Every 71 seconds someone in this country develops Alzheimer’s, a progressive and fatal disease that destroys brain cells. As the population of the state and country ages, the number of Alzheimer’s patients is increasing. Emotional and financial burdens to families are enormous.
Dr. Curtis Lee Greer, a Tupelo resident who is board certified in family and geriatric medicine, has many patients with Alzheimer’s.
“I have a specific interest in this disease partly due to the overwhelming toll that it can pose to both patients and families,” he says. “Like many other chronic diseases, it truly affects the whole family network and not just the patient. It is sad to see a patient who is losing recognition of family members and close friends. I try to provide the best care and treatment to the patient and their loved ones as they go through this terrible disease.”
The projections for an increase in this disease are staggering, says Dr. Lee Volters, a neurologist and medical director of the stroke program and in-patient rehabilitation at Memorial Hospital at Gulfport.
“As medicine gets better at keeping people alive longer, people will get primary degenerative disorders,” he said. “These disorders are Parkinson’s Disease, dementia and Alzheimer’s. Imagine the costs of caring for 40 million patients with Alzheimer’s by the year 2050 and another 20 million with Parkinson’s.”
Volters and Greer see a correlation with the growing number of Alzheimer’s patients and the growing number of aging Americans. “Alzheimer’s is a disease of the elderly and with the aging of America, it is going to become more prevalent,” Greer said.
As program director of the Mississippi Chapter of the Alzheimer’s Association, Barb Dobrosky is involved with awareness, education and family support. The chapter, formed in the mid-1980s, now has 24 support groups throughout the state.
“Our main goal is to be out there providing information for all types of organizations and all caregivers,” she said. “We provide printed materials, care consultation one by one and by telephone, workshops and a helpline. We want families and caregivers to realize there is support to help them cope.”
The chapter recently added Medic Alert+Safe Return to its services for patients and families. It teamed up with the National Medic Alert system to develop a bracelet bearing the message “memory impairment” and a phone number to call.
“Basically it’s for those who wander,” Dobrosky said. “Someone wearing the bracelet is put on national alert.”
Dr. Mark Meeks, a geriatrician at University of Mississippi Medical Center (UMC) who teaches and sees private practice patients, agrees the number of patients is rising and will be a big problem if a cure is not found. He says there is no research presently being done on the disease at UMC, although research is being done elsewhere.
“Unfortunately, there is nothing new right now in drug treatment. We are using what’s been around 10 years,” he said. “These drugs have shown modest clinical benefits — not dramatic and not stopping the progression of the disease.”
Greer and Volters use a dual drug therapy with an inhibitor such as Aricept along with Namenda, a drug that helps the brain work naturally.
“There are several drugs that are good, but Aricept has fewer side effects,” Volters said. “The combination works best and allows patients to stay home with the least problems. We see about 50% positive results.”
Greer tells patients and families that these medications will not cure the disease, but hopefully slow the progression.
“I also try to incorporate behavioral techniques for caregivers and provide resources for them to cope with this disease,” he added. “For instance, I will recommend sitters to come in and help with patient care for some period of time during the week so the caregiver can get out and not have the burden of caring for their loved one. I find this not only helps the patient, but also allows the caregiver to come back refreshed and able to assume their duties once again.”
Both of these professionals recommend a book developed by Johns Hopkins University Medical School titled “The 36 Hour Day” for patients’ families.
Dobrosky thinks a lot of people are in denial about the growing number of Alzheimer’s patients. “At health fairs, many people won’t take our information about the 10 signs of the disease,” she said. “We have to deal with what is going on. Yes, it’s increasing. Get your head out of the sand and learn more about it.”
As for research, Volters says several studies are looking at anti-inflammatories that have not yet panned out. There is also research being done with nerve growth cell factor and stem cell growth.
“Stem cell growth is probably the best hope for the future, but it is down the road,” he said. “Researchers can now take substance that’s not from a fetus. There are people working on ways to do this so no one will object to it. I think that’s where we go from here.”
Meeks says it’s important for patients to have more objective testing and screening to test memory, cognitive thinking and orientation to look for treatable causes other than Alzheimer’s in the elderly.
“We can get information and history from family members and caregivers and get lab tests such as a brain scan to look for abnormalities,” he said. “Maybe the patient has a brain tumor or other things we can treat.”
He sees the physician’s role to educate patients and caregivers of the diagnosis, what to expect and safety concerns with Alzheimer’s. The patient may initially live at home and then proceed through levels of care.
“For families, care requires a lot of time, patience and money. There is a high incidence of depression among caregivers. If the family has the financial resources, the patient can be cared for at home or go to an adult day care center,” he said. “There are also assisted living centers and some may have a special Alzheimer’s wing, and there are long-term nursing homes where about 50% of patients have dementia.”
Alzheimer’s is rare before age 65 and is more common as a person ages. Dobrosky, however, has dealt with a 39-year-old patient.
Meeks suggests some habits that can help ward off the disease in the elderly. These include: regular exercise; maintaining cognitive activities that engage the mind; eating a lot of fruits and vegetables; and, staying socially connected.
The Alzheimer’s Association Mississippi Chapter will have fund-raising Memory Walks in different parts of the state in October. Information about times and places, along with more information about the disease, is available at www.alz.org/ms/.
Contact MBJ contributing writer Lynn Lofton at firstname.lastname@example.org.