Show Notes
Alzheimer's disease affects nearly 6 million Americans, and that number will grow as Baby Boomers age. Novant Health neurologist Dr. Mark Pippenger discusses the impact Alzheimer’s has on a patient’s family members and friends. He'll dive into concerns he often hears: Are you likely to suffer from the disease? If so, what's treatment going to be like 10 or so years from now?
Transcript:
Cliff Mehrtens
0:08 Welcome to Novant Health Healthy Headlines. This is Cliff Mehrtens. Alzheimer's disease affects nearly 6 million Americans. And that number will increase over the next few years as the baby boomer generation ages. We don't know the exact causes of Alzheimer’s disease and there's no cure, but it's widespread. For some insight into Alzheimer's, we talked to Novant Health behavioral neurologist, Dr. Mark Pippenger, who discusses the impact Alzheimer's has on a patient's close family members, how Alzheimer's affects more than just your memory loss. Some misconceptions about the disease, and what does Alzheimer’s and its treatment look like 10 years from now, be sure to stick around till the end to learn how Alzheimer's got its name. You can find stories like this and hundreds of others by searching Novant Health and Healthy Headlines. Thank you for listening. What's the biggest a misconception or two that you hear about Alzheimer's?
Well, I think one of the biggest misconceptions is that it's just part of normal aging. And I see patients all the time who have been to their primary doctor and their children are worried because they're forgetting things. They can't keep up with their medicine. And they're told it's just normal age. And that's probably one of the biggest misconceptions is it is somehow normal. It's not it's very, very common, but it's not normal. So Alzheimer disease, it's never normal. Another misconception I see concerns the medications we use to treat the disease. So many physicians think that the medications don't work. And so they won't give people medicine for Alzheimer disease, because they have the impression that drugs are not effective. And that often comes from not understanding how the drug is supposed to work. So the drugs that we use delay decline, they don't make people better in the short run, not often, sometimes a little. But people think that they're supposed to fix the problem. If they're effective, and they don't, they just delay things getting worse. So I'd say that that particular misconception stops many people from having the benefit of treatment, because other people think that it's not worth giving the medicine, we think actually that they do have a big effect.
As our population ages more baby boomers are going to reach the ages of 7075 in the next few years. That's what does Alzheimer's and its treatment look like 10 years from now.
in 10 years, we're extremely hopeful in the field, that in 10 years time will have drugs that will more effectively shut down the progression of disease. And it's a realistic goal, we believe because a lot of research is going on every year. In fact, just next week, I'm going to the big annual research meeting where we review all that's going on. And it's a full week of activity. Every day, all day, there'll be 4-5000 clinicians and researchers present reviewing all of this. So a lot is going on, we really believe that in 10 years time will have drugs that will significantly slow down or even totally stop disease progression. At that point will probably be using more sophisticated tools to try and diagnose the presence of Alzheimer disease before someone even becomes memory impaired. So before the earliest memory changes, we want to be able to diagnose the disease. And there's every expectation that in 10 year’s time, we'll be able to do that. And we'll be able to give drugs that are more effective in slowing down or even stopping disease progression.
On the plus side of 50 doc and sometimes offered thanks for not what I had for breakfast, but the name of the Tom Hanks movie I tried to recall that I saw 20 years ago or something like that. And people my age will sometimes joke about you might be - 'Oh, you have Alzheimer's,' - it's not a funny subject. But memory loss like that is not always an indication that something serious is wrong as part of the normal aging process. Isn't that right?
That's correct. There are cognitive changes, which actually begin, you know, as early as your 30s or 40s, we start to see some changes in the normal individual. And the normal changes will consist of a slowing down of mental processes, difficulty retrieving memories quickly. And and that will take the form of not being able to think of the name of someone you run into, or not being able to think of a word you want to use in conversation. So you're talking to somebody and you want to tell them about your laptop, and for some reason that word just escaped to you. And you can't come up with the word laptop. And you may have to describe it, you know, that little portable computer, and then later the word laptop comes back to you. So it becomes more difficult to multitask to keep up with more than one thing at a time. Because the speed of your thinking slows down and you can't switch between things as easily. All of those things are commonly seen with normal aging. They don't indicate a disease being present. But, you know, diseases like Alzheimer's disease also often begin with losing memory for words and memory for names. So when is it a problem, you need to get checked out? Well, I tell people, anytime you're worried about it, it doesn't hurt to see a specialist who's experienced in the field, who can do a little extra testing and maybe reassure you that what you're experiencing is normal for your age. Or on the other hand, if there is a problem, may be able to take steps to do something to try and help.
Dr. Pippenger, Alzheimer's isn't only about memory loss, there's some other moods and things that happened that are affected tell us what sort of moods that can be created or altered for someone who has been diagnosed with Alzheimer's?
Sure, you're right, the disease affects more than just memory. You know, typically memory is the thing that's affected first. And that's one of the most important symptoms that we see. But along with the memory problem, we get changes in emotion. Depression and anxiety are more common in people who have Alzheimer disease and who develop dementia. And part of that may be prompted by the cognitive impairment itself, so that someone begins to lose the ability to do things. And they are on some level aware that they're not able to do it. And so they need to rely on someone else for safety and security. And they become anxious if that person isn't immediately available. So that's one way anxiety can be created by the disease. But the disease may affect the chemical structure of the brain and make it easier for that person to become anxious, easier for them to become depressed. So particularly when people with Alzheimer disease are bored, or when they don't have anything to do. Depression is more common. And we also have a range of behavioral symptoms, which will occur in most people with Alzheimer's disease at some point will have some behavioral symptoms. And those very often are also prompted by the cognitive deficits so that a person who has Alzheimer's disease is usually unaware, anything's wrong. And when someone tries to explain to them, that they shouldn't drive a car, for example, they can't understand that. So they may become angry because people are trying to keep them from doing what they want to do. So it's more likely that someone would react with an angry tone, they may also develop delusional thinking. So it's common for someone with Alzheimer disease, to think that there are other people living in the house, even though there's no real evidence that anyone's there. Or they may think that people are stealing their things. And it's easy to understand how that can happen because they misplace something. And they think it can't be me. So someone must have taken it. And so they developed delusions of people are stealing from them. In rare cases, we can even see hallucinations. So people may even see things that aren't there or hear things that aren't there. That's much less common than the delusions, or the false beliefs about things that are there. Too much activity can impact on someone and can provoke behavioral outburst to little activity. So overstimulation such as when you have a birthday party, for your granddad, who has Alzheimer disease, and turns 90, and you throw a birthday party with all the little great grandchildren, you can have a lot of trouble because all of that dizziness of people running around and little voices can overstimulate the person and they may have a catastrophic emotional reaction. So the disease does that the disease sets that up. And it's all these other symptoms that cause more problem for most people than the actual memory loss itself. So it's often the behavioral problems that are more difficult to deal with.
Nearly 6 million people have Alzheimer's in the United States. That's right. How does that affect? Obviously, that's a lot of people that are affected, but talk a little bit about how it affects other people, family members, sure, caregivers, their web of friends, co workers, it affects a lot more than just the people are diagnosed with Alzheimer's.
Sure it does. Because Alzheimer disease causes a dementia, it causes people to have difficulty in functioning. And it requires the help of other people to take care of these folks. Now, you know, on a most basic level, you need someone who can help remind a person about medications, who can help them keep up with medicines kept keep up with their bills, their finances, keep up with simple things like eating food, you know, figuring out how to get food and when to eat. And that's a lot of work, it usually falls to a person's spouse if they're married, or to their children. Very often, these diseases affect older individuals. So their adult children will become responsible for trying to take care of them and trying to give them this assistance, that it's a demanding job, it takes full time care in most cases. And so you can imagine that makes it very difficult for any one person to provide that care, because it's literally around the clock job. And it's quite devastating also, because the disease seems to eat away at someone's personality, because their thinking is affected and they become more confused. It may be that someone as they develop more memory trouble gets confused about who their family members are. So for family members, there's a huge impact because it takes their time to try to provide care for someone they love. That that takes away their ability to work their ability to earn income. It takes a lot of money in some cases for them to have medical care. Although I often point out It shouldn't be as expensive as it sometimes is. But But getting that care can cost money. In caregivers of families can't earn money because they're so busy taking care. If you hire a professional caregiver, that costs money, or if someone has to move into an assisted living, or a nursing home facility, that's expensive. So someone has to help pay for that. Plus, there's the emotional impact of watching someone you love, lose their memory, and especially when they lose their memory of who you are. So you're someone important in their life and they no longer really remember exactly who you are. That's that's a devastating impact.
Hello, this is Cliff Mehrtens again; I'm often intrigued with the stories of how different medical conditions got name; as a baseball fan, Lou Gehrig's disease is an easy one. But you know, Crohn's disease, Parkinson's disease, Hodgkin's lymphoma, they're all named after people. So I wondered what was the story behind Alzheimer's? Well, disease is named after Dr. Alois Alzheimer, a German neuro pathologist. Way back in 1906, Dr. Alzheimer noticed some changes in the brain tissue of a woman who had died of an unusual mental illness her symptoms, including memory loss, language problems, and some unpredictable behavior. Dr. Alzheimer presented his findings in what was the first form of description of pre-senile dementia, hence the disease was named after him. Alzheimer's. Thank you again for listening.