Since I’ve been a consumer journalist for many years, I’ve written a number of articles about memory mistakes after 40.
What I learned is that it’s typical for busy people to begin making memory errors around age 40. What is recommended is that people stay active and engage in activities that stimulate the brain, such as games, puzzles, and learning a foreign language.
However, a survey by the Alzheimer’s Foundation of America adds some new information.
Many caregivers mistakenly interpret certain behaviors as a normal part of aging rather than as symptoms of Alzheimer’s disease or another dementia. As a result, the diagnosis of a loved one’s Alzheimer’s could be delayed.
A survey conducted by Harris Interactive of relatives and friends who care for people with dementia examined how behavioral symptoms compare to cognitive symptoms in their impact on diagnosis, disease management, caregivers’ well being, and other issues. Cognitive symptoms are symptoms such as memory loss and confusion.
Respondents report the most frequent behaviors, exhibited daily to about once a week, are irritability, late-day confusion, anxiety, and sleeplessness.
Only 14 percent of respondents thought they’re managing the person’s behavioral symptoms better than their cognitive ones. And the survey showed that healthcare professionals are suggesting a multi-pronged treatment for behavioral symptoms, including non-drug interventions.
“The survey findings sound another loud wake-up call that we must address this public health crisis, and reinforce that education and early detection must be among the nation’s key strategies in tackling it,” Eric J. Hall, foundation president and CEO, said in a statement.
Two-thirds of respondents who provided care prior to diagnosis believed their loved one’s behaviors were “just a normal part of aging,” according to the survey. Sixty-seven percent said these thoughts delayed getting a diagnosis.
Often cognitive symptoms, 40 percent, or a combination of cognitive and behavioral symptoms, 40 percent, triggered a doctor’s visit, outweighing behaviors, 12 percent, as a factor.
To cope with behavioral challenges, 80 percent of caregivers report that the healthcare provider suggested medication:
- A prescribed name brand drug, 67 percent, or a generic version, 30 percent, specifically for Alzheimer’s disease or dementia, or;
- Medications to treat behaviors, 26 percent, such as anti-depressants, 45 percent; anti-anxiety medications, 28 percent; antipsychotics, 21 percent; and mood stabilizers, 12 percent.
While the U.S. Food and Drug Administration hasn’t approved any medications to specifically treat the behavioral symptoms of dementia, doctors are permitted to prescribe a drug for a different illness than what the FDA has approved it for, known as off-label use.
The survey also showed that 82 percent of physicians and 92 percent of social workers suggested behavioral modifications, environmental changes, and other non-drug interventions, such as communication techniques, support groups, reducing noise and clutter, and activities like music and artwork.
“Behavioral treatments are the treatment of choice,” said Jacobo Mintzer, M.D., chairman of foundation’s Medical and Scientific Advisory Board and Alzheimer’s researcher.
- About one-third of respondents believe non-drug options help “a lot,” especially sticking to routines, 53 percent.
- Among individuals with dementia taking at least one medication, 47 percent of caregivers say medications to treat specific behaviors help a lot – more than double those, 21 percent, who say an Alzheimer’s-specific drug medication helps a lot.
While nearly half of caregivers say they manage both classes of symptoms equally well, fewer think they’re coping well with more severe behaviors: irritability, anger, inappropriate sexual behavior, aggression, personality changes, and paranoia and/or suspiciousness.
Aggression, 59 percent, and fear of self-harm to the diagnosed person, 54 percent, or injury to other family members, 48 percent, would be the most likely reasons for long-term care placement of loved ones. Women, 35 percent, are less likely than men, 48 percent, to feel they can handle aggressive behavior.
The behaviors by people with dementia are triggered most often by frustration followed by unfamiliar surroundings and a “desire to go home,” the majority of caregivers said in the survey.
Concerning the impact on their lives, caregivers are rocked by both behavior and cognitive symptoms, with each equally impairing their own health – causing fatigue and difficulty sleeping – as well as limiting their social and work lives.
Alzheimer's disease statistics
About 5.1 million Americans are living with Alzheimer’s disease, and, with advanced age posing the greatest risk, the incidence is expected to skyrocket as the nation’s population ages. It's a big issue facing baby boomers.
Informal caregivers provide more than 80 percent of all long-term care services at a market value of $450 billion annually.