My husband asked his doctor; “How can I be sure that my symptoms aren’t the result of a stroke or another treatable condition?”
“There is no definitive test for Alzheimer’s disease and it can be misdiagnosed in patients suffering depression, memory deficits, as the result of normal aging, arterial blockages or even certain vitamin deficiencies. If we rule out other possibilities and then apply criteria developed by various medical organizations, we might be able to arrive at a diagnosis.”
“Doctor, what stage of Alzheimer’s would you guess my husband has reached and what comes next?”
The progressive deterioration of brain function in Alzheimer’s disease is divided into seven stages. By the last stage, patients require round-the-clock care. In the first, second and third stages of this slow-moving illness, symptoms are minimal and many patients work and live independently.
I asked; “What can my husband do to preserve his health and mental abilities for as long as possible?”
There are no treatments to halt or cure Alzheimer’s disease. Studies have shown that exercise, a healthy diet and some mental stimulation may delay the onset of disabling symptoms.
(Fortunately, my husband still played bridge and chess, which I think helped tremendously.)
“Doctor, what physical symptoms should we anticipate?” I asked.
Your husband might complain of problems with his memory and organizational abilities, but Alzheimer’s attacks the brain’s motor centers, resulting in problems with balance and co-ordination as well as certain reflexes, including the ability to swallow.
“What about brain neuroimaging?”
Imaging is rarely useful for determining the severity of this disease.
“What about the chances of our children inheriting Alzheimer’s disease? Should they undergo genetic testing?”
Scientists have identified several gene mutations associated with an increased risk of developing Alzheimer’s disease but the predictive value of each mutation is low. As a result, genetic testing is useful only for individuals who have several close relatives suffering from early-onset forms of the disease.
“What drugs are available and how well do they work?”
There are two types of drugs on the market and both have been shown to delay brain deterioration for a brief period in about half the people treated.
“Do you think that my husband should still be driving?”
Driving is often a focal point of familial controversy. Th diagnosis of Alzheimer’s disease does not always require that a patient immediately stop driving. An objective medical evaluation can be helpful in clarifying the extent of a new patient’s disability.
(I handled it by offering to drive whenever possible repeating how much I loved driving. In time, I think that he forgot the mechanics of driving and when his geriatric neurologist told him to stop, he took notice. However, he blamed me for having asked that question in the first place.)
“Doctor, what can I do to make things easier on my family?” my husband asked in his caring, supportive and loving manner.”
Because Alzheimer’s erodes cognitive ability, it is important for you to plan for the day when you can no longer take care of your affairs. Organize medical and durable powers of attorney that authorize your wife to deal with banks, insurance companies and doctors on your behalf.