Alzheimer's diagnosis is critical

Although an estimated 4.5 million Americans have Alzheimer's disease — a number expected to triple as baby boomers age — it's not an inevitable part of growing old. And early diagnosis and treatment are essential.

For one thing, not all dementia is caused by Alzheimer's. And some of the other causes — such as thyroid disease or a vitamin B12 deficiency — can be treated and the symptoms relieved or reversed, according to Dr. Cherie Brunker, acting chief of geriatrics at LDS Hospital, who is also board certified in palliative care.

Brunker and Kelly Davis Garrett, Ph.D., a neuropsychologist at LDS Hospital, will be featured on tomorrow's Deseret Morning News/Intermountain Health Care Hotline. From 10 a.m. to noon, the two will answer phoned-in questions about Alzheimer's disease and dementia.

Alzheimer's disease is more than just memory loss. Besides memory, it would include loss in an area such as calculation or visual-spatial skills. Progressive over time, it interferes with life function, unlike the small memory lapses that plague everyone at some time. Some early signs of the disease include getting lost, losing the ability to handle finances and diminishing ability to care for one's self, such as forgetting to change clothes or to eat.

"There are medications available that can improve functional ability," said Brunker. While they don't cure the disease, "that's important. Even if it means postponing going to a nursing home for six months, that makes a big difference."

Alzheimer's disease is considered an aging issue because of the numbers, though early onset is possible. Of those over 80 years old, as many as 40 percent have dementia — and 65 percent of those have Alzheimer's, Brunker said. Other causes include hydrocephalus, Parkinson's disease and cerebral vascular disease. Prior stroke and head injury play a role in cognitive loss, as well, and may increase the risk of developing Alzheimer's disease.

The difference between Alzheimer's and dementia with cerebral vascular diseases is the course of the illness. It's hard to pinpoint the beginning of the insidious, progressive Alzheimer's disease. With cerebral vascular disease, "Mom was suddenly worse," people say. That's because a kind of stroke caused the change and the individual might be fairly stable, then have another stroke and progress. Some people have both conditions.

No one's sure how to prevent Alzheimer's disease, though theories surface. But cerebral vascular disease prevention includes not smoking, controlling blood pressure and cholesterol, exercising, taking aspirin therapy and controlling diabetes.