By Virginia Thornley, M.D., Neurologist
February 15, 2018
Introduction
Alzheimer’s disease is a neurodegenerative disorder affecting memory. It is thought to be caused by progressive loss of cells that control memory and cognition. A substance called acetylcholine is secreted which enhances memory, cognition, and attention. In Alzheimer’s disease, a destructive process occurs in the brain cells with accumulation of plaques composed of beta-amyloid. When this destruction of acetylcholine-producing cells occurs then there is less of the acetylcholine which is necessary for transmitting signals that control memory, attention, and cognition. Risk factors include the presence of certain genes such as the APOE gene.
Keeping Mentally Fit
Engaging in activities that involve the thought processes such as doing crossword puzzles, reading engaging books or novels or doing soduko puzzles may help boost the
neural connections. The more brain cells are utilized the more their capacity is exercised. This is the reason why those in mentally rich occupations where lifelong complex decision-making skills are made, Alzheimer’s disease is not detected until later stages because the brain was constantly engaged for decades. Engaging in conversations, being social by going out and talking to people increase neural connections. Appreciating the arts, going to the theater engaging your brain will help boost neural connections.
Talking to neighbors or even buying at the convenience store activate mental processes. Engaging in listening, comprehending and speaking during conversations and interactions also sustain rich neural connections.
Someone sitting at home all day long will perform significantly worse than someone who is actively out and about speaking and engaging. The old adage use it or you lose it rings true.
Staying healthy
It is always a good idea to stay fit and active, even more so when diseases affecting the brain are present. Diseases that affect and constrict the small blood vessels will also affect the end terminal cells. Therefore, high blood pressure, high cholesterol and diabetes mellitus which all affect small vessels can also cause small blockages in blood flow to the brain. This does not help with Alzheimer’s disease. Consulting with a physician is helpful to ensure that any risk factors are under control.
Cues to help remember
A medicine box helps with memory. Bringing a friend or relative to doctors’ appointments helps with not forgetting medical advice. Writing a list helps with tasks that need to be done for the day. Placing medicine by the toothpaste helps with remembering to take important medications. Writing down doctors’ appointments and placing on the refrigerator in bold letters is another good idea. Little things may be remembered by using cues such as these. However, if forgetting extremely important details such as turning off the stove, leaving the water running or not locking the door at night occur, living alone is not feasible. Supervised living conditions are appropriate. Consult with a physician who can direct towards the correct resources and assistance.
Discussing long-term issues
If a loved one has been diagnosed with Alzheimer’s disease, it is a good time to get affairs in order. It is a difficult topic to discuss but it is the optimal time to formulate long-term plans, while preferences are known. If the disease is progressing such that decline is imminent resulting in greater supervision, steps to come up with long-term plans for care are beneficial.
Another subject which is difficult to broach are wishes in the event anything happens and preferences in the hospital for resuscitation. There are many families who come together during an event such as this only to sadly discover that this topic was never discussed. This results in lengthy discussions during an already trying and emotional time. Preparation for the future is key.
Consult with a neurologist
At this point in time, there are no medications that cure Alzheimer’s disease. Generally speaking, some may slow the progression depending on the severity and can enhance the availability of acetylcholine. Ongoing research continues.
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