HEALTH DEFINITIONS:

Health Education Resources For All:

Rose Hill Healthcare Resources is dedicated to educating others on important health issues. Along with excellent home care services, we pride ourselves on being the most informative home care agency in Northern Virginia. We bring health resources to you so you can spend less time searching for facts and more time learning. Our health resources and facts are designed to provide education, information sharing, and additional support to caregivers and clients. Here are some knowledgeable facts on the following:

  • Dementia
  • Alzheimer's
  • Parkinson's Disease

Facts About Dementia:

The term "dementia" is used to describe patients with impaired intellectual capacity. Dementia patients may also be labeled as having "presenile" or "senile" dementia, "chronic" or "organic brain syndrome," "arterio‑sclerosis," or "cerebral atrophy." Dementia is not a normal part of the aging process.

Dementia can be caused by abnormal disease processes and can affect younger as well as older persons.

Symptoms of Dementia are:

  • Short‑term memory loss
  • Inability to think problems through
  • Inability to complete complex tasks
  • Confusion
  • Difficulty concentrating
  • and paranoid, inappropriate or bizarre behavior

Diagnosing Dementia:

To diagnose dementia, a complete medical and neuropsychological evaluation is recommended and a complete patient history is very important. Brain scans such as CT ("CAT" scans) or MRI (Magnetic Resonance Imaging) are an important part of the process. PET (Positron Emission Tomography) and SPECT (Single Photon Emission Computed Tomography) are newer, less available techniques which cannot be done in all hospitals.

Dementia Care:

Chronic or irreversible dementia requires special care. Special arrangements and support must be offered to families who care for a dementia patient at home. Behavior management techniques (such as controlling wandering, disorientation, sleeplessness or incontinence), safety precautions for home care (such as attending to electrical appliances, car keys, supervision and doors that lock) and legal considerations (for arranging finances, conservatorships or durable power of attorney) should be attended to by family caregivers. Most care is provided at home but some patients may require placement in some type of residential facility in later stages.

Facts About Alzheimer's:

Alzheimer's is the most common form of dementia which is defined as a "deterioration of intellectual function and other cognitive skills, leading to a decline in the ability to perform activities of daily living" (Merck Manual of Geriatrics). Alzheimer's dementia is a progressive neurological disorder and usually occurs in old age. A decline in cognitive functions such as remembering, planning and reasoning may be signs of onset Alzheimer's.

Alzheimer's disease is named after a German physician, Dr. Alois Alzheimer, who discovered changes in the brain tissue of a deceased mental patient. He saw abnormal "clumps" and tangled "bundles of fibers" which today are known as amyloid plaques and neurofibrillary tangles. Later research into Alzheimer's disease found the death of nerve cells that control memory and areas of thinking. Also, chemicals that carry messages back and forth appear to be at lower levels in the brains of people with Alzheimer's. Scientists believe approximately 4 million Americans suffer from Alzheimer's disease. Risk increases with age, but Alzheimer's is not a normal part of aging.

Symptoms of Alzheimer’s (7 Stages):

Although each person with Alzheimer's is different, most progress through a series of stages, each of which is characterized by more serious Alzheimer's symptoms. Scientists and physicians have developed seven stages of Alzheimer’s symptoms to describe how you or your loved one will change over time.

  • Stage 1 of Alzheimer's (Unaware of Impairment)
  • Stage 2 of Alzheimer's (Low Awareness of Impairment)
  • Stage 3 of Alzheimer's (Increased Awareness of Impairment)
  • Stage 4 of Alzheimer's (Mild Alzheimer's)
  • Stage 5 of Alzheimer's (Moderate Alzheimer's)
  • Stage 6 of Alzheimer's (Moderate to Severe Alzheimer's)
  • Stage 7 of Alzheimer's (Severe Alzheimer's)

Alzheimer's is a progressive disease that first manifests itself with problems usually related to memory. Over time, people have more difficulty with tasks. By the end of the disease process, Alzheimer's is pretty easy to recognize. The goal is to find out from family and friends as quickly as possible when something is abnormal in order to do something about it.

Caring for an Alzheimer's Patient:

Set up home care provided by qualified caregivers. Because sudden changes in environment can adversely affect the Alzheimer's patient, home care can be a great way to maintain the patient’s current environment while providing him with the care he needs.

Facts About Parkinson's Disease:

Parkinson’s disease (also known as Parkinson disease, or PD) is a neurological disorder that occurs when certain neurons in the brain die or become impaired. These nerve cells, located in a midbrain structure that controls muscle movement, produce dopamine, the chemical responsible for coordinated muscle function.

Symptoms of Parkinson’s disease begin to appear when 80 percent of these neurons become damaged. Unlike many diseases, PD affects both men and women equally, as well as people of all ethnicity and socio-economic backgrounds. According to the National Parkinson Foundation (NPF), approximately 60,000 new cases of PD are diagnosed each year, joining the 1.5 million Americans who have the disease. The condition usually affects those over age 65. Approximately 1 percent of seniors have some form of the disease.

Symptoms:

Persistent body tremor is the most common symptom of Parkinson’s disease in the elderly. Sluggish movement, stiffness and challenges with balance are also indicators, as are hand cramps, shuffling, frozen facial expressions, muffled speech patterns, and depression.

Parkinson’s disease in the elderly is not easily diagnosed, as neither x-rays nor blood tests reveal the condition, though blood tests and magnetic resonance imaging (MRI) can be used to eliminate other conditions. Usually the early symptoms are quite mild, affecting one side of the body. These early symptoms often do not require medication. Though tremors are often the first symptom and the least disabling, they often cause the most embarrassment for the patient.

Like Alzheimer’s disease, the most common neurodegenerative condition in America, symptoms of Parkinson’s patients progress and worsen over time. Increased tremors affect dexterity, while movement slows considerably (called bradykinesia). These physical changes impact the most routine habits like getting dressed or rising from a chair. Posture begins to stoop, as the head and shoulders press forward to compensate for the apparent lack of balance.

Symptoms may occur on one or both sides of the body, but typically begin on one side and eventually spread to the other side as well. Some Parkinson’s patients may also develop dementia late in the process, although it’s still unclear how likely this symptom is.

Because there is so much variability among patients in how the disease progresses, doctors are not able to accurately predict how quickly symptoms will worsen, or even which specific symptoms will develop for each patient. This makes Parkinson’s disease in the elderly a difficult disease to diagnose properly.

Diagnosis:

According to the NPF, profiles of Parkinson’s disease patients vary significantly. For example, even though, 5 to 10 percent of those affected have a family history of PD, the remaining 90 percent of those affected have no family history of the disease. Environmental toxins are also potentially influential in the onset of PD, yet only a small percentage of patients have been exposed to these toxins. “How one person displays symptoms may be quite different from another patient,” explains Ruth Hagestuen, director of field studies at the NPF. “However, the sooner a patient visits a neurologist the better. That way, a treatment regimen can be implemented, because this is a chronic illness, and will require many modes of treatment over time to maintain life quality.” In order to properly diagnose Parkinson’s disease in the elderly, a neurologist or other qualified physician must make the appropriate neurological examination and evaluate the patient’s complete medical history. During the visit the doctor may also be able to personally observe some of the symptoms affecting the patient.

To further complicate diagnosis, onset of PD symptoms does not definitively mean the patient has the disease. Parkinsonism, the term for displaying symptoms without actually having Parkinson’s disease, was found in 35 percent of those patients monitored in a recent study. Parkinsonism is often the result of medication, blocked blood vessels in the brain, and other chronic conditions like dementia. Several conditions, called atypical parkinsonism, mimic PD symptoms. These diseases can obscure early diagnosis of PD, another significant reason why a neurology appointment should be scheduled early in the diagnosis process.

According to the NPF, the conditions that are most similar to PD display a wide range of familiar symptoms:

  • Progressive supranuclear palsy results in imbalance, falling, stiffening of the midsection, and difficulty with eye movement. This condition, affecting people after the age of 50, typically worsens more rapidly than PD.
  • Corticobasal degeneration is uncommon but also progresses more rapidly than PD. This condition affects speech, balance, and posture, and also leads to slowness of movement. Limbs affected by this condition often become severely or completely disabled as it progresses.
  • Multiple system atrophy is the most difficult disease to distinguish from PD. Earlier onset (mid 50’s) and rapid progression are two characteristics of this neurodegenerative disease of unknown cause. Other symptoms arise as this condition intensifies, symptoms that suggest other compromised systems of the body.
  • Vascular parkinsonism is caused by a series of small strokes, usually leading to mobility challenges and is located more often in the legs than the arms. Though treatment is the same for vascular parkinsonism as for PD, it is much less successful.
  • Lewy body dementia (LBD). Lewy bodies are round protein structures that develop among brain cells, displacing them and disrupting their functioning. Patients with LBD will typically exhibit parkinsonism in addition to cognitive impairment similar to Alzheimer’s disease and vivid hallucinations.