Alzheimer’s & Dementia Care – Questions & Answers

Can a DNA test predict whether an individual will develop Dementia?

This test is called “Predictive DNA “ testing and is not the same as using a DNA test to assist in the diagnosis of the cause of dementia.

  • Early Onset AD: especially when it affects multiple people in the family, any individual whose parent has or has dementia may consider predictive DNA testing. Commercial DNA tests are only available for the PS1 gene. They are not available for the extremely rare PS2 & APP mutations.

    A mutation in the PS1 gene indicates the individual ha s very high risk of developing dementia and AD at an age similar to others in the family. The decision to undergo predictive genetic testing before the onset of dementia symptoms is very complicated and personal and should not be taken lightly. The current genetic counseling protocol for pre-symptomatic testing includes pre-test counseling and examinations, DNA testing, and post-test counseling.

  • Late Onset AD: An individual with no family history of dementia or with a parent and or other relatives who developed symptoms after the age of 65may think that he or she would like to be tested. However, given the late age of disease onset, it is highly unlikely that the person will have a mutation in PSI (or, the other causative genes), so predictive testing as described for early onset disease will not be useful.

How can I reduce the risk of developing Alzheimer’s disease or other dementias?

Exercise your Brain regularly. Encourage your brain cells to form new connections or relations between cells. Work on Crossword puzzles, scrabble, word searches, board games and Sudoku puzzles daily. Play a musical instrument, learn something unfamiliar or new word every day.

Exercise your Body regularly. Walk 30 minutes each day, do aerobic activity couple times a week to keep blood vessels in better health. Obesity and being over-weight has been linked to Alzheimer’s in women. Lack of sleep can lead to problems with thinking, decision making and mood.

Eat smart. Increase your intake of fresh fruits and vegetables, limit cholesterol, saturated and trans-fatty acids and sugar to foster heart. Add omega-3 fatty acids, fish oil and olive oils to diet. Foods that are high in anti-oxidants and low in cholesterol and sugar help to control other health conditions that may increase the risk of dementia.

How do you when and how to stop a Dementia patient from driving?

The National Safety Council reports that it is more difficult for an adult child to discuss funeral plans or selling the family home than to ask a parent to stop driving. Although this topic is one of the hardest for family members, ignoring it can lead to disastrous consequences. In most states, the family of the elderly driver has the responsibility of deciding when he or she should no longer drive a car.

  • First, look at the recent driving history. Is there a pattern of running stop signs, failing to yield or new dents in the car? Has your loved one complained about getting lost, or taken a long time to run short errands at familiar places? Have other people complained about their driving?
  • Remember for most seniors, especially men, the ability to drive a car represent control and freedom. Be mindful of the great loss no longer driving can be. Studies show that giving up driving can lead to depression and increased awareness of mortality. Make sure you have information about transportation options before discussing the topic with your senior. (Bus schedules, Senior Transport Services, Private Caregivers, family members, etc.) Contact the National Transit Hotline at 1-800-527-8279. Be prepared to offer to drive them to errands and appointments yourself, if possible.
  • Ask for assistance from their doctor or family friends. The news that they can no longer drive is often better accepted if it comes from someone outside the family.
  • Ask your loved one to take a driving test, or a driving refresher course. The DMV may revoke or refuse to renew their license.
  • If they refuse to stop driving, you may need to take more drastic measures such as; taking the keys or disabling the car.

The National Motorists Association reports that the majority of automobile accidents involving elderly drivers are a result of Alzheimer’s disease and other diseases that affect memory, understanding and judgment. Statistics show that the seniors are more likely to be involved in multiple-vehicle accidents than others drivers, and these accidents are more likely to be fatal.

Are all Alzheimer’s patients at risk for wandering? What causes it, and what can be done to prevent it?

The Alzheimer’s Association reports that 60 percent of Alzheimer’s patients will wander at some point during their disease, and all that are ambulatory are at risk. Wandering can be caused by anxiety, agitation or confusion. Often, the Alzheimer’s patient will become confused in a new environment, try to “go home” even when they are at home, or attempt to perform a familiar task such as a hobby, work or picking up the children. Although there is no way to prevent wandering, there are measures caregivers can take to lessen the occurrence of wandering, and to keep their loved one safe.

  • Never leave an Alzheimer’s patient at home alone.
  • Register your patient with Safe Return through the Alzheimer’s Association. (1-888-572-8566 or www.alz.org .) This is a 24 hour nationwide response service for Dementia patients who have a medical emergency.
  • Talk with their doctor. Some medication side effects could contribute to wandering, while others could help to lessen the symptoms.
  • Encourage mental and physical activity during waking hours, and try to prevent excessive napping. Exercise and simple tasks such as folding clothes or sweeping helps to reduce anxiety and restlessness, promotes better sleep and less nocturnal wandering.
  • Limit evening fluids, and be sure they have used the bathroom before going to bed.
  • Place pressure-sensitive mats at the bedside or doorway, alarms on exit doors and gates on dangerous stairwells. Door locks should be placed out of sight, but with keys easily accessible to caregivers for emergency exit.
  • Inform your local emergency responders and neighbors of your loved ones condition, and ask them to call if they see them alone. Keep emergency numbers and a recent photo easily accessible.

What causes Alzheimer’s disease, and can it be prevented?

Although scientists do not know the cause of Alzheimer’s disease, it is believed that lifestyle, genetics and environment all play a role. Age appears to be the number one factor with a 10% risk at age 65, and that risk doubles every five years thereafter. What causes the Alzheimer’s process to begin is still unclear, but we do know that the damage to the brain begins many years before the symptoms are recognized. Structural and chemical changes cause gradual loss of ability to learn, remember and function.

Alzheimer’s disease is the 4th leading cause of death, the 3rd most expensive, and ¾ of patients will require residential care within 5 years of diagnosis. Alzheimer’s disease is the most common form of dementia, but many people have a combination or “mixed” dementia, such as Alzheimer’s and Vascular Dementia. It is estimated that over 5 million Americans have some form of dementia, and that number is expected to reach 15 million by 2050. The following are believed to be contributing factors in the development of memory disorders:

  • Chronic Stress
  • Smoking after age 65
  • Obesity
  • Diabetes
  • Genetics (25%)

To date, there is no conclusive research that shows that we can prevent Alzheimer’s disease. Early diagnosis and treatment cannot reverse the effects, but can greatly improve quality of life. No medications available today can reverse brain deterioration, but scientist are now testing over 90 new drugs.

Although we have no control over our age or genetic makeup, there are some lifestyle changes that are widely believed to delay or prevent Alzheimer’s disease.

  • Get enough sleep – sleep deprivation has been associated with increased risk for heart disease, cancer and cognitive problems.
  • Get regular exercise-According to a Mayo Clinic study, no single lifestyle choice has as much impact on aging and Alzheimer’s disease as exercise.
  • Challenge your brain-learn a new language or a new skill, read, stay socially active.
  • Eat brain-healthy foods-Omega-3 fatty acids, fresh fruits and vegetables. Avoid processed foods, and foods high in transfats.
  • Reduce stress and learn to relax-prolonged stress can greatly increase Alzheimer’s risk.

How can I prevent Caregiver Stress while caring for a Dementia patient?

The strain of being a Caregiver can cause feelings of guilt, anger, anxiety and lead to total exhaustion or “Caregiver Burnout.” The stress of Caregiving can be also have a negative effect on physical health. Caring for a Dementia patient can be especially difficult because of the length of time and all the challenges associated with memory impairment.

  • Educate yourself about the disease and its progression so you have a better understanding of the behaviors and needs of the person you are caring for.
  • Join support groups in your area. There is comfort in being with people that are having similar experiences. You can also learn gain valuable information from other Caregivers .
  • Don’t be afraid to call on family, friends or professional Caregivers to help with care.
  • Seek appropriate financial and legal advice. Making proper arrangements early can prevent difficult problems later.
  • Set realistic goals. You can do everything perfectly all the time, just do your best.
  • Take time for yourself. Stay in touch with family and friends, keep doctor’s appointments and try to eat will and get some exercise. The best Caregivers take care of themselves first.
  • Try to maintain healthy eating habits. Increased stress cause increased levels of hormones that can lead to cravings for high fat and high sugar foods. Over eating these high calorie foods can lead to weight gain that is associated with diabetes, heart disease and high blood pressure. Be mindful of what you are eating, keep plenty of fruits, vegetables and healthy snacks handy so you will be less tempted to indulge during weak moments.