April 7, 2011 in Features

Alzheimer’s link concerns daughter

Peter H. Gott, M.D., United Media
 

DEAR DR. GOTT: I recently had an MRI that showed some brain atrophy. A few days ago, I read a report that people whose mothers had Alzheimer’s show more rapid progression of brain atrophy.

I’m 67, and my mother had what I believe was the Alzheimer’s/vascular combo dementia. No autopsy was performed. She showed symptoms in her early 70s, died at 85, and had two sisters who also had dementia.

The recent MRI will have to be my “base.” How soon should I have another to monitor possible deterioration? What is the probability of me getting Alzheimer’s?

DEAR READER: Atrophy of any tissue translates to a loss of cells. In the case of the brain, this can mean either the entire brain or a limited focal area has shrunk. When both cerebral hemispheres are affected, thought and behavioral function may be impaired. Atrophy is not the same as Alzheimer’s.

As we age, the risk of developing Alzheimer’s increases. A family history will further increase that risk. Other factors include being female, long-standing hypertension and trauma to the head. Early-onset Alzheimer’s is defined as appearing before the age of 65, is relatively uncommon, may be hereditary, and advances rather rapidly. Late-onset Alzheimer’s can affect those 65 or older.

As symptoms become apparent, a person may be confused, forgetful, unable to find the way home, have hallucinations, use incorrect words when speaking or speak in unintelligible sentences, may misplace things, suffer from depression, experience a change in sleep patterns and a great deal more. Most of us lose our car keys on occasion, repeat ourselves or forget an important appointment. It’s a situation I refer to as having “overloaded circuits.” It happens. However, with the presence of Alzheimer’s, the situation worsens and symptoms become more pronounced.

Treatment is initially provided in the form of medication aimed at slowing progression of the disease. There are a number of medications available on the market to do just that and to control aggressive behavior that might be present. There are also support groups for the patient and caregivers.

The only true means of diagnosing Alzheimer’s is through brain-tissue samples after death, which will likely reveal twisted protein fragments within nerve cells that clog those cells, areas of dying nerve cells around protein and abnormal clusters of dead and dying nerve cells. Prior to death, a physician will base his thoughts on the results of a physical and mental examination to include testing of coordination, balance, muscle strength and tone, in-depth memory testing, asking the date, the name of the president, remembering three key words presented and more. Laboratory testing might be ordered to rule out thyroid abnormalities. Radiologic testing to include a PET scan, CT or MRI might be appropriate. Be sure to ask your neurologist when he or she recommends follow-up testing.

Herbs and alternative medications have been promoted to delay or even prevent Alzheimer’s; however, an expert panel convened by the National Institutes of Health determined there is insufficient evidence to justify taking vitamins B, C, E, folic acid or beta carotene. Foods high in omega-3 fatty acids hold more promise; however, there is still inadequate evidence. Currently, the strongest evidence suggests that reducing your risk of heart disease may also decrease your risk of developing Alzheimer’s. You can’t control your gene pool but you can control your lifestyle.

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