In 2013 there were 84,767 deaths from Alzheimer's disease in the U.S. As the sixth leading cause of death, it’s well established on the top ten list.
But most people, myself included, don’t worry about dying of Alzheimer’s disease. We fear living with the disease, not dying from the disease.
Most of us can stand back and admit we all have to die from something, and Alzheimer’s is as good a choice as any if it’s just about dying. But 5.3 million people have Alzheimer’s disease in the U.S., and the average time from diagnosis to death is estimated at eight years. That’s a long time to spend losing memory, faculties, and sense of self.
So the fear of the disease weighs heavy as we approach our golden years. We look to prevention, but prevention lets us down.
There are no conclusive studies that show specific actions we can take to reduce the risk of Alzheimer’s. There is an association between heart disease, diabetes and Alzheimer’s, so the best prevention we have now is to live a heart healthy lifestyle. Eat right and get plenty of exercise. Correlation does not equal causation, but there are many benefits to these lifestyle choices. So why not pursue them?
Further, an association exists between a reduced risk of Alzheimer’s, a life full of strong social connection, and an engaged mind. Again correlation and causation aren’t the same thing. We need more research in this area.
This is why the FTC stopped Lumosity from marketing the cognitive benefits of their online games. They also fined them for these unsubstantiated claims. Scientists agree there is no proven benefit from this sort of activity, but many believe we will be able to develop an approach in the future that will work. In the meantime, I’m asserting my own opinion that a rich intellectual and social life is more valuable than skill at online games. Online games don’t do much for loneliness either.
If the prospects for preventing Alzheimer’s are a let down, treatment is an even bigger disappointment. Currently, two types of drugs are approved for treatment of Alzheimer’s symptoms. Cholinesterase inhibitors (Aricept, Exelon and Razadyne) and memantine (Namenda) are used to treat memory loss, confusion, and deficits in reasoning caused by Alzheimer’s disease.
While these drugs offer improvement in symptoms over placebo, the improvement is somewhat limited. Further, the results only seem to last about six months or so. Caregivers are relieved of about an hour of caregiving per day by these drugs. Nursing home admission is either slightly delayed or not delayed at all, depending on the study. Yet, Aricept alone is raking in two billion in sales annually.
With 5.3 million people currently with Alzheimer’s disease and significant growth for decades, the market for remedies is so huge it’s incredibly attractive to pharmaceutical companies. One result is plenty of direct-to-consumer advertising. And when you or someone you love has Alzheimer’s, that advertising can be ruthlessly effective. You want to grab any little bit of hope you can. But it’s important to discuss this option thoroughly with your doctor to gain a realistic understanding of likely benefits.
That huge market does offer one advantage. A drug that truly slows or stops the progression of Alzheimer’s will be a blockbuster, so lots of research is happening right now. In the near future we may well have better options available than we do today.
There is some discussion of early testing for Alzheimer’s, trying to catch the disease in its earliest stages. This is a patently bad idea with the treatment options we have today. It’s a great way for pharmaceutical companies to sell more drugs before the disease starts interfering with patients’ lives. But with no treatment to stop the disease progression, there is no benefit to a patient who may have very early Alzheimer’s but is functioning well.
Just say no to early screening until we have a real treatment available to us.
According to the Alzheimer’s Association, these ten signs are a red flag for Alzheimer’s:
- Memory loss that disrupts daily life,
- Challenges in planning or solving problems,
- Difficulty performing familiar tasks at home, at work or at leisure,
- Confusion with time or place,
- Trouble understanding visual images and spatial relationships,
- New problems with words in speaking or writing,
- Misplacing things and losing the ability to retrace steps,
- Decreased or poor judgment,
- Withdrawal from work or social activities, and.
- Changes in mood or personality
If you or a loved one is experiencing these, it’s probably time to take action. In addition, early-onset Alzheimer’s - disease that presents before age of 65 - is most likely genetic. Genetic testing for younger individuals whose parents had early-onset Alzheimer’s may aid planning for the future.
And what of the fear of Alzheimer’s? My mother used to tell me not to borrow trouble – it was her paraphrase of Matthew 6:34. She was certainly right about that.
Amy Rogers MD is not a practicing physician and nothing written here should be taken as medical advice from either Amy or AssetBuilder. Medical decisions should be made with care in consultation with your health care provider.