Diagnosed With Alzheimer’s? Ask Your Doctor These 8 Questions
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Diagnosed With Alzheimer’s? Ask Your Doctor These 8 Questions

Get the facts and learn ways to cope with this life-changing disease.

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The prospect of developing Alzheimer’s disease can cause people great anxiety—and moreso as they approach age 65, when risk starts to increase. Currently some 5.3 million Americans age 65 and older have Alzheimer’s disease, and nearly two-thirds of them are women. While the brain disorder is not considered a normal part of aging, those numbers will, nonetheless, increase as the population ages. In fact, according to the Alzheimer’s Association, an American develops Alzheimer’s disease—the most common type of dementia—every 66 seconds.

If you’re diagnosed with this disorder, you’ll likely experience a wide range of emotions, from sadness to anger to fear about what the future may hold. But one reaction that is quite common is relief, says Phaedra Dowell, MD, a neurologist with Menorah Medical Center in Overland Park, Kansas. That’s because, finally, it becomes clear why you have trouble with things like following a recipe or finding your way home after driving to the store.

In spite of the challenges, there are proactive steps you can take to help slow the progression of the disease. And by being informed, you’ll know what changes lie ahead so that you can plan for your future care. These are top questions to ask about what to expect after an Alzheimer’s diagnosis.

What stage am I at?

2 / 9 What stage am I at?

Stages of Alzheimer’s refer to how severe your disease is,” says Dr. Dowell. “It goes from mild, to moderate, to severe.” A test called the Mini-Mental State Examination (MMSE) can be used to establish a baseline for cognitive ability. Scores range from 0 to 30, the maximum score. “If you get 30 out of 30, that means you likely don’t have Alzheimer’s disease,” she says. According to the Alzheimer’s Association, a score of 20 to 24 suggests mild dementia; 13 to 20 suggests moderate dementia and less than 12 indicates severe dementia.

“But an MMSE is limited, as it is a quick in-office test,” says Dowell. “More thorough testing, such as a neuropsychological test, can provide more complete information.” Dowell says that this kind of assessment, done with a neuropsychologist, can take several hours since the doctor is evaluating all aspects of cognition. 

How quickly can I expect the disease to progress?

3 / 9 How quickly can I expect the disease to progress?

Researchers believe that biological changes in the brain that lead to Alzheimer’s may begin years, if not decades, before symptoms such as confusion and memory loss first appear. Once they do, Dowell says that the pace of progression is highly individual. “Sometimes people will go for several years in the mild category, and then they'll go another several years in the moderate,” she says. But no matter the pace, brain function continues to deteriorate.

Life expectancy can vary between 3 to 10 years, on average, but much depends on the age of diagnosis. Patients who start to experience cognitive troubles in their sixties and seventies could expect a median life span of another 7 to 10 years, while those diagnosed in their nineties could live for approximately three more years.

How is Alzheimer’s disease treated?

4 / 9 How is Alzheimer’s disease treated?

Unfortunately, the loss of neurons and brain functioning is irreversible. Although there is not yet a cure, researchers around the world are working hard to crack the code to identify and treat Alzheimer’s disease before mental decline starts. On a more positive side, Dowell says, there are medications that can slow its progression. “None of the medications will improve your memory to [the level] it was before you had the disease,” she says. “The slope will continue to trend downward, but it will be at a slower rate.”

The Alzheimer’s Association lists five medications that are currently FDA-approved for treating the disease:

  • Donepezil (Aricept—all stages)
  • Galantamine (Razadyne—mild to moderate)
  • Memantine (Namenda—moderate to severe)
  • Rivastigmine (Exelon—all stages)
  • Donepezil and memantine (Namzaric—moderate to severe)
Can Alzheimer’s lead to other conditions?

5 / 9 Can Alzheimer’s lead to other conditions?

“People with Alzheimer's are prone to developing depression or anxiety,” says Dowell. “Part of that is because of the actual changes that are going on in the brain, and part is from a coping standpoint.”

Since depression in itself can cause memory problems, those problems will worsen if you also have Alzheimer’s. “Oftentimes, if you address the depression, through counseling or medication, memory can improve,” she says. People who are depressed also tend to have trouble with sleep, which interferes with learning and the formation of memories, according to the National Sleep Foundation. Again, addressing depression can help alleviate sleep-related issues that impact cognitive function.

Can diet help?

6 / 9 Can diet help?

“What's good for your health seems to be good for your brain as well,” says Dowell. “When we start thinking about what diets might be beneficial for people, it's usually heart-healthy diets.”

Numerous studies have suggested that following the Mediterranean diet may slow cognitive decline. In fact, researchers with the University of Michigan’s Health and Retirement Study found that among nearly 6,000 participants, those who followed the Mediterranean diet or MIND diet most closely had a 30 to 35 percent lower risk of cognitive impairment. “These diets may be beneficial both from a prevention standpoint and helping people once they develop Alzheimer’s,” says Dowell.

Are there ways to slow down progression?

7 / 9 Are there ways to slow down progression?

There is one simple habit that may help you live better with the disease: exercise. “There has been research that has been proven to show that exercise does slow cognitive decline,” says Dowell.

In one Danish study, published in the Journal of Alzheimer’s Disease, 200 people with Alzheimer’s disease between the ages of 50 and 90 were randomly assigned to either participate in supervised aerobic exercise sessions lasting 16 weeks or to receive usual care. The researchers found that the exercisers not only had fewer psychiatric symptoms, such as depression and irritability, but saw significant improvements in mental speed and attention when compared to the non-exercisers.

“We don't fully understand if it's a certain amount of exercise, or the type of exercise, but just getting moving is important,” says Dowell. The Centers for Disease Control and Prevention (CDC) recommends 150 minutes of moderately vigorous aerobic exercise (for example, brisk walking) per week. 

How can I prepare for the future?

8 / 9 How can I prepare for the future?

As your condition progresses you will need more help with daily activities, such as cooking, housekeeping and paying bills. Dowell says it’s important to start early discussions about:

  • Goals of care
  • Where you’ll live
  • Who will be available to help, whether it’s family, friends or a caregiver
  • Any specific medical requests

“Some people feel that they absolutely want to stay in their home and not go to a nursing home,” says Dowell. “In any case, they need to start making arrangements early, not later.”

When must I quit driving?

9 / 9 When must I quit driving?

“Giving up driving is probably one of the most challenging things patients cope with," Dowell says. "They struggle with depression after losing their ability to drive."

Unfortunately, there comes a point when driving becomes a hazard not only to yourself, but to others on the road. For example, you may become confused and step on the gas at a red light, or lose your way home.

Dowell says if those who are familiar with your driving believe it’s time to surrender your keys, it’s wise to listen to them. If you’re still unsure, enlist the help of a third party, such as your doctor or a trusted friend, or look into getting an assessment from an occupational therapy driving rehabilitation specialist, who can evaluate your driving skills.

One resource for those with Alzheimer’s disease, their families and caregivers is the US Department of Health and Human Services Eldercare Locator, which can help you find transportation, in-home services, housing options and other assistance.

Living With Alzheimer's Disease

Living With Alzheimer's Disease

Alzheimer's disease affects all facets of life. Whether it's handling daily tasks like getting dressed or going shopping, learning to live with Alzheimer's is a challenging process. Adapt to the diagnosis by making simple changes. ...

These could include taking picture cards to the grocery store if you have trouble remembering common words or items, incorporating exercise into your daily routine and joining an Adult Day Center. These and other strategies can help you manage the disease on a daily basis.
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