PITTSBURG — June is Alzheimer's Disease and Brain Awareness Month.

Alzheimer’s is a type of dementia which causes problems with memory, thinking and behaviors.

It's the most common form of dementia, accounts to about 60 to 80 percent of cases and is the sixth leading cause of death in the United States.

According to Community Health Center of Southeast Kansas Physician Dr. Julie Stewart, Alzheimer’s Disease is the result of changes in the brain.

“One important thing to note is microscopic changes take place in the brain long before there are signs of memory loss,” she said. “The brain has these different nerve cells and each nerve cell connects with another, forming communication networks.

“Different nerve cell networks have special jobs, some are involved in thinking, some learning, some remembering, some involved in the five senses … these brain cells operate like a factory, they receive energy, oxygen, perform microscopic process and then the cell communicates with the next cell, and emmits waste.”

She said damage prevents the cell’s “factory” from running.

“And so you get — just like in a real factory — these tiny microscopic factories backups and breakdowns which cause problems from that particular part in the communication channel on downwards and communications stops in that one area,” she said. “As the damage spreads the cells lose the ability to do their jobs and eventually die and that’s what causes the irreversible change in the brain with Alzheimer’s.

“This is when people lose their ability to speak or lose their memory, because they are not able to store that information.”

The damage is caused by two different “structures.”

One structure is called plaque and it’s a deposit of protein fragments that build up in the spaces between nerve cells.

“It serves as a barrier where the nerves cannot communicate any more,” Stewart said.

The other structure are called tangles which are “twisted fibers” of another protein that actually builds up inside the cells themselves.

It’s not just people who are 65 and older who end up with dementia and Alzheimer’s, Stewart said.  

“About 200,000 Americans under the age of 65 have younger onset Alzheimer's Disease, also called early-onset,” she said. “While that’s less common, that is still something to be watching out for.”

Stewart said there is currently no cure, but there are treatments available to delay the progression of the disease. Early treatment, she said, could help improve a patient’s quality of life.

One of the common misconceptions, Stewart said, is it is a normal part of aging, as people get older their memories get “stale.”

“We all know that we lose a few fine tuned details as we get older we don’t remember everything as sharply as we used to, but to see this regression of memory and interference with their thinking and behavior — that is not normal,” Stewart said. “People see their loved ones tend to consistently forget where they left their keys or put their keys in the fridge or they have trouble balancing their checkbook and paying their bills, where they haven’t had trouble before.”
Stewart said short-term memory is most affected.

“They’ll have a lot of trouble in the beginning with remembering new data that they are told, and that is why often with people with dementia will forget what they had for lunch but they can tell you where they went to grade school 60, 70 years ago,” she said.

People are encouraged to visit their primary care provider to begin assessment and receive treatment as early as possible.

“That’s why home health companies are eager to get in and help the family members because we don’t want to assume as soon as they are diagnosed with Alzheimer’s, they need to be casted off and removed,” Stewart said. “We want to keep them in the family setting where they tend to do better and it delays the progression of the disease because they have the familiarity.”
People diagnosed with Alzheimer's live an average of eight years after their symptoms become noticeable to others, Stewart said.

“That can range considerably, it can be rapid — in about five years — and up to 20 years, depending on their age and morbidities and the amount intervention that they get early on,” she said. “Eventually we know they forget the names of love ones and (begin) not realizing where they are.”

Along with primary care, there are home health programs which assist with both family and patients.

“This is definitely the type of disease process that affects a family and not just a patient, and it takes a very strong emotional toll on both the patient and the family … when they realize that they are starting to forget things and that they are starting to lose some of their faculties, it could be a very devastating realization,” Stewart said. “We want to support them through that and let them know they are not alone — certainly for caregivers and families they need a lot of reassurance and care as well.”

Stewart said for many families — who may be what is called a “care team” for the patient — it can be difficult to watch a loved one go through the changes caused by the disease. It can be difficult to have that person say harsh things and “flail around,” especially if the family does not understand why.

“That kind of erosion of a relationship can happen if the family and the patient are not really tucked into good care and support in helping with bonding and coping skills that will augment that relationship as it changes overtime with the disease progression,” Stewart said.  

The care team helps the individual with daily activities, shopping, paying bills, cleaning the house and ultimately bathing and toileting with the patient, Stewart said.

She said the CHC SEK has family medicine doctors and nurses who provide care for the aging population.

“(The) importance of our primary care team is to have a physician that’s familiar with your case, a nurse who is familiar and someone that can coordinate specialty appointments that are needed,” she said.  

Stewart said health centers, such as CHC SEK can help connect people with behavioral health services and home health services, including assisting through transitions as the patients reach various stages.

Treatment can include medication, social support and set routines to give the patient familiarity.

Stewart said there are early intervention services and things such as reading and crossword puzzles “to use as much mental flexibility as they have it,” and help keep the mind sharp.

Although there is no cure yet, Stewart said there have been great strides in finding treatment options and a cure.

“Alzheimer’s can feel like a very hopeless disease, but that when people realize 90 percent of what we know about Alzheimer's Disease has been discovered in the last 20 years, that gives a lot of hope that we are learning about this at an exponential rate and so we very much on the forefront of uncovering more and more aspects of this disease so that we can treat it, we can delay the onsets and see if we can’t reverse some of the damage even,” she said.  

— Stephanie Potter is a staff writer at the Morning Sun. She can be emailed at spotter@morningsun.net or follow her on Twitter @PittStephP and Instagram @stephanie_morningsun.