Overcoming Alzheimer's

by Molly M. Ginty

Whatever stage of life you’re in, and whether you’re physically fit or living with chronic illness, you can find ways to be a wise steward of your health and well-being. Our health and wholeness are important keys to responding to God’s call for us and acting boldly on that call. That’s why Women of the ELCA have embarked on a new health initiative: Raising up Healthy Women and Girls. This ongoing column represents our commitment to the issue of women’s health.

When Patricia Negri began to leave her daughter, she disappeared by degrees. First she fell silent in the middle of conversations. Then she ignored pleas that she bathe and wash her hair. Finally, she lost the words she needed to communicate, along with her motor functioning.

"In the end, she was no longer able to recognize me," says Kathleen Negri, a Denver, Colorado, resident who nursed her mother for six years. "But when she died, all I could do was rejoice because I knew she was finally free."

The story of the Negris, mother and daughter, illustrates the unique needs of women when it comes to Alzheimer’s disease, a form of dementia that typically strikes after age 65. Alzheimer’s affects 4.5 million Americans, has no cure, and has such dire emotional, physical, and financial consequences for those who have it and their loved ones that authorities have named November National Alzheimer’s Disease Awareness Month.

"Women are not only at increased risk for getting Alzheimer’s, but also more likely to take care of Alzheimer’s patients," says Amy Niles, president of the National Women’s Health Resource Center based in Red Bank, New Jersey. "Thus, women bear a double burden when it comes to this progressive, irreversibledisease."

Though women are only slightly more likely to develop Alzheimer’s than men, its prevalence among women is twice as high because women live longer — with a life expectancy of 80 years compared to 75 for men. Half of all women over 85 in the United States will eventually develop this disease. More women than men struggle with obesity, diabetes, high blood pressure, and high cholesterol — conditions that boost the risk of Alzheimer’s.

Scientists believe Alzheimer’s develops when brain proteins stop performing their normal function and instead cluster into two types of lesions: neurofibrillary tangles and amyloid plaques. Over time, these lesions interfere with nerve transmission, killing neurons and eroding language, learning, memory, and reason.

Though some people have a genetic predisposition for Alzheimer’s, most have no family history of the disease.

Some patients undergo dramatic personality changes or become depressed or violent, but others remain emotionally stable. While some progress from simple forgetfulness to severe dementia in as little as five years, others manage to stave off dementia for a decade or more.

Early symptoms include confusion, memory loss, and judgment problems. Next come anxiety, insomnia, and wandering. Eventually, patients lose their speech, appetite, bladder, and bowel control, becoming completely dependent on their caregivers.

According to the Chicago–based Alzheimer’s Association (www.alz.org), more than 70 percent of Alzheimer’s patients live at home. And according to the Family Caregiver Alliance in San Francisco, the typical Alzheimer’s caregiver is a 46–year–old married woman with a part–or full–time job. "Women are the health CEOs of their households," says Niles. "We tend to take care of everyone else, even if it means putting our own needs second."

Caregivers’ workloads — and the accompanying stress — can take their toll. Studies show that women who care for Alzheimer’s patients are at increased risk for cardiovascular disease, anxiety, and depression.

Mary Rolsch of Lakewood, Colorado, cared for her mother for three years before she died in 2002. "I lost my temper one too many times," says Rolsch. "I felt like I was short–changing everybody: my husband, my kids, my boss, my mom, and myself."

Whether they vent their frustrations to friends or join support groups sponsored by the Alzheimer’s Association, caregivers can find ways to cope.

"To nurture myself, I learned to clarify my role with my mother and stop expecting a ‘thank you,’" says Negri. "I learned to limit my time with her and take time for myself. I got together with friends. I got massages. I kept a journal. And some days, I just sat down and cried."

Because the population of those over age 85 is reaching record levels in the United States, the number of people with Alzheimer’s is expected to quadruple by 2050. With the disease already racking up $100 billion in health–care costs per year, the price of this epidemic could become astronomical.

The good news is that women can ward off Alzheimer’s by maintaining good health practices such as getting regular exercise, having a strong support network, eating lots of fruits, vegetables, and fish, and keeping the mind active. Taking blood–pressure medication (such as enzyme inhibitors, beta blockers, calcium channel blockers, and diuretics) and cholesterol–lowering drugs (such as statins and fibrates) can have a protective effect. So can taking a pass on hormone replacement therapy, which can double the risk of Alzheimer’s in some postmenopausal women.

Even better news: scientists are working to develop new treatments in addition to the five neurotransmitter drugs already FDA–approved. In March, researchers discovered an enzyme that may curb both forms of brain lesions that are found in Alzheimer’s patients.

Health advocates hold out hope for a vaccine — and for future breakthroughs that can ease the plight of Alzheimer’s patients and their caregivers.

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

Article published in Lutheran Woman Today, November 2006