Dementia and Alzheimers Disease
Jul 21, 2015
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Nothing can go faster than the speed of light. But that cosmic speed limit is inconsequential when you are running around our planet. It would take a beam of light about 0.006 seconds to go from Dauphin to Vancouver. Or about 0.13 seconds to go around the whole Earth. It only takes 8 minutes for light to go all the way from the Sun to our planet. So it hurts my brain to think that it takes 4 hours and 25 minutes for the New Horizons Space probe to beam it's amazing photos from Pluto all the way back to Earth. Pluto is so far away it took New Horizons 10 years just to get there.
It can be hard to imagine what you will be doing 10 or more years into the future. Experts tell us that Alzheimer's disease will affect Canadians more and more in the coming years. That is because as a nation, we are getting older. In 2011, the first wave of the baby boomers turned 65. There is less dementia in the population before the age of 65. However, the risk for dementia doubles every five years after age 65.
In 2008, 480,618 Canadians were living with dementia and Alzheimers disease. That is about 1.5% of Canadians. As the baby boomers age, by 2038 this number will almost triple to 1.3 million people or 2.8% of the population. Dementia doesn't just affect the person with the disease. One in five Canadians aged 45 and older provides some form of care to seniors living with long-term health problems. In 2008, it is estimated we had 15,400 few care home beds than we needed. By 2038, when the tidal wave of baby boomers with dementia crashes on our shores, we will be short 157,500 care home beds.
Alzheimers disease is the most common form of dementia. It accounts for 64 per cent of all dementias in Canada. Dementia is a condition with symptoms like loss of memory, poor judgment and reasoning, changing moods and change in ability to talk and communicate. Alzheirmers disease was discovered by Dr. Alois Alzheimer in the early 1900s. He found plaques and tangles in the brains of some dementia patients after they died. These are still the hallmarks doctors look for when confirming Alzheimers disease after the death of the patient.
So if I lose my car keys, do I have Alzheimer's? Probably not. Forgetting things occasionally is normal as we age. Dementia and Alzheirmers disease are different than normal forgetting as we age. Forgetting where you put the car keys is probably normal aging. Forgetting how to drive a car might be dementia. Forgetting the name of an acquaintance might be normal aging. Forgetting who your immediate family members are might be dementia. If you are worried about your memory, but your relatives are not, it is probably normal aging. If your relatives are worried about your memory, but you arent aware there is any problem, it might be dementia.
There are a few other Alzheimer's and dementia myths that should be dispelled. If my mom/dad/uncle/grandma etc had Alzheimer's I'm going to get it, right? No. Only about 5% of Alzheimer's runs in families. Aluminum pots cause Alzheimer's, right? There is no good evidence that aluminum exposure causes any dementia. If I do a Sudko, crossword puzzle, or brain traing video games every day it will prevent Alzheimer's, right? There is no proof they will. However, getting regular exercise and eating a heart healthy diet really might help prevent dementia.
In Alzheimer's disease, brain cells die. This results in of loss of memory and cognitive functioning. One key brain chemical, acetylcholine, appears to be in short supply in Alzheimers disease. Many drugs used to treat Alzheimer's disease are aimed at increasing the amount of acetylcholine in the brain.
Cholinesterase is an enzyme that breaks down acetylcholine. Drugs that inhibit this enzyme will leave more acetylcholine in the brain. The first cholinesterase inhibitor to gain wide scale use in Canada was donepezil or Aricept. We now also have rivastigmine or Exelon and galantamine or Reminyl. All three of these cholinesterase inhibitors are indicated for mild to moderate Alzheimers disease.
Memantine or Ebixa is a little different. It is called an NMDA receptor antagonist. It works on a different brain chemical called glutamate. It is approved for use in moderate to severe Alzheimers and can be used with Aricept.
Here is the bad news. None of these medications is a cure. None of these medications will stop the disease from progressing. The best any of these medications can do is help manage symptoms and help maintain a persons functioning for as long as possible. I see a lot of false hope in the pharmacy that these medications will cure a loved one with Alzheimers. They wont. And these medications are expensive and not always covered by Manitoba Health.
The future for Alzheirmers may be brighter, though. The researchers are learning more about how to prevent the dementia and are working on future treatments. One thing bit of research I found interesting is that preventing concussions and head injuries in the young may help those people to avoid dementia when they are older. And there is research happening today that we hope will produce treatments in 5 to 10 years that may be able to slow and stop the progression of Alzheimers disease.
The future of the New Horizons Space probe is bright too. It has passed Pluto, but will be sending back pictures and readings for the next 18 months. Then off to the mysterious Kuiper belt!
For more information see: Alzheimers Society of Canada www.alzheimers.ca
Rising Tide: The Impact of Dementia on Canadian Society - www.alzheimer.ca/~/media/Files/national/Advocacy/ASC_Rising_Tide_Full_Report_e.pdf
Myths and Realities about Alzheimer's - www.alzheimer.ca/en/About-dementia/Alzheimer-s-disease/Myth-and-reality-about-Alzheimer-s-disease
New Horizons Space Probe - http://pluto.jhuapl.edu/index.php
As always if you have any questions or concerns about these or other products, ask your pharmacist.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
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