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Is Alzheimer’s a Spectrum Disease, Similar to Autism Spectrum Disorder?

Mary, a retired college professor, was unhappy when her ophthalmologist insisted that she stop driving. It happened when Mary informed her about her Alzheimer’s diagnosis. Mary’s vision hadn’t changed in 10 years, and she felt perfectly capable of driving at that point in time. At an appointment with her neurologist, Mary expressed her dismay about her car keys being taken away. For Mary, she may forget a word or two here and there, but she honestly felt that her driving was safe and unaffected, thus far.

Mary was one of the many examples that Dr. Gayatri Devi uses in her research. She discusses what she calls being placed in a “diagnostic inbox,” where if you have Alzheimer’s or another form of dementia, it is assumed you have certain symptoms. She disagrees and feels that similar to Autism Spectrum Disorder (ASD), Alzheimer’s should be seen as a spectrum disorder, as well, because everyone with the disease experiences varying symptoms. So, in the case of Mary, some seniors in her situation should indeed stop driving, while others may still be able to drive safely for several more years to come, depending on their symptoms and the severity of them at the time.

Dr. Devi’s research provides some hope of treatment options that treat Alzheimer’s patients’ based on their symptoms. Published more than 50 times in peer-reviewed journals, her current research focus is on neurologic diseases including stroke, dementia and chronic pain. Besides being a strong believer that Alzheimer’s is different for everyone who has it, she recently wrote a book — “The Spectrum of Hope: An Optimistic and New Approach to Alzheimer’s Disease and Other Dementias” — to dispel some of the most-widely believed myths about Alzheimer’s, as follows:

Myth #1: Alzheimer’s typically gets diagnosed in internist’s offices:  According to Dr. Devi, 97% of patients with mild Alzheimer’s disease don’t get diagnosed in their internist offices, and half of patients with moderate Alzheimer’s don’t get diagnosed there either.

Myth #2: Alzheimer’s treatment doesn’t work, so why bother: According to Dr. Devi, Alzheimer’s treatment does make a difference, and patients do benefit from it, as long as behaviors exhibited by the specific patient are treated individually (no one size fits all solutions). “It depends on the individual patient,” Devi said.

Myth #3: If your parents or grandparents have had Alzheimer’s, you are more likely to get it also:  According to Dr. Devi, in most cases, genetics has little to do with it. In fact, less than 5% of Alzheimer’s cases are from genetics.

Myth #4: There is no way to prevent Alzheimer’s:  According to Dr. Devi, “[y]ou can prevent up to 60% of Alzheimer’s cases” by lifestyle changes and modifications to your diet, regardless of symptoms. When it comes to diet, make sure that you’re eating food that’s good for your heart. A Mediterranean diet, for instance, is also a good anti-Alzheimer’s diet. In addition, be sure that you’re active. Exercise 30 minutes a day, three times a week. Controlling risk factors such as high blood pressure and diabetes is also important.

Myth #5: You cannot stop the progression of Alzheimer’s: While there’s currently no way to reverse Alzheimer’s, we can certainly stop the progression, according to Dr. Devi. Similar to colonoscopies and mammograms, Devi said she thinks everyone over the age of 50 should have “baseline brain evaluations” including “a map of our brain’s strengths and weaknesses.” That way, “we can look back and say, look, it’s about the same as it was 10 years ago, nothing to worry about. And, if there’s a problem, we can intervene earlier. Devi says, “(t)he earlier we intervene to treat a person, the better the response to treatment.”
For the best outcome, Dr. Devi encourages people who are worried about memory impairment to seek a diagnosis, because early treatment of symptoms will enable doctors and caregivers to manage the disease more effectively.

Behavioral Therapy for Alzheimer’s

When it comes to autism spectrum disorder, because every child has unique symptoms, each child typically receives therapy to meet their specific needs. The same premise can work for Alzheimer’s.

According to the Alzheimer’s Association, there are strategies available to identify and address needs that the person with Alzheimer’s may have, and that non-drug approaches should always be tried first.

ABA Therapy for Alzheimer’s

For autism spectrum disorder, Applied Behavioral Analysis (ABA) is a popular therapy. Similar to ASD, Alzheimer’s is primarily expressed and diagnosed through abnormal behaviors, which may or may not include:

Severe memory loss, particularly of short-term memory
Decreased logic and reasoning skills
Difficulty communicating
Depression and anxiety
Inappropriate behavior and personality change

According to AppliedBehavioralAnalysisedu.org, all of these issues can be successfully addressed through the use of applied behavior analysis techniques, either applied individually or as part of adjustments made in the environment of care facilities.
Although in many cases Alzheimer’s patients cannot remember what they learned in ABA therapy, certain things do reach the patients, and a clear understanding of what led up to the behavior can help caregivers adjust environmental factors to make life easier for the patients.

For instance, in one experiment, the use of personalized shadow boxes helped some dementia patients find their rooms more easily in a long-term care facility. The therapist treating the patients recognized that short-term memory failure made it difficult for the patients to remember their room numbers in the unfamiliar facility. But long-term memories are often preserved. By taking personal items and pictures that the patients were long familiar with and using those to mark the rooms, patients were more easily able to identify their rooms.

Solving these types of issues not only addresses the immediate problems facing dementia patients, but also serves to reduce the frustrations of their daily lives.

Alzheimer’s Planning at The Farr Law Firm

Regardless of symptoms, persons with Alzheimer’s and their families face special legal and financial needs. Controlling the high costs of caring for a loved one with Alzheimer’s, and navigating the emotionally and physically demanding requirements of caregiving, require the assistance of a highly skilled and specialized expert in the field of Alzheimer’s planning.

Here at The Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from Alzheimer’s and their loved ones.  We help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If you have a loved one who you believe is suffering from Alzheimer’s or any other type of dementia, please call us as soon as possible to make an appointment for a consultation:

Fairfax Alzheimer’s Planning: 703-691-1888
Fredericksburg Alzheimer’s Planning: 540-479-1435
Rockville Alzheimer’s Planning: 301-519-8041
DC Alzheimer’s Planning: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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