“Doctor, I’m afraid it’s Alzheimer’s disease.”
This statement is one of the more common ones that I hear from a patient or their caregiver when they come to see me for memory loss. Often, this fear accompanies stories of misplaced keys, forgotten appointments or lost names in conversation. I also hear of personality changes, paranoid thoughts or bizarre behavior. Our cognition encompasses our skills in memory, attention, concentration, planning, language, calculations and judgment with input from all of our senses. The loss of any of these pieces can strike fear in us and our loved ones.
It is important understand what is normal for age. Some mild worsening is expected with the aging process. A 75-year-old brain is not as efficient as a 25-year-old brain. But more progressive losses are not normal.
It is also critical that families appreciate other basic terms that doctors use to describe problems with thinking. Mild cognitive impairment (MCI) details general worsening beyond normal aging. Here, patients are still able to accomplish most of their activities of daily living, but the cognitive changes are becoming more troublesome. MCI is often accompanied by more mood changes, like irritability, sadness or anxiety. Dementia describes more profound loss of several cognitive abilities, having progressed to a stage where patients require more assistance and may not be safe to work, drive, handle finances or stay alone.
The aforementioned diagnoses are made only after a healthcare provider has investigated other potentially reversible causes of cognitive changes, as other illnesses, medication side effects or pure mood changes may mimic forgetfulness or confusion. And when one is labeled with a diagnosis of dementia, the medical practitioner still tries to diagnose the likely cause of dementia. This is where the patient’s family may hear such diagnoses as Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), vascular dementia (VaD), frontotemporal dementia (FTD) and others. These may look like an alphabet soup of initials, but our experts know that each of these conditions leaves its mark on the brain in unique ways. Medications, supplements, diet and exercise are all currently used to try to curtail the symptoms, while the definitive ability to reverse the damage remains elusive.
The impact of dementia on society is enormous, and it will only grow with an otherwise older and healthier population that remains at risk. In Louisiana, we currently estimate nearly 85,000 people are affected with dementia. Nationally, dementia care costs have been estimated at about $56,000 per patient per year and largely result from potentially avoidable complications and emergency visits.
The future of dementia care is benefiting from a technology boom in medicine. New scans that “tag” damaged brain cells are being developed to improve the accuracy of diagnosis. Telemedicine can use digital audio/video feeds to provide virtual patient visits – connecting specialists with patients and their care partners in the convenience of their local clinics or homes. Clinical trials are ongoing internationally to investigate potential causes and cures. As such, Ochsner Neuroscience Institute is energized to remain on the forefront of cognitive care for our region and beyond.