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Ask an Expert about Alzheimer's Disease

Latest Questions and Answers
My mother is in a nursing home and has recently been passing out. She was taken to the hospital, where they performed blood work and performed a CAT scan. All of the tests came back negative. They don't know why she is passing out. Is it possible that her blood pressure is too low? [ 03/10/11 ]

Passing out, or "syncope", can result from any of a number of medical causes, and low blood pressure is certainly one of the possibilities. Passing out occurs typically when brain activity is interrupted, which can occur through oxygen deprivation (from low blood pressure, transient ischemic attacks, or cardiac arrhythmias, for example) or through electrical disorganization that occurs during a seizure. Low blood pressure itself has many causes, some of which (like dehydration) are easy to fix. A comprehensive medical work up would be necessary in order to determine the exact cause of these distressing episodes.

I recently read about a new drug used in Germany that has shown to be effective in either slowing down or possibly reversing Alzheimer’s disease. I can't remember the name of the drug and was hoping that you could help. Also, are there any new medications and is a cure in the future? [ 03/10/11 ]

You may be thinking of metformin. It's an anti-diabetic drug that received some attention for its ability to affect Alzheimer's disease; however, an apparently credible report has suggested that metformin alone actually increases beta amyloid generation, while in the presence of insulin the effect on Alzheimer's disease (AD) may be more positive.

Concerning your second question, an absolute cure for AD may still be a long way in the future; however, there are several promising therapeutic strategies currently being developed and tested that could effectively treat the disease in AD patients. Many of these potential therapies are at the human clinical testing stage, so it may not be long before one or more of them receives FDA approval and can be used by the general public. However, despite the diligent efforts of scores of scientists and doctors, there is really no way of telling when any one such therapy will become available.

Medicare is telling me that I need to switch to the generic form of Aricept. I truly believe that the generic is different from the original, and I don’t want to change. Is the generic version of Aricept different from the brand? [ 03/09/11 ]

Aricept is the brand name for donepezil, and there are no studies that indicate the brand name is superior. Some patients feel that they notice a difference, however, and your prescribing physician should be able to contact your insurer to request that you get access to Aricept, which might involve a larger expense on your part. I assume that you are dealing with a "Medicare Part D" plan concerning this issue, so you may also want to consider asking for help from SHINE (Serving Health Information Needs of Elders) at 1-800-AGE-INFO in reviewing your insurance and the other available options.

My mom was diagnosed with Alzheimer's disease. Her speech sometimes is not understandable and she cannot walk on her own because she loses her balance and falls. She also does not want to eat much and prefers only certain foods. Also, she leans sideways when she sits in a car or on the couch. Recently, it has become difficult to give her medicine. She sucks on it like candy. It's also hard to check her mouth to see if she has swallowed the pill because she does like us to do that. We were crushing the medicine up and putting it in certain foods like peanut butter or mashed potatoes, but that isn't working well now because she is not eating very much. Are these symptoms are normal. Is there anything that can help her to eat more? Does the winter season make her symptoms worse? [ 02/25/11 ]

Of course it is terribly difficult to witness a loved one succumb to this disease, but you can take some comfort in knowing that you are providing her with very good care. Regarding your mother's loss of balance and sideways leaning, it is possible that she is suffering from vertigo, which can affect elderly individuals regardless of whether or not they have Alzheimer's disease. Your mother's physician can test for vertigo and possibly even correct it depending on its cause.

It is fairly common for AD patients to have decreased appetites and lose weight as a result. A decreased appetite may be due to a loss of interest in food, decreased or altered sense of taste, decreased energy expenditure (therefore requiring a lower caloric intake), or a loss of the feeling of pleasure or satisfaction normally derived from eating (referred to as anhedonia). Because she is eating less, what she does eat therefore matters more. Your job is thus to make sure her food is nutrient rich so that every bite counts. If nothing else, you can try using liquid meal supplements to provide her with additional calories and essential nutrients. Some additional caregiver tips for encouraging AD patients to eat are provided by the Alzheimer's Disease Education and Referral Center (ADEAR) through the National Institute on Aging (NIA).

Finally, the long and often sunless winter months experienced in more northerly climates can sometimes lead to a condition called Seasonal Affective Disorder (SAD). Although no study has formally tested this, since Alzheimer's patients are more prone to develop apathy or depression than non-AD persons, dreary winters might affect the mood of these patients and increase the risk for depression. Regular exposure to sunlight can help to improve an Alzheimer's patient's overall mood and—when combined with calming, dim lighting in the evening—can help to keep a patient's circadian clock on track. This internal clock frequently becomes disrupted in Alzheimer's patients, such that they end up being awake at night and sleeping during the day.

My mother sleeps on the couch during the daytime. If she gets up, it is usually because she wants something to eat; however, very rarely does she complete her meal. She gets up several times during the night to watch TV and eat. When her exercise therapist, speech therapist and nurse stop by, she does what they ask, but she does not listen as well to her family's requests. What should be our expectations? [ 02/23/11 ]

As Alzheimer's disease (AD) robs a person of memory and logic, it also affects the portions of the brain involved in emotional responses. Alzheimer patients therefore often have blunted emotions, and may appear apathetic or depressed. They appear to lose interest in their surroundings and can become withdrawn. Because depression is also commonly observed in patients with AD, particularly in the early stages of the disease, it can be difficult to determine whether a patient's blunted emotions are due to depression or simply a symptom of the disease. It may therefore be warranted to have your mother evaluated by her physician to specifically test for depression, because antidepressants might be helpful if she is confirmed to have depression.

In general, remember to stay calm and positive when speaking to your mother or asking her to do something. Sometimes it is all in the way of how you ask her rather than what it is you want her to do. For example, if you ask for her help in accomplishing a task, you are more likely to get a positive response then if you just tell her what to do. Because the therapists and nurse probably work with many dementia patients, they have learned good techniques for getting patients to work with them. So don't be afraid to ask these professionals for any specific suggestions about how to best work with your mother.

My mother is in an EMI Residential Unit and has been suffering with Alzheimer's disease for 2 years. She is unable to walk anymore and is fully incontinent. Up until recently she has been eating well and has always had a cheery disposition. All of a sudden, however, she has become very tearful and doesn't know why. We don't know if she is in pain; we get contradictory answers. Is it possible that these behaviors are symptoms of Alzheimer's disease and we just have to muddle through as best we can? There seems no where to turn to ask questions. Thank you in advance for any advice you have to offer. [ 02/23/11 ]

Alzheimer's disease affects a person's mood as much as it affects his or her memory. Blunted and/or exaggerated emotional responses are characteristic of the disease, and emotional changes can occur suddenly and without warning. Excessive tearfulness, sadness, anger, fear, or anxiety can all rear their horrible heads at times, and families of AD patients are often just as surprised and confused about these unexpected emotions as are the patients. The important thing to keep in mind is that these negative emotions and behaviors are symptoms of the disease and are not conscious decisions on the part of your mother.

And as for finding answers to any questions you may have, the EMI unit should have staff trained in dementia care who can provide you with answers to your questions, or at the very least direct you to suitable resources in your area. If you haven't already considered it, it may also be helpful for you to join an Alzheimer's disease support group. The people in these support groups often are a wealth of knowledge and, more importantly, have experienced much of the same emotional roller coaster as you have undoubtedly experienced yourself.

Could herpes cause Alzheimer’s disease? [ 02/18/11 ]

Although current research in the causes and treatments of Alzheimer's disease (AD) have focused predominantly on other hypotheses, there is a respected researcher promoting the possible link between Herpes Simplex Virus type 1 (HSV1) and AD. Professor Ruth Itzhaki and colleagues at the University of Manchester have investigated suggestive data supporting this connection. They have pointed out that HSV1 infects most people and that it resides in their peripheral nervous systems. Professor Itzhaki's team showed that HSV1 is contained in many AD amyloid plaques and that HSV1 infection of nerve cells under experimental conditions can induce the formation of these plaques. The risk is higher in individuals who have HSV1 and the APOE4 gene, which is the gene most strongly associated with the chances of developing AD. The theory proposed by Professor Itzhaki is that neuronal death induced by HSV1 infection in elderly people with reduced immunity releases amyloid, which then contributes to the development of plaques. Further research will help to determine if there is indeed a relationship between HSV1 and the development of Alzheimer's disease.

My maternal grandmother and mother were diagnosed with Alzheimer's disease. I’m terrified of following in their footsteps, especially since I cared for both of them. When I forget something, fear overcomes me due to my experience with family members who have had this terrible disease. Is there anything else I can do? I am a retired teacher, and wonder if I should return to work or volunteer to keep my mind active? By the way, I take Aricept and Namenda under a physician’s care. [ 02/17/11 ]

In time, it may be possible to identify people at higher risk for Alzheimer's disease and to prescribe a specific preventive program for them. At this point, however, the advice for reducing the risk of Alzheimer's disease is essentially the same as the advice given for the promotion of general healthy aging. It is not clear to me why you're taking Aricept and Namenda unless you have been diagnosed with Alzheimer's disease already. You should discuss the advisability of continuing these medications with a knowledgeable clinician since neither of these medications have been shown to prevent this neurological disorder.

Although there is preliminary data to support the benefit of some interventions, such as physical activity and cardiovascular risk reduction, nothing at this time has definitively been shown to prevent Alzheimer's disease or other dementias. The following are some general healthy aging tips that you may wish to explore:

  • Engage in physical exercise
  • Eat a nutritious diet
  • Exercise your mind
  • Cultivate social connections
  • Develop a sense of meaning in your life
  • Maintain adequate sleep
  • Reduce stress
  • Schedule activities that you enjoy

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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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