SUMMIT, NJ – Often friends and family worry that a loved one who is forgetting words or losing their car keys is in the beginning stages of dementia – it could be normal aging.
That became clear at Atlantic Neuroscience Institute’s second memory loss symposium, “A Day to Remember: A Conference for Those Living with Memory Loss,” held at Overlook Medical Center on Saturday, March 9. It featured talks by two memory and cognitive neurologists Dr. Anjali Patel and Dr. Saurabh Sharma from the Memory and Cognitive Disorder Center of the Atlantic Neuroscience Institute and by Dr. Michele Elkins, a geriatrician.
Dr. Patel spoke of the different types of dementia, while Dr. Sharma discussed treatment options for memory loss. Dr. Elkins discussed how to live with dementia after its diagnosis.
Dr. Patel explored memory loss from Mild Cognitive Impairment (MCI) to Alzheimer’s Disease (AD) and beyond.
Many people experience MCI, changes in memory and thinking that hasn't made a huge impact on their daily life and function. Dr. Patel said, "About 12 to 15 percent of people with MCI” will develop AD or another form of dementia; some people stay the same and others get better.
The most common form of dementia is AD, but more exist: Lewy Body; Vascular; Frontotemporal; Parkinson's disease; Huntington’s disease; chronic traumatic encephalopathy (CTE); and some secondary dementias that occur because of disorders that damage the brain. Some conditions that look like dementia develop from nutritional deficiencies, hormone dysfunction, side effects of medications or chronic infections, and can be reversed.
A cognitive neurologist can diagnose most memory problems by giving a complete physical, with blood work, cognitive tests and, if necessary, ordering an MRI of the brain or CT scan of the head. With an accurate diagnosis, the disease can be managed with proper treatment. Everyone will know the prognosis and participate in making decisions about care, living options, financial and legal matters and taking part in a clinical research trial. Find out about clinical trials for dementia or any other disease at www.clinicaltrials.gov.
With no cure in sight, Dr. Sharma reviewed the types of interventions that will help manage the disease and possibly prevent secondary dementias. These include: keeping blood pressure within normal ranges; controlling cholesterol; treating sleep apnea; following the MIND diet; being physically and socially active, and limiting alcohol intake.
To manage the primary symptoms of AD, there are two types of medications – Cholinesterase inhibitors i.e. Aricept, Exelon and Razadyne; and Memantine, an NMDA receptor, i.e. Namenda. They are not a cure, and don’t prevent the progression of the underlying disease. Of those taking cholinesterase inhibitors, about 1/3 of the people improve, 1/3 stabilize and 1/3 have no response. Memantine blocks excessive glutamate release, allowing better function of the impaired brain, and is usually indicated for people with moderate to severe symptoms of dementia, he said.
Changes in a patient’s condition can cause cognitive decline and depression. Giving the patient more freedom to make their own choices, to participate in once favorite activities or even music might help, Dr. Sharma said.
If insomnia strikes, it could be anxiety, but it could be from drinking coffee or tea four hours before bedtime. Dr. Sharma recommended trying natural remedies such as melatonin or herbal teas before relying on medication and not using Benadryl or benzos.
Drug therapies are available for other behavioral symptoms, including mood stabilizers, anticonvulsants and neuroleptics. Dr. Sharma said make sure to use medically proven drugs and avoid supplements for which “reliable research on the efficacy and safety” is not available.
Drs. Patel and Sharma have offices in Summit, Union and West Orange. Dr. Sharma also has an office in Martinsville. To set up an appointment, call 908-522-2829.