Am I next?
Will I also be overcome by this torrent of rushing water that starts quietly in the placid stream hundreds of feet above the falls, discreetly making forward progress and trickling over the waters edge, then quickly gaining downward momentum, until finally, at breakneck speed, it crashes frantically into everything in its path.
Having two maternal generations of Dementia at my back, the possibility of myself, and my siblings succumbing to this disease is certainly something to consider. But what are the risk factors and what can we do to prevent this from happening?
The diagnosis of Dementia in a loved one creates an anxiety that is multifaceted, and when you receive this dreaded news you come face to face with a future full of apprehension.
Initially, there is the realization that you will lose who that person represents to you in this life, (mother, father, husband, wife, etc.), while they are still living. Then slowly the angst begins to seep in all of the lifestyle changes that will surround that loss.
Can she live at home? Who will be her caregiver? And when she can no longer live at home, where will she go? Can we afford assisted living, memory care, or a nursing home? Is there enough money to care for her? What will insurance cover? How long will she live, and will she outlive her money? How will she live with this disease, and how will she die? How will we manage this disease? Can I handle this?
I was still living at home when my grandmother, (Ma), was diagnosed with Alzheimer’s Dementia, so I was no stranger to this disease when my mom was diagnosed.
Mom was so busy handling the day to day details of Ma’s dementia that she rarely had time to converse about it, other than to make it well known that she, herself, would never, ever go into a Nursing Home. I know her journey with Ma’s dementia, which spanned the entire decade of 1980, terrified her, but she never spoke of falling victim to this disease herself. Perhaps speaking of it made it a real possibility that she did not want to consider. My mom redefined strong willed, and I can just imagine her thinking she could elude this disease just by willing it away-her thoughts being something like, “I simply won’t have this”!
Unfortunately, she could run, but she could not hide. Genetics probably being high blood pressure and high cholesterol, or small, silent strokes in midlife, created the perfect storm which collectively resulted in her Dementia. Mom, unlike her mother, was ahead of her generation in many lifestyle choices that today are thought to be advantageous in helping to ward off Alzheimers. She didn’t smoke. She ate very healthy. She maintained a good weight. She walked daily. She was a socail butterfly. She worked well into her 60’s. I don’t recall any serious head trauma. Solely from a lifestyle perspective mom should have sidestepped Alzheimers.
But anything that affects the condition of our heart, and all of its vessels, also affects our brain. So mom’s blood pressure in midlife which always ran slightly north of normal and her marginally elevated cholesterol may have caused small blood clots that from time to time travelled to her brain and interrupted blood flow, resulting in permanent damage to that area, and eventually leading to cognitive impairment. A couple of these small strokes may be inconsequential, and they go unnoticed as they do not directly affect vital functions such as vision or speech. But in mom’s case, an MRI revealed significant collective damage resulting from these tiny, silent strokes occurring over two to three decades. Mom didn’t know what was happening in her brain over time, and by the time she started displaying symptoms the damage was already done. I don’t recall any books on Alzheimers laying around the house after Ma’s diagnosis, and mom didn’t have a computer, or a tablet, or even a cell phone with WiFi back then, so her information was limited to what she gleaned from health care professionals. And that information was still in it’s infancy.
But today we have a wealth of information at our fingertips, websites such as the Alzheimers Association, (www.alz.org). Web MD, UsAgainstAlzheimers, (www.usagainstalzheimers.org), Alzheimers Foundation of America, (alzfdn.org), and many more that have excellent resources available for information about Dementia, caregiving, the latest research findings, and advice for being proactive.
So every time I forget a name, or I search for the right word, or misplace something, I usually make a bad joke about it and blame it on Alzheimers. And the experts say that as long as I eventually remember that name, or the right word, and recall where I put that misplaced item, I should be OK. Someone once told me the difference lies in not forgetting where you left your keys, but forgetting the purpose of your keys.
So in order not to be next, I try to be proactive, not only in my lifestyle choices, but also in my thoughts. By not allowing myself to be anxious about the things I cannot control, I try to focus instead on those thing I can control, like what I put in my mouth, and how much I exercise, or controlling my weight, blood pressure and cholesterol.
Like an hour glass, our sand will some day run out, and usually not by our choice of method. I have had numerous conversations with health care providers over the years regarding which is worse, cognitive impairment or physical impairment, including chronic, terminal diseases such as cancer. Most believed that Dementia is harder on the family, while physical impairment, and chronic diseases are equally difficult on both the patient and the family. Mild dementia was tough on mom as we had to make choices to keep her safe which resulted in her loosing her independence. But the more she forgot as the disease progressed, the more at ease she became. She also had breakthroughs, or glimpses of cognizance in moderate to late stage Dementia, and these occasions usually caused her anxiety as she realized, if only for a moment, who and where she was, or what she had lost, but then just as quickly, she slipped back into the woozy world of Dementia.
So what increases our risks? According to the Alzheimers Association risk factors include:
Age, the most significant, increasing as we get older. The risk of developing Alzheimer’s doubles every five years after 65.
Gender, women being slightly more likely to develop Alzheimers than men.
Medical History, any conditions that affect the heart and its vessels also increase your chances of developing Dementia. These conditions include diabetes, mid-life high blood pressure and high cholesterol, obesity, heart attack, arrhythmias and stroke. Also a history of depression, and severe or repeated head injuries
Environmental and lifestyle factors, which include an unhealthy diet consisting of too much unsaturated fat, smoking, lack of exercise, drinking above the recommended level of alcohol, lack of social and mental activity.
We are all going to age, and we can’t change our gender, or genetics. But we can modify our environmental and lifestyle choices.
And then there is always that beautiful thing called hope! Hope that someday soon a breakthrough in the field of research will bring about a cure.
My son is in his second year of Medical School, and one of his Professor’s of Pharmacology, Dr David Morgan, a leading Alzheimer’s researcher at USF Morsani College of Medicine’s Byrd Alzheimer’s Institute, recently told his students that a pharmacological cure was in the very near future. This possible cure, already in clinical trials, is in the form of a pharmacologic agent, a monoclonal antibody that breaks up the amyloid plaque in the brain-the hallmark of Alzheimer’s.
That is hope!
And my hope is that in the very near future no one will have to ask the question, “am I next?”
Am I next?
Am I next?