Like many diseases, Alzheimer’s disease is best treated when diagnosed at an early stage. Currently, only about 40 percent of patients are diagnosed early. I have observed that it is common for families to avoid seeking medical evaluation because of the stigma attached to Alzheimer’s disease.
Studies show that without treatment, patients typically live four to six years after diagnosis. With early diagnosis and treatment, patients may live 10 to 12 years. Some people question whether the patient has a good quality of life during those later years, as Alzheimer’s is a progressive disease. However, medication does help patients even in the late stages.
For example, a 77-year-old woman in our clinic was diagnosed at a moderate stage of Alzheimer’s disease. Staging is typically based on the Mini Mental State Examination (MMSE), which asks the patient questions relating to memory, orientation, language, visual spatial function and executive function. A perfect score is 30. A score of 10 to 19 indicates a moderate stage, and a score lower than 10 is severe.
Our patient initially scored 11. After a year of treatment with a combination two-drug therapy, her score improved to 16, and she retained that score for two more years. The next year she had a sharp decline with a score of seven, but rebounded with a rise to 10 for three more years. Although she continued to have typical symptoms of memory loss, repeating herself and some confusion, she could still perform some housework, travel and go shopping. She liked sporting events and had no behavioral problems. As this case illustrates, even at a late stage, patients can benefit from proper management.
Hopelessness dominates various sources of information about Alzheimer’s disease, and much of the negative news emphasizes that there is no cure. However, 80 to 90 percent of patients benefit from treatment, remaining stable for a longer period of time and possibly improving for some period of time. Medications can help the patient continue activities of daily living and remain living at home. Treatment can also help control behavior problems and reduce caregiver burden.
Family and caregivers should be aware of the symptoms of Alzheimer’s disease and seek medical evaluation early. Too often, diagnosis is delayed two to four years. Early symptoms include memory loss, misplacing items, decline in activities of daily living, difficulty with complicated tasks, getting lost and making financial mistakes. Additional symptoms occur as the disease progresses.
These signs of dementia can also appear with diseases and conditions other than Alzheimer’s. Early diagnosis can determine the exact cause of the problems and the appropriate treatment. Families and caregivers can best serve the patient and themselves by seeking early diagnosis and becoming well informed about the disease.
E. David Kirk is an internal medicine physician with Kansas Physicians Group.