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Tuesday, Sept. 25, 2018

DEMENTIA & ALZHEIMER’S DISEASE

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Signs, symptoms & treatments

It is common to hear “dementia” and “Alzheimer’s disease” used interchangeably, but they are not the same. Dementia is a general term that refers to symptoms that affect cognitive functions such as difficulty managing finances or making complex decisions, losing track of time, impaired speech or language skills, and repeating questions. Dementia occurs when healthy brain cells become damaged and stop performing their normal functions. There are several different mechanisms of dementia that result in unique patterns of dysfunction.

Alzheimer’s disease, or AD, falls under the dementia umbrella and is the most common type, with an estimated 60 to 80 percent of people diagnosed with dementia having Alzheimer’s disease. According to the National Institutes of Health, it is estimated that more than five million people in the United States have Alzheimer’s disease. Symptoms of dementia that are specific to Alzheimer’s disease include difficulty remembering events, conversations and faces; disorientation and confusion; depression and withdrawal from work, friends and family; difficulty following a conversation, and trouble completing routine tasks.

Dementia and Alzheimer’s disease occur most commonly in older adults, but that doesn’t make it a normal part of aging. Normal aging results in decreased memory efficiency, making it more difficult and time-consuming to remember. A key difference between normal and abnormal aging is that, in healthy aging, memory retrieval is eventually successful. In Alzheimer’s disease memory consolidation and retrieval are impaired, decreasing the likelihood of successful completion of a memory task even over a long time period.

The Alzheimer’s Association reports that Alzheimer’s is the sixth leading cause of death in the United States, and the number of Americans living with this disease is expected to rise to 14 million people by the year 2050. There is currently no cure for dementia or Alzheimer’s disease; however, doctors, allied health professionals and researchers at LSU Health Shreveport’s Center for Brain Health work year-round to study brain disorders, like Alzheimer’s disease, with the goal to one day find a treatment and cure. The Center for Brain Health is unique because it combines clinical care expertise, neuroscience research and neurological rehabilitation, enabling every aspect of a disease to be addressed and studied.

At LSU Health Shreveport, we also have ongoing studies and are looking for people with and without the disease. Alzheimer’s and other age-related neurodegenerative disorders occur with different frequencies in men and women as well as Caucasian,

African-American and Latino populations. One of the research focuses at the Center for Brain Health is to collect data from a diverse population so that advances in understanding and treatment apply to all.

We have two new studies of disease mechanism that are currently enrolling participants. We need people with Alzheimer’s or Parkinson’s disease, or healthy people between the ages of 55 and 85. The studies are short-term and non-invasive. Participation involves two visits, one to get a brain MRI and one to take some “brain teaser” type tests. If you are interested in participating in a study, please call us or email lsuhscbrainhealth@gmail.com. We would love to tell you more about our studies and how you can contribute to a cure.

There is also an ongoing national effort to test new drugs that could impact disease mechanism. If you are interested in participating in a trial, the largest database of available studies is located at www.ClinicalTrials.gov. Patients and their families can identify trials in their area. It is important to learn about the risks and benefits of a trial before participating. Investigators are good sources of information, so asking questions when you contact study coordinators is encouraged. Contacting investigators does not involve an obligation to participate, and all participants are free to change their mind and withdraw from a study at any time. However, participation is a valuable opportunity to gain access to the very latest treatments.

The LSU Health Shreveport School of Allied Health Professions and the Center for Brain Health also offer neurorehabilitative therapies that can assist both individuals who are diagnosed with AD as well as their caregivers. Therapeutic exercise has been shown to reduce the downward slope of disability seen with Alzheimer’s disease. Physical exercise activates a release of chemicals in the brain which are neuroprotective in nature. Daily exercise also improves blood flow and serves to moderate the brain atrophy that is typically associated with AD.

Physical activity also improves mood and decreases agitated behavior, increases muscular strength, and improves balance and flexibility in individuals diagnosed with AD. Physical strength is very important for fall prevention, as fall risks are typically heightened in later stages of AD. Neurological rehabilitation can also help with pain management, as up to 50 percent of individuals with AD suffer from regular pain.

Physical therapists can also assist caregivers of individuals with AD by teaching proper body mechanics to improve safety in the home and the community. Caregivers are also instructed on how to use adaptive equipment and assistive devices such as walkers and canes.

The increasing impact on the lives of those affected by Alzheimer’s disease, and those caring for a loved one diagnosed with the disease, is recognized by healthcare professionals around the world. The majority of individuals with AD (65-75 percent) are cared for at home by family members, and the burden can be significant. Support for caregivers is critical, and one of many excellent resources is AARP (www. aarp.org/caregiving). The Alzheimer’s Agency of Shreveport Bossier (www.alzagency.org) is an outstanding local group that provides support and services for Alzheimer’s patients and caregivers. The Alzheimer’s Association also has a chapter in Shreveport (www.alz.org/ louisiana), and they provide support, education and research fund-raising.

Dr. Elizabeth Disbrow, director of the Center for Brain Health at LSU Health Shreveport, Dr. Marie Vasquez Morgan, associate professor, School of Allied Health Professions – Program of Physical Therapy.

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