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Trouble ahead: Aging and chronic disease
Although you easily can mistake early stages of Alzheimer’s and Parkinson’s disease for each other, the conditions take a path all their own. Knowing what to look for can help you get care for a loved one as early as possible. |
What’s the matter, Mom?
Your grandparent or your spouse stares blankly for several seconds before answering a question. Puts the car keys in the freezer and leaves the turkey in the car. Slouches and shuffles his feet. Confuses words that sound similar. Becomes weepy at the drop of a hat. Is it Alzheimer’s, just old age, or something else?
The myth of “just old age”
First, let’s get one thing straight: Rapidly declining physical and mental abilities aren’t a normal part of aging, no matter what anyone tells you. The sooner you take action to control or reverse the decline, the better your chances of getting effective treatment, whether it’s a cure or slowing the progress of a medical condition. Just as pain signals something’s wrong, changes in behavior or thinking can indicate real, treatable physical problems. Alzheimer’s and Parkinson’s, two devastating degenerative disorders, are brain diseases – physical conditions with many thought- and behavior-related symptoms. They’re similar in some ways, but they also have significant differences.
Alzheimer’s disease: a steady downhill slide
Alzheimer’s disease is the most common cause of dementia, accounting for half of all cases of dementia. In a normal brain, cells called neurons transmit signals from cell to cell using chemicals called neurotransmitters. With Alzheimer’s, the neurons begin to die, the brain manufactures lower levels of neurotransmitters, and the signals don’t connect properly – kind of like a short circuit in an electrical wiring system. Problems with the blood vessels, inherited disorders, and some unusual infections account for the other causes of dementia. The symptoms of Alzheimer’s follow a pattern of increasing memory loss. While a person may not have every symptom, the following are common signs and they usually develop in about the same order.
Stage 1 – Mild:
- Forgetfulness. Everyone forgets sometimes. At first, you may not notice a family member misses more than usual. In early stages, she may sense something’s not quite right, and she’ll work hard to cover up. She may write down every little thing, make light of her forgetfulness, or just worry more about what she may have missed.
Stage 2 – Moderate:
- Lost short-term memory. Uncle Pete has detailed memories from years ago, but doesn’t recall the new neighbor’s name or what he had for lunch. He misplaces things or puts them in odd places.
- Loss of abstract thinking. Balancing a checkbook is impossible – Mom can still count apples, but math is beyond her.
- Confused conversation. Grandpa will try to say one thing, but something else will come out. He knows what he wants to say, but he’s losing his connection between words and meanings.
- Disorientation. Aunt Mary may lose touch with times and dates, and she’ll get lost in familiar places. She’s confused by even simple directions, and she may not know where she is, even though she’s been there hundreds of times.
- Loss of judgment. Grandma can’t make a plan or decision, and she doesn’t know what to do in even a minor emergency, like a pot boiling over.
- Personality changes. Dad may be anxious or have mood swings and angry outbursts. Early on, these changes may come from fear or frustration at being disoriented, forgetting, or being unable to do what he knows should be easy.
Stage 3 – Severe dementia:
- Inability to remember even the most basic things, like the names of family members or everyday objects.
- Language loss that extends to reading, writing, the ability to recognize the meanings of numbers, and eventually, the ability to speak.
- Disorientation and agitation – Bill may wake up in the middle of the night and demand to be taken home, which can be disconcerting for family members.
- Difficulty with familiar tasks. Sequencing ability is lost – step-by-step procedures like bathing become ordeals, and after a while, impossible.
- Major personality changes. Depression, restlessness, withdrawal, and even aggression and other inappropriate behavior can occur.
In the final stages, a person with Alzheimer’s disease is completely bedridden and unable to do anything for himself. However, many people die of other causes, like pneumonia, before they reach that point.
Parkinson’s disease: peaks and valleys
Parkinson’s disease affects a specific part of the brain called the substantia nigra, or “black substance,” which is a control center for movement. Symptoms of Parkinson’s can appear in any order, and they usually start slowly and increase gradually. All symptoms don’t appear in all patients. In fact, the symptom friends and family often notice first – shaking – isn’t all that common. Every Parkinson’s patient is different.
For all those reasons, the disease can be misdiagnosed easily, especially early on. If forgetfulness and trouble with words are the first obvious symptoms, Parkinson’s may be mistaken for Alzheimer’s. Fortunately, most patients with Parkinson’s have no loss of mental capacity. On the other hand, moodiness, changes in sleep habits, and withdrawal could be taken as a psychological ailment. Just as every patient’s symptoms are different, every patient responds differently to treatment. And people with Parkinson’s often seem to get a little better for periods of time, then slide a little farther down – one step forward and two steps back.
The major symptoms of Parkinson’s disease are:
- Slow movement when standing up, sitting down, or walking, because signals aren’t getting from the brain to the muscles as quickly as they should.
- Rigidity or muscle stiffness that can cause muscle pain, especially with movement.
- Poor balance because of lost reflexes that help posture.
- Trembling in the hands, fingers, arms, feet, or mouth, usually when resting rather than moving about.
- Parkinson’s Gait – The symptoms listed above can cause Uncle Fred to walk with his shoulders stooped and head down, leaning unnaturally, either backward or forward.His arms don’t swing with his stride, and he shuffles his feet, unable to pick them up off the floor. Often, he’ll have trouble getting started or freeze for several seconds in mid-step.
Secondary symptoms can include:
- Trouble with swallowing, choking, or excessive salivation that causes drooling.
- Constipation or loss of bowel or bladder control.
- Loss of intellectual capacity; anxiety, depression, and isolation.
- Forgetfulness – unlike Alzheimer’s, though, the memory of a person with Parkinson’s comes and goes. Aunt Sue may not remember something now, but it will come back to her tomorrow, and she’s more likely to be confused about when it happened than to forget it completely.
- Disorientation.
- Insomnia.
- Dry, scaly skin.
- Trouble communicating – slow response to questions, soft, whispery voice, and small, cramped handwriting.
Unfortunately, the side effects of many commonly prescribed drugs for Parkinson’s disease include hallucinations, disorientation, serious memory loss, and other symptoms similar to Alzheimer’s, making things that much more confusing. If someone with Parkinson’s starts to display any of these symptoms, call the doctor – a prescription change may be in order.
What now?
It’s easy to understand why these diseases are so feared. They’re both incurable, and they can destroy the people you love years before they actually die. While you can do things that might slow them down, they’re easy to miss in the early stages, when intervention would do the most good. No one knows what triggers either Alzheimer’s or Parkinson’s disease. Scientists continue to investigate the possibilities – genetics, environmental factors, and brain infections, among other things.
The most important thing to do is follow the doctor’s orders. Many medications can help with the symptoms of both diseases, and others may slow their progress. For people with Alzheimer’s or Parkinson’s, or even those who think they might be at risk because of family history, some of the best actions are counteractions. Try these activities to help slow or ward off disease:
- Play games that use memory, vocabulary, and decision-making skills, like Scrabble, or trivia or card games.
- Visual imaging. If you can’t write yourself a note to call the plumber when you get home, make a mental picture of a telephone hanging on your door, with a leaky faucet beside it. Start a habit of imaging, even if you can’t jot down a reminder.
- Make up games using daily activities. For example, if you’re going to the store for three or four things, put the list in alphabetical order and rehearse it two or three times in your head. Then see if you can remember all the items without looking.
- Sign up for exercise classes that improve balance and flexibility, like yoga or Pilates.
- Use physical exercise in any form to ease muscle stiffness, pain, and difficult movement.
- Try facial exercises, like making faces in the mirror, to help with eating and swallowing.
Your doctor can help determine how much you can safely do, so remember to discuss your exercise program before you start.
The bottom line
Alzheimer’s and Parkinson’s are both degenerative brain diseases that destroy basic functions people take for granted. Whether you have one of these conditions, you’re caring for someone who does, or you’re concerned about your future, you can do some things to take control of your life.
For more information on this article:
Visit the HealthWise® Library: Go to MyHumana, click on “Health and Wellness,” then “Health Centers,” and select any of the Centers. The HealthWise links are at the bottom of the Health Centers pages.
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