My spouse has Alzheimer's

By Eulalee Thompson
Alzheimer's Disease mainly affects people over 65 years. - File

One of the downsides of living longer, is that there are many diseases waiting for us in ambush, just planning their attack. Alzheimer's is one of them. At the turn of the last century it was never a major medical concern but, the increased life expectancy means that more of us will fall prey to this brain-wasting condition.

IT IS not easy for wives or husbands (and other family members as well) to care for spouses who are gradually deteriorating under the devastating effects of Alzheimer's disease.
Some of these caregivers speak of once efficient and brilliant spouses, who, almost all of a sudden, cannot tie their shoelaces or who stuff garbage in the toilet bowl or put their dentures in the sugar bowl or misplace personal items and then accuse family members of stealing them.

One of the warning signs of Alzheimer's is a disorientation to time and place and some of these patients may even get lost in their own houses as they try to find the bathroom.

"It is difficult for caregivers but it is important to understand as a caregiver that you cannot fit them into your timetable, you have to fit into theirs. They may not, for instance, feel like bathing at the time that you would like them to, so you have to bathe them when they are ready. It is difficult for the caregivers but speak softly to them and understand that the person is not being spiteful; it is just a part of the illness," said Dr. Venice Bernard-Wright, family medicine practitioner.

Caregivers for patients with Alzheimer's, she said, are prone to depression, heightened stress, physical illness and frustration.

"The may become emotionally burdened and socially isolated as friends and other family members drift away as the patient's illness progresses," Dr. Bernard-Wright said.

Caregivers, she said may experience burn-out and should seek counselling and advice. They may reach another breaking point when the patient become incontinent of urine and faeces and develop blood sores.

The risks factors for many chronic diseases are well known and are useful in prevention and treatment but unfortunately, it is difficult to predict Alzheimer's - there seem to be no clear risk factor for the condition other than old age. Also, the odds seem to stacked against women - some studies indicate that the female/male ratio of Alzheimer's patients is about three to one.

More recent studies are focusing on heredity, that is, possible genetic links; in fact, a slightly higher risk for developing the disease is being shown for people with a first-degree relative who already has the condition. The treatment available offers a limited scope in relieving the symptoms.

Scientists are still uncertain why healthy brain tissues degenerate in patients with Alzheimer's but it is this degeneration that results in a steady decline in the patient's cognitive skills and memory. They know that a healthy brain has about 140 billion neurons (or nerve cells) that relay electrical and chemical signals to each other. These neurons die slowly in people with Alzheimer's and there is a decrease in the production of neurotransmitters or brain chemicals.

Dr. Bernard-Wright explained that the
memory loss, is not just simple forgetfulness, as experienced by many people, but it is a progressive condition starting with slight memory loss and confusion eventually leading to mental impairment - the patient's ability to reason, learn and remember.

Recent research on Alzheimer's

IN THE last five years or so, scientists have been focusing on the genetic links in Alzheimer's. They have located four specific genes associated with the condition and are continuing their search.

In familial Alzheimer's disease (also early-onset Alzheimer's) - the form of the condition that occurs in people under 65 years - the scientists are finding stronger genetic links than in the second form of the condition, late-onset Alzheimer's. Mutations of three genes have been
isolated :

*the amyloid precursor protein (APP) on chromosome 21

*the presenilin 1 (PS1) gene on chromosome 14

* and the presenilin 2 (PS2) gene located on chromosome 1.

The late-onset Alzheimer's occurs in patients older than 65 years older. The scientists have located a gene on chromosome 19, apolipoprotein E (apo E) which they linked to this form of Alzheimer's. Other reports in the journal Science, also point to another gene on chromosome 10, that is linked to late-onset Alzheimer's.

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