may find images in mirrors confusing or frightening.
Keep photographs and other meaningful objects around the house.
Regular exercise is an important part of everybody’s wellness plan — and those with Alzheimer’s are no exception. Activities such as a daily walk can help improve mood and maintain the health of joints, muscles and the heart.
Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer’s carries identification or wears a medical alert bracelet if she or he walks unaccompanied.
People with Alzheimer’s who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs.
People with Alzheimer’s may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation.
High-calorie, healthy shakes and smoothies. You can supplement milkshakes with protein powders (available at grocery stores, drugstores and discount retailers) or use your blender to make smoothies featuring your favorite ingredients.
Water, juice and other healthy beverages. Try to ensure that a person with Alzheimer’s drinks at least several full glasses of liquids every day. Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger a frequent need to urinate.
Certain nutritional supplements are marketed as “medical foods” specifically to treat Alzheimer’s disease. The Food and Drug Administration (FDA) does not approve products marketed as medical foods. Despite marketing claims, there’s no definitive data showing that any of these supplements is beneficial or safe.
I’m Dr. Helton.
I started practicing medicine in the year 2000, and over the past 18 years have treated and served over 15,000 patients. I’m the current president of the Middle Tennessee chapter of Family Physicians, an Executive board member of the Tennessee Academy of Family Physicians and Chairman of St. Thomas Rutherford Hospital Family Medicine Department.
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