Alzheimer’s Disease is Under-Treated
In 2001, Psychiatric News reported that few Alzheimer’s patients received state-of-the-art care. Half of mild- and moderate-stage Alzheimer’s patients were not taking any FDA-approved medications, even though medication helps patients function better and for longer, which makes caregiving easier.
When Dr. Murali Doraiswamy asked one hundred physicians, all Alzheimer’s experts, they admitted that they order better, more sophisticated tests and treatments for family and close friends than they do for their average patient.
Best Practices Are No Longer Secret
To redress that, the good doctor, together with social worker Lisa Gwyther and health and science writer Tina Adler, wrote The Alzheimer’s Action Plan, sharing the experts’ knowledge so that patients and family can understand Alzheimer’s and take specific steps to get the most from their medical community and social supports.
Early Detection Is Worth It
Alzheimer’s was once diagnosed only in mild or moderate cases. Now, people with mild cognitive impairment or even probable Alzheimer’s are driving themselves in for screening tests. Early detection allows for early medication, which can add months and sometimes years of higher quality time. Screening often reveals copycat conditions, not Alzheimer’s, that are reversible. If nothing else, early detection can minimize personal embarrassment, financial woes, and accidents invited by unrecognized, untreated Alzheimer’s.
Chapter Four suggests starting with a superspecialist, e.g., a geriatric psychiatrist, a geriatrician with a special interest in dementia, or a behavioral neurologist. If insurance allows only a primary-care doctor, page 98 includes a checklist of tests to take to the appointment. Chapter Five explains how to prepare for the initial appointment, what to expect, and what to ask.
Managing the Doctors
Superspecialists may diagnose but not treat Alzheimer’s, leaving patients and family with uncertain expectations regarding followup care. Chapter Seven explains how to recognize a good doctor, items each appointment should address, questions to ask each step of the way, and why staging (again, and again) matters.
Drugs take eight to twenty years to reach the market. On average, Alzheimer’s patients die within eight years of diagnosis. A clinical trial may be the only way to get tomorrow’s treatments today. Chapter Nine explains the process.
Living with a Diagnosis
Part Three addresses life after an Alzheimer’s diagnosis. Chapter Eleven is for the patient; Chapter Twelve for the family. Someone in every Alzheimer’s family should be tasked with dissecting both chapters and making assignments.
The Bottom Line
Published in 2008, The Alzheimer’s Action Plan is overdue for an update, but is well organized, thorough, and practical. At $20 from Amazon, it’s a great value as a desk reference and a roadmap, whether Alzheimer’s is confirmed or merely feared.