What is Alzheimer’s disease?

Alzheimer’s disease is a common type of dementia that is related to age. Dementia is when a person has significant forgetfulness, loses the ability to critically think and all this interferes with normal daily activities of life. Alzheimer’s disease is known to be progressive and it is more than the memory that is affected. This disease affects the control though and even language. It may appear to be very mild at the beginning such as some memory loss but over time this may progress into not having the ability to carry on a conversation anymore.


Why should I care about this?

· According to the Alzheimer’s Association from the 2019 statistics:

o Alzheimer’s disease is the 6th leading cause of death in the United States. It literally kills more than breast cancer and prostate cancer combined!

o In other words, 1 in 3 seniors dies with Alzheimer’s or another dementia.

o Today, more than 5 million Americans are living with this disease. By 2050, this number is projected to rise to nearly 14 million!

o Between 2000 and 2018, deaths from heart disease have declined by 7.8%, while deaths from Alzheimer’s has increased by 146%!



What do we actually know about Alzheimer’s disease?

This disease is difficult to study but everyday researchers are gathering new information. We know that the years before we even see the symptoms in an individual, their brain is already changing in neurotransmitter balance. We do know that age, family history and genetics may play a huge role in determining who is at higher risk for the development of this disease. Statistics have also showed that almost two-thirds of Americans with Alzheimer’s are women and African Americans are twice as likely to have Alzheimer’s compared to Caucasians. Hispanics are also 1.5 times more likely to have Alzheimer’s compared to Caucasians.

There is growing evidence that maintaining healthy physical, mental and social activities reduces the chance of developing Alzheimer’s disease. It is important to maintain good heart health as this has been linked to the disease progression. This means that controlling blood pressure and blood cholesterol to lower the chance of stroke is important. It is also suspected that education, diet, and environment may also play a role but this is still under investigation.



How do I know if my memory loss or a family members’ is associated with Alzheimer’s disease?

As we age, it is expected that we may have some cognitive decline. However, Alzheimer’s disease is more aggressive than simply occasional memory loss. There are some signs we can look out for to help us determine if there is more going on than just normal aging.

In addition to occasional memory loss, patients with Alzheimer’s disease may have more experiences of



· Memory loss that affects their quality of life such as forgetting where they live or directions on how to get home.

· They may also lose the ability to perform activities they previously could do such as critically think to pay bills or handle cash.

· Temporally misplacing items happens to all of us, however patients with Alzheimer’s disease may not even be able to retrace their steps at all.

· They may also lose the ability to judge if a decision is correct which may put their lives or others in danger if they are left alone.

· The changes made in the brain can lead to changes in their behaviors and moods which can change their entire personality in some cases.



~However, having any of these experiences happen to you does not necessarily mean you have Alzheimer’s disease occurring. It is important to always check with your doctor to determine the true causes of these symptoms.



What is the treatment plan for patients with Alzheimer’s disease?

Today, there is currently no cure to Alzheimer’s disease. Instead, there are treatment paths available to patients that may help people maintain their mental function, delay the symptoms of severe Alzheimer’s disease and help with any behavioral symptoms if needed.



What are the medication options available?

There are two main groups of medications currently used to treat Alzheimer’s disease. These are used to treat memory loss, confusion, and problems with thinking and reasoning.

Option 1: Drug class is known as cholinesterase inhibitors and the drugs under this class are:

· Donepezil (Aricept)

o Dosed once daily in the evenings, may cause diarrhea, nausea and insomnia. This is the preferred agent in its class as it is associated with the least side effects compared to the rest.

· Rivastigmine (Exelon)

o Dosed twice a day, available as oral tablets or patch, may cause weight loss, more diarrhea than donepezil, dizziness, or headache. Not to be used in epilepsy patients, as can worsen seizures. If more than 3 days of medication is missed, need to advise doctor to restart at lowest dose.

· Galantamine (Razadyne)

o Dosed once or twice daily as tablets in the morning with food to reduce stomach irritation and plenty of water. Side effects include more nausea and vomiting than donepezil. Like Rivastigmine, if more than 3 days of medication is missed, need to advise doctor to restart at lowest dose.



Option 2: The second drug class is the NMDA receptor antagonist and the main drug used in this class is:

· Memantine (Namenda)

o Dosed once daily, requires weekly titration of dose to reach higher target dose. Side effects include constipation or diarrhea, vomiting and headache. Like Rivastigmine and Galantamine, if more than 3 days of medication is missed, need to advise doctor to restart at lowest dose.

~ Depending on the patient’s severity of disease, it is possible to combine the two options to preserve memory if previous individual treatment did not work in moderate to severe disease. The doctor will determine which medication is best for the patient depending on their liver and kidney function and potential benefit versus risk from the selected medication.


What should I look out for in an accidental overdose of these medications?

Since a patient may be suffering from memory loss it is possible that they may ingest more medication that originally prescribed.

You may suspect overdose in a family member if they suddenly begin to experience severe dizziness, drowsiness, weakness, trouble walking, slow or fast heart rate, sweating, confusion, agitation, hallucinations, unusual thoughts or behavior, weak or shallow breathing, fainting or seizure.

Seek emergency medical attention by calling 911 or Poison Control Center at 1-800-222-1222.





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