BODY SIGNAL ALLERT/CONFUSION THAT DEVELOPS SLOWLY: TREATMENT
If an adult child brings in an elderly parent and complains that the parent has been confused and forgetful lately, I ask the parent to draw a clock face, to both diagnose the adult and reassure the child. If the parent can draw a clock and hands and place the numbers in their proper place, I tell the parent and child that there’s nothing to worry about. With normal aging, an elderly person’s concepts of space and time gradually become more difficult for them to grasp; I feel that as long as they include all of the numbers as well as the hands, they are okay. If, however, you notice that an elderly relative has become increasingly confused over a long period of time and that it’s beginning to affect the quality of her life, the first step is for her to see her physician, who will probably conduct blood tests to check for vitamin deficiencies, thyroid disease, or another underlying treatable illness. If, however, the doctor determines that your relative does have Alzheimer’s disease, treatment will depend on the severity of the disease.
If placement in a nursing home is not necessary, many people with Alzheimer’s disease will thrive in a day program at a specialized center. The daily activity, as well as regular treatment, can help ease the underlying depression that is a common problem for many people with Alzheimer’s.
Recently a new medication called Cognex or Tacrine has been shown to help some people with Alzheimer’s. These medications seem to slow and even reverse some of the cognitive changes in these patients by improving the response of the neurotransmitters. In the beginning, the doctor will start a patient out on a low dose of the medication and slowly increase it over a period of several weeks. But the effects are usually not dramatic; slowing the speed at which Alzheimer’s progresses can take months to occur. Cognex or Tacrine can also be highly toxic to the liver, so a patient needs to be monitored regularly with blood tests to check the degree of toxicity. Even though these medications are a bright light on the horizon for Alzheimer’s patients, I don’t consider them to be a panacea, as I’ve seen them work well in some of my patients while they’ve had no effect on others.
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