DEMENTIAS

DEMENTIA AND MILD COGNITIVE IMPAIRMENT

Besides Alzheimer’s Disease there are many other causes of dementia and mild cognitive impairment (MCI), such as Dementia with Lewy Bodies, FTD, Vascular Dementia, Drug-induced Dementia and Depression.

Please contact us at Out and About Colorado if you are in need of care. Generally we are able to offer a program that will provide socialization and stimulation for someone with mild to moderate dementia regardless of diagnosis, so please get in touch.

DESCRIPTION OF EARLY ONSET ALZHEIMER’S DISEASE

Answer below is written by Ms. Megan Carnarius. Please refer to her website at megancarnarius.com to learn about her newly published book on caring for those with dementia, A Deeper Perspective on Alzheimer’s and Other Dementias: Practical Tools and Spiritual Insights
Q: I’ve heard about early-onset Alzheimer’s. What does this mean?

A: Early-onset Alzheimer’s occurs as a diagnosis when someone is under the age of 65. This is still considered rare and occurs in about five percent of all Alzheimer’s cases. It is difficult to get a proper diagnosis at times because clinicians don’t typically look for this disease when trying to figure out what is causing problems for this younger individual. Sometimes psychiatric approaches are attempted before a proper diagnosis is reached. Symptoms can start occurring between the ages of 45 to 55, in some cases. The youngest reported case of Alzheimer’s was 29 years of age. However this person had Downs Syndrome, which can cause an increased risk for Alzheimer’s disease.

Researchers have been studying genetic correlations, by mapping family histories for incidences of the disease; and have identified specific genetic markers. Different chromosomes can trigger different ages of onset. One family may have triggers for early onset; whereas another family may have triggers in their mid-70s or 80s. Because Alzheimer’s disease can occur repeatedly in a family group, or only one individual may have it, there is still a lot of research occurring to understand this more. Geneticists hope to one day be able to create an inoculation. Because changes occur to the brain prior to seeing outward symptoms, researchers would want the inoculation given perhaps ten to twenty years before a family’s known age of onset. Therefore if a family was having early onset at 65, and if research could halt the triggers by inoculating at 45, that would be their hope.

This does not resolve family situations right now, unfortunately. This disease is challenging and early-onset can be particularly devastating to the hopes and dreams one had for the expected life plan. In some instances, the following problems can occur:

                    • Wage earners are not ready for retirement.
                    • Jobs may have been lost due to poor performance prior to understanding what was happening.
                    • Children may not be raised.
                    • Families may also be caring for parents in their senior years.
                    • Young individuals don’t qualify for Medicare, causing financial stress to families.
                    • Powers of attorney, wills and plans for end-of-life need to be pulled together, if not already done so.

In this field, our clinical experience with this process is that it tends to move faster for individuals who are diagnosed with early-onset than their older counterparts. We do not know why this is but recent research about brain plasticity and development of new neural pathways may shed some light. For example, given an extra thirty to forty years of life, with extra coping and learning, there must be increased mapping in the brain. As a brain is affected by this disease, the more neural pathways one has developed through a lifetime, take longer to affect. And the more options for compensation and alternative pathways can help someone cope outwardly longer, even as the disease is progressing inside the brain.

Because of the typical health and vitality of the body in younger years, early onset can be particularly stunning with balance changes or functional changes occurring within days- rather that than weeks and months. I have worked specifically with dementia since 1989 and the hardest cases I have worked with by far are early-onset situations. I do not mean to create a sense of fear, but planning is key. Families need to talk about difficult ‘what-ifs’ to help everyone determine the most positive process and plan properly-especially if early-onset is a genetic condition.

Early-onset Alzheimer’s can be devastating, to say the least. The Alzheimer’s Association host early-onset support groups and social activities for families working through the diagnosis, in some areas of the country. Helping families find these supports is crucial.

“Research suggests that social interaction with others is an important part of maintaining your brain. Changes in memory or language abilities can make some social situations more challenging, but it is important to practice both expressing and listening to conversations.  Social interactions that include activities are also stimulating….for example, going on an outing to a park, zoo, museum, movie, play, sporting event, or concert takes the emphasis off of verbal communication and allows for enjoyable companionship based on a shared experience.”

“Social interactions that prompt reminiscence may stimulate long-term memory, while the conversation can exercise language, attention, and listening abilities…Anytime you engage in an activity that involves others, you are likely to be exercising your mind.” 

Lisa Snyder, MSW, LCSW

Author: “Living Your Best with Early-Stage Alzheimer’s”

FRONTOTEMPORAL DEGENERATION (FTD)

Frontotemporal dementia is often misdiagnosed as a psychiatric problem or as Alzheimer’s disease. But frontotemporal dementia tends to occur at a younger age than does Alzheimer’s disease, generally between the ages of 40 and 75. (Mayo Clinic)

Excerpts below are taken from a book we recommend, which addresses in particular FTD (frontotemporal degeneration)

“Non-Alzheimer’s disorders are often considered rare; however, they are not actually that uncommon. It could be said that FTD is often misdiagnosed and under-recognized.”

“The term dementia refers to a clinical syndrome, a combination or pattern of clinical features. Thus, dementia is not a disease but rather a syndrome that can be associated with many different underlying diseases.”

What If It’s Not Alzheimer’s?: A Caregiver’s Guide To Dementia 3rd Edition by Gary Radin (Editor) and Lisa Radin (Editor) Published by Prometheus Books, 2014

From The Alzheimer’s Association website:
FTD used to be called Pick’s disease after Arnold Pick, a physician who in 1892 first described a patient with distinct symptoms affecting language. Some doctors still use the term “Pick’s disease.” Other terms you may see used to describe FTD include frontotemporal disorders, frontotemporal degenerations and frontal lobe disorders.