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Alzheimer's Awareness: Why Bother?

  • Each year, we designate November as National Alzheimer's Awareness Month. But surely, the public is already well aware of this horrible disease. After all, Alzheimer's has directly affected approximately 1 in every 2 families and the others must have certainly noted its prominent coverage in the news. We don't really need more awareness, right?

    WRONG

    Some of the information below may surprise you. That is to say, it is information about which you are not presently aware. However, by merely learning the seven facts below you will be helping to reduce the Alzheimer's problem.

    That's right. Simply being aware of this information and sharing it with your social networks will facilitate a more informed and more effective approach to combating the threat we face from this disease. With more discourse, we can begin to erode the lingering stigma that currently prevents some people with early symptoms from seeking timely medical attention.

    1.) We generally detect Alzheimer's at the end-stage of the disease.
    On average, Alzheimer's follows a 14-year course from the onset of the first symptoms until death. There is some variability across patients but 14 years is pretty typical. The more surprising news is that, on average, we diagnose Alzheimer's in years 8-10 of that disease course. This means that for most patients, symptoms go undiagnosed and untreated for at least seven years, during which time the lesions spread through the brain and cause irreparable damage. Please be aware that we diagnose Alzheimer's disease far too late to optimize the effects of currently available treatments.

    2.) Memory loss is not a part of normal aging.
    The point about end-stage detection raises the obvious question of "why" we diagnose this disease so late. There are many contributing factors but most of them can be reduced through awareness and education. Some patients resist medical attention in the early stages because they fear a stigmatizing label or because they are misinformed to believe that Alzheimer's cannot be treated. Many people, including a startling number of physicians, incorrectly believe that memory loss is a normal part of aging. Improving the timeliness of diagnoses for Alzheimer's is, in many ways, a problem that can be addressed through awareness and education. Please be aware that memory loss is not a part of normal aging and, regardless of the cause of the memory loss, timely medical intervention is best.

    3.) Current Alzheimer's drugs are probably more effective than you think.
    Our widespread practice of late detection has many negative consequences. For example, one of the reasons that current treatments are often deemed ineffective is because they are routinely prescribed for patients with end-stage disease who already have massive brain damage. With earlier intervention, treatment can be administered to patients with healthier brains, many of whom will respond more vigorously to the recommended therapy. Yes, we need better treatments, but a great start would be to intervene earlier with the treatments we already have. Please be aware that "we have no cure" does not mean "there is no treatment".

    5.) The Alzheimer's drug pipeline is full.
    Through an intense research effort over the past twenty years, scientists have gained a lot of insight about Alzheimer's disease mechanisms and about other factors that increase the risk for the disease. Much has been learned and some very promising drugs, based on sound theoretical approaches, are in FDA clinical trials right now. While much of the disease remains shrouded in mystery and we may still be a long way from better treatments, it is possible that an effective agent is already in the pipeline. Please be aware that, although we don't know when, better treatments for Alzheimer's are certainly on the way.

    6.) Taking good care of your heart will help your brain stay healthy.
    The health of your brain is very closely tied to the health of your body, particularly your heart. Researchers have shown conclusively that high cholesterol, high blood pressure, and obesity all confer greater risk for cognitive decline. The mechanisms that keep oxygen rich blood flowing through your body play a key role in maintaining a healthy brain. Everyone should be aware about the close association between vascular health and cognitive health. Please be aware that maintaining good vascular health will help you age with cognitive vitality.

    7.) Managing risk factors may delay or prevent cognitive problems later in life.
    There are well-identified risk factors for Alzheimer's disease that are within our power to manage. These include diabetes, head injuries, smoking, poor diet, lethargy, and isolation. With greater awareness of these facts, we can imagine a world where diabetics take more care to control their blood sugar, where helmets are more prevalent in recreational activities that are likely to cause head trauma, where people smoke less and eat more fruits and vegetables, and where everyone makes a better effort to exercise and to stay socially engaged on a regular basis. While these facts may not be well known, they are all well proven. Galvanizing an effort to publicize them is one purpose of National Alzheimer's Awareness Month and is a goal of the Orange County Vital Brain Program. Please be aware that many risk factors for Alzheimer's can be actively managed to reduce the likelihood of cognitive decline.

    So why bother with Alzheimer's awareness? Because it is a terrible disease poised to ravage our aging society and the lack of education and awareness has lead to a stigma that prevents a more proactive approach to early intervention. The result is that we diagnose it too late, which hampers the efficacy of available treatments. A more educated public could manage risk factors to minimize the likelihood of Alzheimer's, could monitor personal cognitive health with greater vigilance, and could seek medical attention at the earliest sign of decline. Physicians could then diagnose problems earlier and prescribe appropriate treatment including diet, exercise, and drugs to slow disease progression as much as possible. In the end, we could have fewer cases, more effective treatment, slower progression, higher quality of life, and lower healthcare costs. The social, emotional, and fiscal benefits of awareness and education in this area are too large to quantify.

    By reading this article, you have increased your understanding of the problem and raised your awareness about what can be done. That is a great step in the right direction but you can do one thing more. You can help to spread this message.

    On behalf of the Orange County Vital Aging Program, please share this article with your friends to promote more widespread awareness. Post it to your Facebook page, mark it in Delicious, Tweet it, Digg it, or email it. It doesn't matter how you do your part, it only matters that you get it done.

    7 Facts to be Aware of:


    1.  We generally detect Alzheimer's at the end stage of the disease.
    2.  Memory loss is not a part of normal aging.
    3.  Current Alzheimer's drugs are probably more effective than you think.
    4.  Alzheimer's disease can be treated.
    5.  The Alzheimer's drug pipeline is full.
    6.  Taking good care of your heart will help your brain stay healthy.
    7.  Managing risk factors may delay or prevent cognitive problems later in life.