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Early diagnosis may be key in slowing Alzheimer's epidemic

An Alzheimer's patient performs neurological cognitive tests Monday, Dec. 17, 2012, in Columbus, Ohio.
An Alzheimer's patient performs neurological cognitive tests Monday, Dec. 17, 2012, in Columbus, Ohio.
Associated Press

SALT LAKE CITY — New data suggest more could be done to tackle the growing epidemic of Alzheimer's disease in Utah.

But individuals must take action to make a difference.

"Someone may dismiss early memory problems as normal aging, but there's actually a fair amount of evidence to say that memory is one of our cognitive abilities that should actually stay relatively stable throughout our lifespan," said Dr. Kevin Duff, an associate professor of neurology and a neuropsychologist at the University of Utah's Center for Alzheimer's Care, Imaging and Research.

Duff said many individuals retain healthy memory function well into their 80s.

When determining whether Alzheimer's disease or other dementias may be an issue, Duff said he considers the frequency of episodes of memory loss, the change from past abilities and the degree that memory lapses affect day-to-day functioning.

"Those are really the variables that start to suggest that it is really a problem," he said. "When there is some drop-off, especially a significant one that affects day-to-day functioning, that is really a sign that it needs to be looked at more closely."

In a 2011 survey of residents in 21 states, nearly 13 percent of Americans age 60 or older reported confusion or memory loss happening more frequently or getting worse in the previous 12 months, the U.S. Centers for Disease Control and Prevention has found. One-third of those surveyed said the decline, which was decidedly more prominent than what is typically associated with age-related dementia, contributed to a loss of function.

In Utah, 17 percent of people surveyed said increased confusion or memory loss interfered with their daily life, but the majority had yet to address the issues with a doctor.

Furthermore, the report states that more than 80 percent of individuals with increased memory problems across the nation have not discussed their symptoms of cognitive decline with a health care provider.

"The high incidence of reported memory loss in the Behavioral Risk Factor Surveillance System survey emphasizes the importance of early intervention and diagnosis to lessen the negative consequences of dementia during the early stages of the disease," said Jack Jenks, executive director of the Alzheimer's Association Utah Chapter.

Jenks said more attention needs to be paid to related public policy decisions, education and outreach, and other efforts to make progress in slowing the growing prevalence of the mind-numbing disease. A statewide plan of action has been launched to break down social stigmas associated with Alzheimer's disease, in order to iron out some misconceptions about the disease that can also lead to a delay in diagnosis.

Memory problems are one of the first warning signs of cognitive decline, and some but not all people with cognitive impairment might develop Alzheimer's disease, according to the CDC.

When memory issues are of concern, doctors often recommend an increase in physical, cognitive and social exercise, including cognitively stimulating activities that spur blood flow and nutrients to the brain to promote better brain health, Duff said.

Some individuals, he said, can recover from what might look like dementia if certain causes, such as medication side effects, depression or nutritional deficiencies, are detected and treated early. A proper evaluation may help to identify those causes sooner.

"One thing that can happen as dementia starts to set in is that people become less aware of the difficulties they are having," Duff said, adding that family members must then bring it up with a doctor. "In that case, it's definitely worth being evaluated."

There are approximately 32,000 people living with Alzheimer's in Utah, requiring the assistance of more than 137,000 unpaid caregivers, most of whom are family members, Jenks said.

The toll is only expected to rise, as the baby boomer generation is aging into its 60s. In fact, a 127 percent increase in the number of Alzheimer's patients is anticipated between 2000 and 2025 in Utah, according to the Alzheimer's Association.

While treatments are not currently available to slow or stop the progression of Alzheimer's and related dementia, early detection allows people to get the maximum benefit from intervention methods that are available, consider participation in a clinical trial, establish a support network and plan for the future.

Research shows that Alzheimer's disease causes changes in the brain years before any symptoms appear, and a better understanding of normal age-related cognitive decline could provide important insights for future prevention efforts.

Self-education and planning tends to benefit those faced with the imminent challenges and anxiety, and sometimes depression and stress that often accompany a diagnosis of the mind-changing illness, the report states.

The federal government in 2012 called for data collection and surveillance efforts to track the prevalence and progression of Alzheimer's disease throughout the country.

While the latest CDC data, a result of the organization's Healthy Brain Initiative, are the first of its kind to report on cognitive decline, additional understanding of the issue is expected with more definitive numbers from the enhanced national research efforts.

The numbers are intended to give states an idea of who might require services and supports now or in the future, as well as prompt action among individuals who might sense something is amiss in their own lives.

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