Alzheimer’s: it’s one of the most dreaded diagnoses an individual or family can receive. September is Alzheimer’s month, and Paws for Reflection is going to address Alzheimer’s in humans today, and Alzheimer’s in cats in the next post.

There are reportedly over 5 million people in the United States with Alzheimer’s. Worldwide, it is reported that 35 million people and their families are affected by some sort of dementia.

Alzheimer’s is devastating because it robs a person of their ability to remember, communicate and in the latter stages perform the basic ‘activities of daily living’ like walking, speaking, toileting, feeding oneself. They forget how to sit in a chair, how to use a fork, how to speak to you in person, say anything about on the phone.

One of the hardest things to lose is their ability to relate to you, to understand the here and now of what’s happening in your life. I know. My mother has Alzheimer’s, and is entering the final stages of this dreaded disease. When she began wandering, I knew I had to place her in a safe environment. It was then that I was willing to open the door to learn about this dreaded disease – but in moderation.

With her moving from residential care into a skilled nursing facility this past spring, I have found it imperative to learn more about this horrendous disease, because information helps me cope with good and bad visits. A few months ago, the good days would have been really bad. Now, I appreciate each and every good day which include:
• When she can interact in some little ways and not dose through the entire visit
• When she can walk to the dining area with just one person helping her
• When she can speak a few words
• When she will try to eat dinner
• When she recognizes me

My mom was my best friend. It’s hard to see her slip into a world with:
• No recognition of today
• Little if any of yesterday
• And bits and pieces of a reality that is not a reality
o There’s a man on the TV
o There’s a cat in the window
o There’s a hallucination about something that’s not real

The problem with Alzheimer’s is that people are so afraid of it (they have a right to be) that they don’t want to talk about it, learn about it, or understand it.

In order to write about cats with Alzheimer’s (my next post) Paws must let you know the disease’s basic ins and outs. The information shared here comes from the Alzheimer’s Association.

• An adult brain contains about 100 billion nerve cells, or neurons, with a dense branching network that connects at more than 100 trillion points, referred to by scientists as a neuron forest. Signals traveling through this neuron forest form the basis of memories, thoughts and feelings. Alzheimer’s targets these neurons, destroying them. These signals that form memories and thoughts move through an individual nerve cells as a tiny electrical charge.
• Nerve cells connect to one another at synapses. When a charge reaches a synapse, it may trigger release of tiny bursts of chemicals called neurotransmitters. The neurotransmitters travel across the synapse, carrying signals to other cells. Alzheimer’s disease disrupts the way electrical charges travel within cells and the activity of neurotransmitters. The disease also causes nerve cells to actually die, and over time, the brain shrinks dramatically..
• In Alzheimer’s the cortex shrivels up, damaging areas involved in thinking, planning and remembering. This loss of brain tissue is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories. This also is the area in which it is believed that Alzheimer’s first appears, and because of this, people don’t remember what was just said to them, and keep asking the same question over and over. They don’t remember the answer, because it never registered in the hippocampus.

Other changes to the brain include:

• Ventricles (fluid-filled spaces within the brain) grow larger
• Nerve cells and synapses are destroyed
• Dead and dying nerve cells contain tangles

Plaques, abnormal clusters of protein fragments, build up between nerve cells Plaques form when protein pieces called beta-amyloid clump together. Beta-amyloid comes from a larger protein found in the fatty membrane surrounding nerve cells. Small pieces of this beta-amylois may block cell to cell signaling at the synapses. Even worse, they may activate immune system cells that trigger inflammation and devour disabled cells.

In areas where tangles are forming, a protein called Tau, which helps keep the brain transport system parallel and orderly, collapses into twisted strands called tangles. The transport tracks fall apart and disintegrate. Plaques and tangles spread through the cortex in a somewhat predictable pattern as Alzheimer’s disease progresses.

The rate of progression varies greatly. People with Alzheimer’s live an average of eight years, but some people may survive up to 20 years. The course of the disease depends in part on age and health..

Changes may begin 20 years or more before diagnosis. In the earliest stages, before symptoms can be detected, plaques and tangles are forming, affecting learning, memory, thinking and planning.

As Alzheimer’s progresses, individuals may experience personality and behavior changes and have trouble recognizing friends and family. Mild to moderate Alzheimer’s can last from two to ten years. In advanced Alzheimer’s disease, which can last from one to five years, most of the cortex is seriously damaged. The brain shrinks dramatically due to widespread cell death. Individuals lose their ability to communicate, to recognize family and loved ones and to care for themselves.

There are plenty of resources, including the Alzheimer’s Association, that have resources to help people cope with this horrendous disease. Reading also helps. Paws found to books, Still Alice and Left Neglected, by Lisa Genova, particularly helpful in learning to understand and cope with this difficult disease.

Remember, Alzheimer’s is a disease, one that costs billions each year. Don’t punish yourself or your loved one. It’s the disease – not you and not them – that’s breaking down their brains. It is the disease that

• Causes them to drift off in the middle of a conversation
• Wander in the middle of the night
• Not identify with today’s happenings, whether it be their best friend just died, you are ill or your son just graduated from college.
• To ask the same question over and over even though you’ve answered it 20 times
• Go into unexplainable outbursts of rage
• Hallucinate and imagine
• And makes them unable to recognize you

Have you had experiences in dealing with Alzheimer’s disease? If so, please share.