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Ask an Expert about Alzheimer's Disease

Latest Questions and Answers
I have read that amino acids can help a person who has Alzheimer’s disease. Please let me know if you have any information on this topic. [ 11/30/10 ]

Amino acids are simple molecules that serve as the building blocks of proteins. Since proteins are necessary for many biological processes, we need to have these amino acids available. Most can be produced within our own bodies, though some are obtained only through dietary means. A diet with adequate protein intake should not lead to amino acid deficiency in a healthy individual, and there is no solid evidence currently that extra supplementation with amino acids alone is helpful in preventing or treating Alzheimer's disease.

Why does amyloid beta aggregate into plaques and fibrils? What exactly is involved in the process of amyloid beta forming monomers, dimers, trimers, oligomers, protofibrils, fibrils, and eventually plaques? I'm really interested into the biochemistry of amyloid beta in pathogenesis of Alzheimer's disease. [ 11/30/10 ]

Amyloid beta is a protein, which means it's a string of amino acids linked through chemical bonds. The fibrils result when peptide strands bind together as a result of the molecular characteristics of the amino acids. Amyloid plaques are sheets of the fibrils bound together as a result of electrostatic and chemical bonding. The precise mechanism through which amyloid causes Alzheimer's disease (if indeed it does) remains unclear, but likely involves interference with synaptic transmission as well as instigation of neuron-killing local inflammatory reactions.

My mother is in the moderate stage of Alzheimer’s disease. She lives in her own home now; however, we think it's time to move her in with family during the next couple of months. Does anyone know how disruptive it would be if she lived with my brother for 3 weeks and me for 1 week each month. My sister thinks it would be best for mom if she moved into an assisted living facility. I appreciate your thoughts on this issue. [ 11/10/10 ]

If it is not possible for you or your brother to keep your mother in one location the entire time, then it might be better if she went to live in an assisted living facility. Predictable routines and environments are typically best for Alzheimer's patients because without such predictability, patients can become easily disorientated and confused, which can lead to anxiety and other behavioral issues. It is wonderful that both you and your brother plan to share responsibility for the care of your mother, but continually relocating her “home” may become a problem as her disease progresses and she becomes less able to adapt to change. Perhaps it seems overwhelming for either you or your brother to take on full responsibility for your mother's care and this is why the joint-custody situation seems appealing. Even though it may appear sensible to consider share custody, it is not ideal for an Alzheimer's disease patient.

Perhaps you and your brother can make other arrangements wherein you both are still involved in your mother's care, but she lives with only one of you full-time. For example, if you mother lived at your brother's home all the time, then you could assist in her care by running errands for your brother, providing some financial assistance, and/or providing respite care on a regular basis so that your brother can take time for himself. An overnight stay at your home might also be okay once or twice a month, but you will need to gauge your mother's reaction to these visits as to whether or not they cause her excessive confusion or anxiety. If an alternative arrangement with your brother is not possible however, then your sister may be right: it may be best to move your mother into a place where she will have a stable and consistent home environment.

My husband was diagnosed with Alzheimer’s disease 7 years ago, and he lived at home until 4 months ago. I want to bring him home for an afternoon visit, but I wonder if this would not be a good idea because his short term memory is gone and he doesn’t know the names of all of his children. I took his trumpet to him last week and he played jazz and improvised for 45 minutes. This is the hardest thing I've ever experienced. We have been married 59 years and I wonder if the life that we knew together is now over? Please help. [ 11/10/10 ]

It certainly is difficult to stand by and watch as the person you've known for so many years starts to slip away, but you still have time to enjoy many things with your husband. Go ahead and bring him home for a visit. If the visit goes well, then consider taking him on an outing or having him visit you at home on a regular basis, perhaps once or twice a week depending on how much you feel he can tolerate. And of course, continue to visit him regularly at the facility as much as you can manage. Alzheimer's disease is curious in that a person may forget his or her own child or spouse but remember how to play the piano or knit, for example. These skills require both motor and cognitive components, and sometimes they are so deeply “ingrained” in a person that multiple areas of the brain would need to be damaged by the disease before the skills are lost. So this is why your husband can still play his trumpet, but cannot always remember the names of his children.

Taking your husband's trumpet for him to play was actually a very clever thing on your part. Music therapy, for example, has been reported as being helpful to Alzheimer's disease (AD) patients in that it helps to reduce stress and anxiety. Also, he must enjoy it because it is something that he can still do well, which provides a sense of gratification and achievement. So encourage him to play whenever you are with him. You can also listen to some of his favorite jazz albums together—he may enjoy listening to familiar music as much as he does playing it. Understandably, you may feel like you are facing a huge dark unknown about your future together. Though difficult to reconcile, this is a completely normal reaction. As hard as it may be for you, try not to think too far into the future. Just like your husband, try to live in the moment and take things day by day. Realize that some days are going to be better for him than others (and some days will thus be worse than others). So try to make the most of your good days together and appreciate all the things that he can still do with you. And while your husband is still capable of talking, try to work out some means of non-verbal communication with him such as by touch or stares—this will help immeasurably when the time comes that your dear husband is no longer able to communicate with you by speech.

My mom is 84 years old and was diagnosed with Alzheimer’s disease approximately 10 years ago. She does not talk and is confused all the time. Lately, she often just sits and she keeps her head down. In fact, her head is way down to her knees most of the time. She looks very uncomfortable. We have tried several things to keep her head up, but it keeps going down again. Is this a part of the disease? Do you have any suggestions? [ 11/10/10 ]

Stooped posture is fairly common in patients with Alzheimer's disease (AD). In some instances, a patient may lean quite significantly to one side or lean forward (such as in your mother's case), in which case it might be called Pisa Syndrome. This stooped posture can also occur in patients with Parkinson's disease (PD) and Lewy Body dementia (LBD). AD can affect brain areas responsible for muscle tone and balance, and therefore gait, postural and balance disturbances can arise. Sometimes, these disturbances are a result of AD medications (such as cholinesterase inhibitors). So it may be helpful to review your mother's medications with her doctor as well as to determine if any other medical factors (PD or LBD) are at play. If her posture is caused by her medications, then adjusting the dose and/or discontinuation of the medication (only on her doctor's approval) should help to resolve the problem.

I provide 24-hour care for a client and I am becoming very frustrated as time goes by. How can I help myself from feeling like this? [ 11/10/10 ]

By “client” I assume your mean that caregiving is your occupation. It is understandable that you feel frustrated considering that you never get any time off. However, you have an obligation to yourself to speak to your client's family about scheduling time off. You need time so that you can relax and decompress, as well as take care of things in your own life. You should tell the family that both your health and your client's care will suffer if you do not get some relief from your responsibilities. Inform your employers that you require at least one day off per week. Do not feel guilty about taking time off because it is necessary for you to maintain your mental and physical health so that you are capable of providing the best care possible for your patient. If the family objects to your request, remind them that this is in the best interest of their loved one—you cannot be an effective caregiver if you feel worn out and at your wit's end.

Also, it may help you in general to speak to other caregivers about what you are going through. They have been there too, and may be able to provide you with some needed moral support. You can search for Alzheimer's caregiver support groups in your area by visiting our Resources section, such as under the Caregiving and Caregiver Support heading in Helpful Organizations.

I am 56 years old and have had a grand mal seizure disorder since I was 35. As long as I take my medication I have no seizures. Before having seizures I had an excellent memory; however, I was informed recently that I have Alzheimer’s disease. Is there any correlation between seizures and the development of dementia or Alzheimer’s disease? [ 11/03/10 ]

Although seizures are not thought to lead to Alzheimer's disease, there are a variety of ways in which seizures are associated with dementia. A seizure in progress interrupts the process of memory formation so that no new memories are made during the seizure and some memories from just before the seizure are not stored. Seizures can cause excessive excitement of brain cells resulting in a destructive effect that damages memory. Seizures that lead to hypoxia (a period of insufficient oxygen levels) or head injury can be even more damaging to the brain. Some of the medications that treat epilepsy produce sedation or forgetfulness in some patients. Furthermore, there are medical conditions (such as brain injury) that can result in both seizures and dementia. Finally, seizures can develop in people affected by Alzheimer's disease although this is not a common occurrence. You are young for the onset of Alzheimer's disease, so if you have experienced epilepsy and memory loss and been told that you have Alzheimer's disease, I hope you will make sure that a physician skilled in the diagnosis and management of dementia confirms this diagnosis.

My grandmother, her sister and my aunt have died from Alzheimer’s disease. My mother was diagnosed 6 years ago and is now in the final stages of the disease. My sister and I have watched my mother succumb to this disorder with great concern and worry if we also are at risk. I do understand the benefits of medications such as Aricept, and wonder if this class of medications could prevent the onset of the disease if they were used prior to the onset of symptoms? If so, how do I encourage my doctor to write a prescription? Right now, he says that as long as I have no symptoms, I shouldn't worry. [ 11/02/10 ]

Your concern is understandable, since it must have been exceedingly difficult to witness the illnesses of your grandmother and her sister, your aunt, and your mother. Indeed you and your sister are at greater risk than individuals without so many affected relatives. If the onset of your relatives' illness was early, the risk is greater. Still, it's very important to realize that many older adults with affected close relatives never develop Alzheimer's disease. The cognitive enhancing medications such as Aricept (donepezil) and others have not been shown to prevent the onset of the disease when used prior to symptom onset. In fact, there is nothing at this time that has definitively been shown to prevent Alzheimer's disease or other dementias; however, there is preliminary data to support the benefit of some interventions, such as physical activity and cardiovascular risk reduction. Please seek evaluation if symptoms of cognitive change are noticed by you or your sister.

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Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

Last Review: 04/29/13

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