November is Alzheimer's Awareness Month

Transcription:

Alyne Ellis (Host):  November is Alzheimer’s Awareness Month and today we’ll find out more about this important health issue. Let’s talk about it with Dr. Mohini Gurme, a Neurologist practicing at Highland Medical P.C. This is Sound Advice, the podcast from Highland Medical P.C. I’m Alyne Ellis. So, Dr. Gurme, I know several people who are experiencing quite a bit of memory loss. Does this mean that they have Alzheimer’s.

Mohini Gurme, MD (Guest):  No, not necessarily. If anyone is concerned about having memory loss, I always encourage people to come in and get checked out. There are some tests that we can do to evaluate things further. I would say it’s a common issue that we see, a common concern that people have and does not necessarily mean that you have Alzheimer’s Disease.

Host:  So, how is Alzheimer’s diagnosed?

Dr. Gurme:  Well we use an approach that involves a couple of different things. One is taking a detailed history. We ask a lot of information from the patient. It’s helpful to get some collateral information from family members, even friends sometimes. Along with that, usually we do some sort of cognitive evaluation in our office. And some diagnostic tests which may include an MRI of the brain and or some blood tests.

Host:  Explain to us what exactly is Alzheimer’s?

Dr. Gurme:  Alzheimer’s Disease is really a neurodegenerative condition. So, what that means is it’s chronic, progressive. So, it does get worse with time. There is no cure for it. What we look for as neurologists to try and tease out or figure out if someone may have Alzheimer’s versus just memory loss that may be appropriate with age; is to really determine if someone is having difficulty with some of their activities of daily living that they wouldn’t have normally had.

Host:  And it’s particularly important to rule out other issues because many cases you use a different medication for Alzheimer’s. So, for example, with Parkinson’s which can cause memory loss; the treatment might be very different?

Dr. Gurme:  Correct. Yes, it is helpful to undergo the evaluation and some of the diagnostic testing because it helps to figure out what type of dementia a person may have. By and large, the Alzheimer’s type is the most common. There are other types of dementias as well and people can benefit from specific treatments depending on what type of dementia they have.

Host:  So, once a patient is diagnosed with Alzheimer’s; what comes then?

Dr. Gurme:  So, once someone has been given a diagnosis of dementia; we do recommend that the patient gets followed over time. Like I said, it is a progressive condition so, I always recommend that we try to be proactive about things rather than reactive. Proactiveness really comes with keeping in touch with the patient, monitoring their status over time. Additionally, there are some treatments we can consider starting and we always recommend a few lifestyle modifications that may help to compensate for the dementia.

Host:  Well let’s start with the treatment options. What are those treatment options?

Dr. Gurme:  Well for Alzheimer’s dementia specifically, there is a category of medications our there that has been shown to be helpful at the early stages. The medications target a certain chemical in the brain known as acetylcholine. The names of the medications are Donepezil and memantine. These are the ones we tend to start with. They have been shown to help slow down the progression of memory loss when utilized in the early to moderate period of the disease.

Host:  And as the disease progresses; do you recommend switching to something else?

Dr. Gurme:  As the disease progresses, we can consider alternative treatment options but oftentimes, we can’t always predict how fast the disease may progress. So, it all depends on that. But along with medication along, we often recommend keeping a routine to daily activities. What we find patients most often require at some point is just more and more supervision with their daily activities.

Host:  And that’s what you mean when you say lifestyle changes?

Dr. Gurme:  Correct. And a lot of that comes from educating family members, potential caregivers and helping them understand the disease and how things may progress and what kind of role they may be playing in that progression. Because people with Alzheimer’s don’t always have that insight that they have the condition or that things are getting worse.

Host:  So, as a neurologist, when you see this diagnosis then you are really working with the family. Can you refer them to services that give them the support and strategies that they need?

Dr. Gurme:  Yes, we can. We are often working with family members. I find that oftentimes our visits are actually geared towards providing some education and support to family members. We do often make referrals. I usually will refer family members to the local Alzheimer’s Society chapter where there they’ll find is a good resource for either social services, some education, support groups that they can go to.

Host:  What about as the medications and the disease progress; how often do you think the patients should come back in with the family to see you?

Dr. Gurme:  Initially, I often recommend at least a six month to yearly follow up. In those follow up visits, if I’m noticing that there’s been more of a progression of the disease than I fell comfortable with or that I would like, i may recommend that we shorten the time between visits. But in the beginning, I usually recommend six months to a year.

Host:  Is there anything in particular that would really cause you alarm? I know for example, that Alzheimer’s patients can just leave the house and wander off someplace.

Dr. Gurme:  Correct and those are things that I will tell family members to let me know about. I encourage them to keep me informed of those things because that’s when it really becomes a safety issue for patients. But that’s also a good indication that their condition is progressing; that they are requiring more supervision.

Host:  So, one final question. If someone is thinking that they might have Alzheimer’s obviously they need to come in, but are there some specific warning signs that really should tip us off that it’s just really important to get to a doctor?

Dr. Gurme:  If you’ve noticed that there are things you were able to do that you just feel like you’re struggling with managing now and you have that insight that’s something’s going on; I always recommend just coming in, getting checked out. If anything may be; this will provide some reassurance. But certainly, if – one of the things to definitely look out for is if any family members, friends, co-workers, colleagues at work, if any of them start to notice or raise concerns about things going on at home, conversations they’ve had with you, how you are managing tasks at work to listen to that and to make an appointment and come and see us. Because oftentimes, the patient themselves may not be so aware of what’s going on.

Host:  Is Alzheimer’s inherited?

Dr. Gurme:  There is a genetic component. I often will ask patients about any family history of Alzheimer’s. I tend to get more concerned about a possible hereditary link in a family if there are other family members who have been diagnosed with Alzheimer’s and I also ask what age they were diagnosed. The younger they were diagnosed; it just raises a concern that there may be a familial component there.

Host:  Dr. Gurme, I really appreciate your time today. That’s Dr. Mohini Gurme, a Neurologist practicing at Highland Medical P.C. Call 1-866-550-HMPC to make an appointment with Dr. Gurme. Thanks for checking out this episode of Sound Advice. If you find this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll see you next time.