Alzheimer's talks strike a nerve

The Alzheimer's Association released its 2019 Facts and Figures Report last week, showing that 97,000 Minnesotans are living with the disease. It estimates that more than 250,000 people in the state are caring for someone with Alzheimer's or another type of dementia.

With the disease touching so many people, it should have come as no surprise that two lectures on the topic in Alexandria drew overflow crowds.

Dr. Joseph E. Gaugler of the University of Minnesota came to town Thursday to break down what the disease is, dispel a few myths, and talk about what can be done. He kicked off the Senior College spring lecture series at Alexandria Technical & Community College by filling the auditorium.

It was the best-attended lecture since ATCC began Senior College in 2006. Communications director Rebekah Summer said the crowd was so large that the college is making plans to provide overflow rooms for future kickoff events.

His talk earlier that day at the Douglas County Library drew another 100 people.

"This just goes to show you the need and the interest in the community," said Library Director Dawn Dailey.

Neither appearance was exactly a lecture by the Robert L. Kane endowed chair in long-term care and aging at the university. They were more of a back-and-forth, with Gaugler fielding a barrage of questions from the audience.

"They were both great conversations," he said following his visit to Alexandria. "It really helps give me a sense of what is the state of understanding of dementia and Alzheimer's, and what are some of the most pressing concerns from people who are living with this."

Changing focus

Gaugler wants to bring his message to every county in Minnesota. Despite Alzheimer's being a progressive disease that robs those who have it of their memories and disrupts their thinking skills and daily life, the professor stressed the importance of attitude in dealing with the disease.

"For us to deliver the best possible care, we have to focus just as much on what people still have, and organize our care around that," he said.

Currently there is no cure for Alzheimer's, but its symptoms are treatable. Gaugler understands why people can feel like it's a death sentence, and in fact it is the sixth leading cause of death in the U.S.

"For those of us who are caring for people with memory loss, we have to really avoid falling into that trap. It's possible to still live with Alzheimer's disease. It is not a death sentence," he said, noting that people who are diagnosed with it are still capable of doing many things. "So it's a matter of how can we focus on that rather than on the decline."

Alzheimer's is the most common form of dementia, is not a normal part of aging, and worsens over time. Although it was first documented in 1906, Gaugler said it has only really captured our attention in the past few decades as the number of Americans living into their 70s and older continues to swell.

"We are rapidly moving into a phase where it will be diagnosed prior to symptoms being evident," he said.

Early diagnosis can enable people to access treatment options earlier, participate in clinical trials on the research front, make lifestyle changes, and plan a course of action.

However, there are other considerations when it comes to being able to diagnosis the disease prior to a person developing it.

"This is a far more complex issue," Gaugler said of whether that information will be welcome. "If one can learn if they are going to get a disease, is it beneficial, and do they want to?"

In a show of hands at the college, more people wished not to know in advance.

Just the facts

Exactly what is Alzheimer's? Posed that question on Thursday, one person defined it as "losing it."

Alzheimer's is the most common form of dementia, which is a general term for a decline in mental abilities. Gaugler said that memory loss is not necessarily the first symptom, although it is the classic symptom. Other aspects can be affected, such as perception and language.

Genetics play a role in Alzheimer's, as does lifestyle behaviors. High blood pressure and high cholesterol, and poorly-controlled diabetes are among the heart factors that increase your chances. Head injuries can also be a risk factor.

Women are more likely to develop Alzheimer's, likely because they live longer than men. The likelihood of the disease doubles for every five-year period after the age of 65. African Americans are twice as likely to get it, and Latino Americans are also more likely.

The prevalence of Alzheimer's among baby boomers is lower, Gaugler said, possibly because they are in better health than their predecessors. The more education one has, the less likely the disease is, he said.

What can be done

A 2015 report by the National Institutes of Health found more consistent evidence of regular physical activity and management of cardiovascular risk factors as helping stave off the disease, and a healthy diet and lifelong learning may reduce the risk of cognitive decline, Gaugler said.

Another study in 2017 assessed risk factors, finding that 35 percent of risk is possibly modifiable. Gaugler called that significant. The factors included: education in early life; hearing loss, hypertension and obesity in mid-life; and smoking, depression, physical inactivity, social isolation and diabetes in late life.

As for treatments, two main drugs may slow symptoms for some time, but Gaugler said they may have moderate effects at best.

Several non-pharmacological approaches are recommended for caregivers: monitor personal comfort; avoid being confrontational or arguing about facts; redirect their attention; allow adequate rest between stimulating events; provide a security object; acknowledge requests and respond to them; look for reasons behind each behavior; explore various solutions; and something that is particularly difficult for some caregivers, don't take the behavior personally.

Gaugler also highlighted a few myths associated with the disease. They included: memory loss is a natural part of aging; Alzheimer's is not fatal; only older people can get the disease; aluminum, aspartame (found in diet drinks), flu shots and silver dental fillings increase risk; and treatments are available to stop the progression.

10 warning signs

• Memory loss that disrupts daily life

• Challenges in planning or solving problems

• Difficulty completing favorite tasks

• Confusion with time and place

• Trouble understanding visual images or spatial relationships

• New problems with words when speaking or writing

• Misplacing things and losing the ability to retrace steps

• Decreased or poor judgment

• Withdrawal from work or social activities

• Changes in mood or personality