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My mom is 90 years old, has Alzheimer’s disease, and often asks irrelevant questions. A brain scan showed that the blood flow to the brain is also becoming reduced, but other medical tests were normal.  At this stage, I am scared that if medications are given to my mom that it might cause her to become bedridden or incontinent. I appreciate your input. [ 05/22/13 ]

You are probably aware that the only way to be certain of Alzheimer’s disease as a diagnosis is to sample tissue from the affected person’s brain and examine it microscopically.  The PET scan, which uses radioactively-labeled tracer molecules to reveal the brain’s secrets, provides strongly suggestive evidence, however. If the scan that showed reduced blood flow was an FDG PET scan, which identifies areas of low metabolism in the brain, then the diagnosis of Alzheimer’s is likely. If it was an arteriogram, looking at blood flow in the neck and head, the diagnosis is as well-established. 

If your mom has a progressive dementia, then it is possible she will become bedridden or incontinent at some point. Some medications make people sleepy or more confused and could also have those effects, and the cholinesterase inhibitors do sometimes cause diarrhea at the beginning of treatment; however, the “cognitive enhancers” such as donepezil or memantine are not generally a cause of incontinence or increased time in bed. 

It would be helpful for you talk with your mom’s doctors about their medication suggestions and your concerns.

My mother has been on and off Namenda at least twice during the last year. She has been off the medication for about two months most recently. During this time, she has become more and more anxious and combative. These symptoms seem to go away when she is put back on the medication. Will Namenda eventually lose its effectiveness? [ 05/22/13 ]

Memantine (Namenda) is indicated for the treatment of moderate to severe Alzheimer’s disease. It is believed to benefit cognitive and behavioral symptoms even at a late stage of the illness. Some evidence supports using this drug as a useful treatment for agitation such as you describe. There may come a time when it loses effectiveness, or when the progression of cognitive and behavioral symptoms of dementia alter your mother’s behavior despite whatever benefit memantine continues to provide. Fortunately, there are other behavioral and medication approaches to treating these symptoms.

I was 60 years old in March of 2013. I have numerous osteoarthritic joints and suffer greatly with movement. An MRI has found brain atrophy and I do have short-term memory loss; however, I am still quite functional. I do worry about what lies ahead. The doctor said that I do not have Alzheimer’s, but he did put me on Aricept and phosphatidylcholine powder. Will this help to prevent the disease? Am I at high risk to develop the disease in the future? If I do not have the disease, then why take the medications? [ 05/22/13 ]

First, it’s important to clarify that neither donepezil (Aricept) nor any other currently available medication has been shown to prevent Alzheimer’s disease. Furthermore, donepezil is not indicated for the treatment of cognitive impairment that falls below the level of dementia. It’s not clear from the limited information that I have as to why you were prescribed phosphatidylcholine and donepezil, though your doctor may have a good reason, and it would be good for you to discuss this further with him or her.  The combination of brain atrophy on MRI and short-term memory loss is indeed worrisome, so if your doctor does not have specialized experience in treating memory disorders, this would be a good time for you to seek evaluation from someone expert in this area.

My dad recently had surgery on his knee, and had to go to my sister’s home to get care because my mother has Alzheimer's disease. My mom also needs care, but since she hasn’t been in her home in two weeks she has gotten worse; there has been a large decline in her memory. Is this change normal? If she goes back to her normal surroundings will she improve? [ 05/22/13 ]

Along with the other changes that Alzheimer’s disease brings, one very important one is diminished “resilience.” Normal cognitive functioning would allow your mother to cope with the temporary change in residence. Alzheimer’s disease, however, makes even small changes in surroundings into a more difficult and challenging adjustment.  In addition, of course, she is experiencing a change in her husband’s health, mobility, and availability. It is likely that she’ll improve once back in her usual surroundings, but sometimes a decline that begins in this way does not fully reverse. You may be able to help her by explaining repeatedly, to the extent she understands, that her husband is making progress in his recovery and that she will soon be back home.

I have a problem with the number 15. That is, if I'm counting in my head, I hesitate when I get to 14, and question what the next number should be. However, I noticed that I do not have a problem if I verbalize the numbers; all the numbers flow the same. That kind of makes sense because I'm bringing in the auditory cortex to help resolve the next number. Why am I having this issue with just the number 15? I doubt there's a "number fifteen neuron." My mother was diagnosed with Alzheimer’s disease somewhere between the ages of 82 to 85. Could my “missing 15” be the start of this brain disease? I'll be 65 on my next birthday. [ 05/22/13 ]

This is a truly baffling question, for which I can find no answer.  I have the same experience with recalling the name of a specific actor, so I hope for your sake and mine that this temporary and circumscribed amnesia is a fluke rather than a warning of more serious illness! In all seriousness, I do not think it likely that this experience is a harbinger of cognitive decline.

How long should a patient with Alzheimer's disease continue taking galantamine and Namenda? Is there any time limitation for taking these medications? My father has taken them for more than two years. Thank you for your advice. [ 05/03/13 ]

Although the therapeutic effects of galantamine and memantine (Namenda) may be modest for many patients, other patients may derive a longer and/or greater degree of benefit. The benefits may extend beyond helping memory and other cognitive functions. For some patients, the benefits include delayed deterioration of “activities of daily living,” delayed emergence of “non-cognitive behavioral symptoms,” and diminished “caregiver burden” (less time per day needed for caretaking). When addressing this concern with families, I ask them what they think the patient’s wishes would be at this stage of illness if he or she were able to make the decision. For some people, withdrawal of supportive treatment might be the appropriate choice. But keep in mind that patients taken off these medications even in a late stage might then deteriorate more quickly.

How long does an Alzheimer’s patient live once they stop eating? [ 05/03/13 ]

The human body is able to go for as long as eight weeks without food, so long as adequate water is taken. Without water, life is unlikely to persist longer than five days. Overall health, activity level, and climate are among the factors that can affect these estimates.

Is it ordinary, or possible that a 55-year-old person with early-onset Alzheimer's disease can move from normal cognition and behavior to anger, violence, lack of self-identity or awareness, and then move back to normal again? While in a state of abnormality, is it possible that the person can function effectively (drive a car, make phone calls, etc.) but not understand his own abnormal behavior and that his actions may have paranoid qualities? Thanks for your reply. [ 05/03/13 ]

Fluctuation of cognitive functioning definitely can occur with Alzheimer’s disease, though it’s even more common with Lewy Body dementia.  In many cases, such sudden behavioral and emotional changes are due to medical conditions such as a urinary tract infection or unrecognized pain difficulties.  If the person you are describing is driving a car when very cognitively impaired, I hope you’ll consider obtaining a formal driving evaluation or taking this potentially dangerous driver off the road for his or her own safety as well as that of others.

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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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