Note: I’m indebted to Kelly Raach, Southern Arizona Regional Director of the American Alzheimer’s Association, for providing information and reviewing this summary.
Alzheimer’s differs from other diseases of old age in that it affects people’s mental as well as physical processes. When diagnosed prior to age 65, it’s considered to be “early onset Alzheimer’s,” which is generally associated with specific genetic markers. But as ages rise, the incidence of Alzheimer’s also rises, even without the genetic markers. Overall, one in eight older Americans struggles with Alzheimer’s. Among individuals over the age of 85, some studies suggest that 50% have Alzheimer’s to some degree.
Because of this, a lot of attention is being focused on understanding the causes of Alzheimer’s and there are regular reports of breakthroughs in the news. In fact, although much about Alzheimer’s remains unknown, our understanding of it has changed dramatically over the past decade.
Formerly considered secondary to a “true” cause of death, Alzheimer’s is now considered a cause of death in its own right; in fact, it’s the sixth most common cause of death among people over 65. The disease unfolds in a predictable way, whether early onset (diagnosed before age 65) or developed at any time later. The progression of the disease as well as the treatment plan are pretty much the same regardless of the age at which one is diagnosed. However, because the time of diagnosis varies greatly, there are considerable differences in how rapidly the disease seems to progress after diagnosis and how effective the treatment is. For more information: The seven stages of Alzheimer’s
Living Alone with Alzheimer’s
Studies show that people who have Alzheimer’s and live alone are more likely to end up in nursing homes at an earlier stage than those who live with others. It may be because people who live alone are more likely to fail to recognize their own decline, or to be in denial about it. Without input from others who know them well, they may fail to seek help until the disease is fairly far advanced. At that point, the drugs don’t work well and functional incapacity comes sooner. People with Alzheimer’s who live alone, estimated to be at least 800,000 today (and rising), often receive attention only when their neighbors or service people call the authorities, or they’re found wandering lost in the night.
There’s no cure for Alzheimer’s. There are drugs which can slow down its progress, especially if taken at the early stages of the disease, but anyone diagnosed with Alzheimer’s will ultimately be unable to manage any of the tasks of daily living and will need extensive care until the end.
The Alzheimer Society of Canada offers advice on living alone with Alzheimer’s, with tips for continuing to live independently for as long as possible.
What to do if you suspect you have Alzheimer’s
A diagnosis of Alzheimer’s is terrifying to anybody, but I’m sure it must be especially terrifying to people without family. The prospect of an extended period when others must make decisions about the most basic aspects of one’s life is hard for anyone to face. It’s easy to understand why people delay getting diagnosed. Yet, if you suspect you might have Alzheimer’s, you’re well advised to get checked as soon as possible. (Learn the Ten Signs of Alzheimer’s.) The earlier identified, the longer you’re likely to be able to remain independent, which translates into time to get your affairs in order.
If you suspect Alzheimer’s or are diagnosed with it, many will have a natural tendency to withdraw. However, developing a support network is essential to managing the disease in its early stages. Fortunately, excellent support is available. The Alzheimer’s Association, which began as an organization to support caregivers, is starting to pay attention to the needs of people with Alzheimer’s who live alone. Their 2012 Report (PDF) for the first time, includes a section on those living along with Alzheimer’s, and they’re slowly changing their materials to speak not only to caregivers and but also directly to those in its early stages. They’ll be able to direct you to support services in your community, inform you of clinical trials, and be with you as you wind down your affairs.
Other Dementias
Old people are subject to dementia from other causes, but although symptoms may be similar to Alzheimer’s, they need to be treated differently. A common cause of dementia symptoms is drug interactions. Since many seniors end up taking multiple medications, it’s a good idea to have a pharmacist or care coordinator review your medications each time a new one is prescribed. Sometimes a change in prescriptions can result in symptoms completely disappearing.