Beneath the surface: Early detection of Alzheimer’s plays crucial role

July 2019 Posted in Community, Your Health

Maxine Davis with her daughter Christy as an infant – and Colonel Sanders. Submitted PhotoS

By Melissa Wagoner

Christy Davis of Silverton recently had to say goodbye to her mother, Maxine Davis, for the last time – but first she had to say hello. 

“Immediately she was stressed out because she was supposed to know me,” Christy said of their initial greeting during her last annual visit.

Suffering from Alzheimer’s disease (AD), Maxine’s memory was slowly declining over the past six years to the point that she no longer remembered her own children.

“On the third time I went to visit her she looked like she maybe knew,” Christy recalled. “She grabbed my arm and she said, ‘I know.’ Then I got to tell her all the things I needed her to know. She had tears pouring down her face and she understood everything – I’m sure of it.”

There are an estimated 5.5 million Americans that suffer from Alzheimer’s disease, according to Dr. Scott Losk, a clinical psychologist and neuropsychologist at the Memory Health Center in Portland. A neurodegenerative disease in which the death of brain cells leads to memory loss, mood and behavior changes, anxiety, sleep problems and more, Alzheimer’s disease is the sixth leading cause of death in the United States, affecting nearly 70,000 Oregonians – a number that is on the rise. 

“By 2025, it is estimated that 84,000 Oregonians will have AD,” Dr. Aimee Pierce, the Director of Clinical Care and Therapeutics for the OHSU Layton Aging and Alzheimer’s disease Center, said. “The main risk factor for AD is age, so as our population ages, the rate of AD will increase. Early baby boomers are entering their senior years, a time of increased risk for AD. Every five years past the age of 65 leads to double the risk of AD. And in fact, the segment of the population that is growing the fastest in the USA, are people over the age of 90 years, who are at highest risk of AD and other forms of dementia.”

Although there is currently no cure for the disease, early detection is key to understanding more about who is at greatest risk for developing it and why. But that early detection can be tricky because early symptoms – which range from short-term memory problems to difficulty with language and impaired judgment that may impede a person’s ability to care for his/herself – are often mistaken for the normal signs of aging or else hidden out of fear or embarrassment.  

“There’s a period of time that’s the hardest for them,” Christy theorized, “when they know they’re losing their memory and they’re trying all kinds of techniques and they’re trying not to show that they’re losing their memory.”

In Maxine’s case, Christy estimates it took nearly ten years before she and her siblings became aware that their mother was suffering from something other than the anxiety and depression that had plagued her throughout her life. 

“It was so much earlier than we knew,” Christy said of her mother’s early exhibition of the disease. “We’ve looked at her behavior and think that this trajectory – this change – was probably somewhere between age 69 and 70.” 

Both the age at which Maxine is estimated to have begun showing the initial signs of Alzheimer’s disease and the fact that she developed the disease after many years of suffering from mental illness are not unusual contributing factors according to Dr. Losk. 

“Our brains like to be happy,” he said. “People who experience chronic, untreated psychiatric symptoms – those really need to be addressed.”

Along with seeking therapy for help with mental health disorders, Dr. Losk and Dr. Pierce also suggest maintaining a high level of social engagement, good nutrition and cardiovascular health throughout life. And Dr. Pierce also urges those who have a family history of Alzheimer’s disease to get tested for the APOE4 gene, which is implicated in the development of the disease.

“Approximately 15 percent of people carry the APOE4 gene (we receive one copy from each parent) and carriers of one copy have a three-fold higher risk of developing AD than the general population,” she explained. “Carriers of two copies have a nine-fold higher risk of developing AD than the general population.”

This quantifiable identifier of a high-risk population is what is driving a new study into a novel preventative treatment for Alzheimer’s disease around the country. The Generation 2 Study – as it is known – is conducted by testing nearly 2,000 healthy individuals aged 60 to 75 to determine if they are carriers of the at-risk gene.

“Carriers of two copies will enter the study, and carriers of one copy will undergo further screening with a PET scan to determine if they are starting to develop amyloid plaques in their brain, which is associated with increased future risk of developing Alzheimer’s disease,” Dr. Pierce summarized. “If amyloid plaques are present, then carriers of one copy will enter the study.”

While research is currently underway, there are more people every day who, like Maxine, receive the Alzheimer’s disease diagnosis, impacting both their lives and the lives of their family members.

“It’s very emotional realizing your parent’s brain is going to shrink and shrink until they are helpless infants,” Christy intoned. “You forget how to walk. You forget how to swallow. You lose the ability to talk. Essentially you’re going back to infancy. Your brain is shrinking.”

Although Maxine – who passed away before this story went to press – had been in full-time care for over six years, it was not until recently that she began to exhibit the late-stage symptoms of the disease. 

“If a word is more than one syllable, she can’t get it out,” Christy said. “After meals they have to take out the food that she forgot to swallow. And she can’t remember that she can’t walk.”

Amazingly, although it was difficult for Christy to witness the disease’s effect on her mother – a woman she remembered as intelligent and hardworking – she was able to find joy in their last days spent together. 

“We’re just going to suspend reality and enjoy each other,” Christy remembered deciding. “There’s all sorts of opportunities for connection. I’ve been more tactile with my mother than I ever was. And I got to tell her all the things I needed her to know.”

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