The most common fear expressed by aging baby-boomers, more than the fear of any physical ailment, is developing a form of dementia. This may be in part a result of seeing the irreversible effects of dementia on their own parent(s), or other family members.  More than 26 million people worldwide have Alzheimer’s disease. That number is expected to reach 100 million by 2050.  Currently in the U.S. about 5 million people are living with Alzheimer’s and that number could reach 13.2 million by 2050. Last year Americans spent $1.4 billion on drugs to treat the disease. The disease puts a huge emotional and financial burden on this generation and leaves its victims often requiring full-time nursing care.

The disease is named after the Bavarian psychiatrist Alois Alzheimer who had a 51-year-old female patient suffering from dementia, delirium and hallucinations. Subsequent to her death, an autopsy was performed. It revealed abnormalities in her brain, including the presence of sticky plaque and tangled fibers in nerves. The exact cause of the disease is still unknown, though researchers believe that genetic factors play a role.

“Dementia” is the loss of intellectual functions — thinking, remembering, and reasoning — severe enough to interfere with everyday life. Dementia may be a result of traumatic brain injury (TBI), vascular causes (such as strokes), Parkinson’s disease, and more.  Some conditions, including depression, drug reactions, nutritional deficiencies or tumors, may mimic dementia.

“Alzheimer’s” is a type of dementia that causes a steady decline in memory and recognition, linguistic problems and degraded motor skills. According to the Alzheimer Association, the disease strikes one out of every 5 people between the ages of 75 and 84, and 42% of those over age 85. People younger than 55 do develop dementia but most “early onset” cases occur between ages 55-64.  In 2000, there were 24 million baby-boomers in that age range and 2% of them, nearly 500,000, had Alzheimer’s disease or another type of cognitive impairment.  By 2010 that number is expected to reach nearly 710,000.

Unfortunately, there is not single diagnostic test to confirm Alzheimer’s disease. The physician must review the person’s (his/her family’s) medical history, do a mental status evaluation of the person, a physical examination, a neurological exam, lab tests (such as blood work, either a CT scan, MRI, PET, or SPECT scan), and psychiatric and psychological evaluations. If all tests are negative the physician will likely consider a dementia or Alzheimer’s disease diagnosis.

Symptoms that may indicate dementia if an individual has increased difficulty with any of these activities:

*Learning and retaining new information — being more repetitive, having trouble remembering recent conversations, events, appointments, & frequently misplacing objects.

*Handling complex tasks — having trouble performing multi-step tasks (i.e. cooking a meal, balancing a checkbook) or following a complex train of thought.

*Reasoning ability — unable to develop a plan to solve problems at home or at work, or showing uncharacteristic disregard for rules of social conduct.

*Spatial ability and orientation — having trouble driving, organizing objects in the house, or finding his/her way around familiar places.

*Language — having increased difficulty in finding the words to express or follow a conversation.

*Behavior — appearing more passive and less responsive, being more irritable than usual, more suspicious than usual, or misinterpreting visual or auditory stimuli.

“Mild Cognitive Impairment” (MCI) is a condition in which a person has problems with memory, language or other mental functions that are noticeable to others and present in testing, but not serious enough to interfere with daily life. This condition is often thought to be a precursor to Alzheimer’s, while some researchers believe it may increase the risk of developing Alzheimer’s but not necessarily. With MCI, nerve cells involved in one aspect of cognitive processing (thinking abilities) are impaired. Currently there is no treatment for MCI approved by the FDA. A large federally funded trial has shown that 10mg of Aricept daily can reduce the risk of progressing from MCI to AD for about 1 year, but the benefit disappears within 3 years.

For additional information on MCI, dementia or Alzheimer’s disease, contact the local Alzheimer’s Association of Central Ohio at 614-457-6003 or visit their website at www.alzheimerscentralohio.org or the national Alzheimer Association 24 hour helpline at 800-272-3900, or their website www.alz.org.

Marcia Wool is a Licensed Independent Social Worker and managing partner of Golden Guidance, LLC, a Geriatric Care Management Practice in New Albany, Ohio.