June is Alzheimer’s Awareness Month

By Frasat Chaudhry, MD  |  6/22/2018

What is Alzheimer’s?

Alzheimer’s disease is a neurodegenerative disorder. It is the most common cause of dementia, a term used to describe a group of symptoms related to a decline in memory and other cognitive skills, often severe enough to negatively impact the ability to perform everyday tasks.

The exact cause of this disease remains unknown, and at this time, there is no known cure.   However, treatment options are available to ease associated symptoms.

Alzheimer’s typically affects older individuals, and it is rare for the disease to present itself before age 60. For those 65 and older, the occurrence and frequency doubles every five years.

Types of memory loss

The most common symptom, often signaling the start of the disease, is memory impairment.

Memories of more recent events are often affected during the early stages. The most common type is related to loss of memories of events occurring at a particular time and place.

Immediate and long-term memories are spared from impairment in the early stages. Memory that impacts motor-based learning and related functions is generally protected until later stages.

Common symptoms include:

  • Executive dysfunction: the inability to make appropriate decisions related to time management and maintain attention to specific tasks.
  • Inability to perform basic, learned motor skills, such as dressing, using utensils and self-care tasks.
  • Visuospatial impairment: a decline in awareness of nearby and surrounding objects in relation to oneself.

Development of mid to late-stage symptoms

As the disease advances, other signs and symptoms emerge. Family members and co-workers, often the first people to notice these changes, may find their loved one or colleague is less motivated, organized and unable to do common and multiple tasks at once.

During the mid to late-stage development of Alzheimer’s, individuals may experience:

  • A sharp decline in understanding of surroundings.
  • Overestimation or underestimation of cognitive shortfalls.
  • An urge to offer alternative explanations for difficulties.
  • Depression.

In addition, other neuropsychiatric symptoms can develop that impact language capabilities and overall behavior, such as:

  • Isolation from social situations.
  • Aggression.
  • Wandering.
  • Impulsivity.
  • Agitation.
  • Sleep disturbances.

Clinical assessments for proper diagnosis

Early diagnosis is crucial. Mental status and mood testing, along with physical and neurological examinations such as magnetic resonance imaging (MRI) and computed tomography (CT) scans of the brain, are done to diagnose the disease and establish specific treatment plans.

In addition, testing allows physicians to rule out other neurological conditions, such as dementia related to Parkinson’s disease, and offer recommendations for specific tasks such as driving capabilities and the need for increased supervision.

However, a definitive diagnosis of Alzheimer’s can only be made through a histopathologic examination, a microscopic examination of brain tissue, after death. This is performed with proper consent from family or healthcare proxy, an individual of the patient’s choice to legally make healthcare decisions on their behalf.

In total, early diagnosis is crucial to the arrangement of appropriate patient-centered care, election of healthcare proxy and the establishment of end-of-life care.

Dr. Frasat Chaudhry is a neurologist with Health Quest Medical Practice’s Kingston Neurology practice. Reach her office at 845-331-5165 (TTY: 1-800-421-1220) or visit healthquest.org/neurology.