Alzheimer’s Awareness Month: Q&A with neurologist Dr. David Wheeler, chairman of Wyoming Dementia Care
By Kristy Bleizeffer Nov 23, 2015
November is National Alzheimer’s Disease Awareness Month, devoted to shining light on a disease that can be devastating for patients, caregivers and families.
More than 5 million Americans have been diagnosed with the disease including 8,800 in Wyoming, according to the Alzheimer’s Association. By 2025, an estimated 13,000 Wyomingites are expected to develop Alzheimer’s as our population grows older. As of now, it cannot be cured.
There is help available. In the interview below, Dr. David Wheeler, a neurologist at Wyoming Medical Center and chairman of Wyoming Dementia Care, talks about Alzheimer’s and the resources available to patients and families.
What is Wyoming Dementia Care?
Wyoming Dementia Care is a not-for-profit organization in Casper providing services to help people who are taking care of a family member or loved one suffering from Alzheimer’s disease and other forms of dementia.
What is Alzheimer’s disease?
Alzheimer’s disease is one of several conditions that can cause dementia. Dementia is a condition of the brain that is progressive over time, meaning symptoms get worse as the disease progresses. It causes changes in memory and other brain functions that are severe enough to impact a person’s ability to take care of themselves.
What are the causes of Alzheimer’s disease?
At this point, we don’t know the specific causes. We do know that there could be a genetic component. Some people who have strong family histories – if, for example, both parents had dementia – they may also develop dementia at a relatively young age. However, most people don’t have a strong family history and don’t develop dementia until later in life, like their 70s or 80s. There must also be some contribution of environment and other exposures throughout our lives.
Some of the things that are known to be associated with an increase risk of dementia are smoking, diabetes, high blood pressure, lack of exercise and, interestingly, a relatively lower level of education.
How is Alzheimer’s diagnosed?
Diagnosis is challenging, and it’s often very subtle in its onset. Often times, as a neurologist, I don’t meet people with dementia until they’ve been suffering with the disease for a couple of years or even longer.
The symptoms of dementia can be mistaken for the symptoms of normal aging. All of us become a little more forgetful as we grow older. All of us struggle to remember the names of people, and sometimes we forget where we place objects. The difference between aging and having dementia is the problem gets worse and worse over time, and it becomes severe enough it impacts one’s ability to take care of themselves.
If you have thinking and memory problems that are really severe, then it’s very likely that you are struggling with some kind of brain disorder, possibly dementia. Diagnosis depends on meeting with a physician who has expertise in recognizing dementia and who can administer the rights tests to look for conditions that mimic dementia or that cause dementia but are not Alzheimer’s disease.
What are some red flags for Alzheimer’s disease?
One of the first things family members often notice is the individual affected starts to repeat themselves. They tell the same story twice in a short period of time. They may not remember details from the conversation you just had with them. Often, these individuals will be frustrated because they genuinely don’t remember, and they think that you are wrong when you remind them that they just said something. Those are common features of important memory problems that need to be paid attention to.
How common is early-onset Alzheimer’s?
It’s relatively uncommon. Just about 1 in 20 patients with Alzheimer’s disease will develop the symptoms of the disease before age 60. Oftentimes those cases are associated with a genetic disposition. We are learning more and more about the types of genes that are involved in early-onset disease, and it’s very likely that understanding will lead to new and revolutionary treatments that might actually lead to the cure. People with early-onset Alzheimer's disease are very strongly encouraged to look into clinical trials so that we can learn more about how the disease progresses and hopefully find a cure soon enough to help some of these patients.
If dementia is progressive, what can people expect if a loved one is diagnosed with early-onset Alzheimer’s?
All of the diseases that cause dementia are what we call neurodegenerative diseases. That means that they get gradually worse over time. The rate at which they get worse depends on the specific disease. So, for example, in the case of Alzheimer’s, the course of the disease is typically between 5 and 15 years from the time of diagnosis.
There are other diseases that are not as common as Alzheimer’s, but they are much more severe with the rate of degeneration happening over just 3 to 5 years from diagnosis.
As of today, there is no cure for Alzheimer’s. However, there are medications that have been shown to significantly slow its rate of progression. So if we recognize the disease early and start these treatments, sometimes we can help people maintain their level of function for the first few years after diagnosis. Ultimately, they will develop the same end stages of Alzheimer’s disease, but we can extend the time that they will be able to stay at home and with their families. And when you are talking about the last 5 to 10 years of a person’s life, spending more than half of that time at home and less time in a nursing home, that is a really positive thing.
We really encourage people to seek expert help early on if you are concerned. It’s appropriate to start treatment as early as possible.
WATCH: Channel 13's Brady Gillum spoke with Neurologist David Wheeler, M.D., for this story about a caregiver of an Alzheimer's patient.
How does Alzheimer’s affect caregivers?
As a doctor, anytime I’m involved in the care of a person with dementia, it’s always true that I’m also helping to take care of the family and the loved ones. A big part of my job is to help people have confidence that we’ve identified the right disease. Dementia is a terminal illness. Everybody dies from it eventually. Making the diagnosis is a big deal; It needs to be done correctly, and the family needs to have confidence that it was done correctly.
Helping people understand what to expect as the weeks, months and years begin to unfold, and giving them insight into how behaviors might change, is also very important. One thing that is really common in patients with Alzheimer’s is they can become really short tempered. It can be common for them to take their anger out on the people they are closest to. That is very upsetting for a family, and it makes it hard to care for somebody who you love with all your heart but who is being mean to you on a regular basis.
I work closely with experts at Wyoming Dementia Care who can provide counseling and support group services to caregivers and families. They can provide insight into why patients behave the way they do and identify coping mechanisms. Another big part of my job is connecting families and patients with the right kinds of resources available in our community.
What are some of the services that Wyoming Dementia Care provides?
Two wonderful services offered by Wyoming Dementia Care are recreational art and music programs with great therapeutic benefits. These allow the person struggling with dementia to express themselves using different parts of their brain than speech or other forms of communication. Our Music and Memory program is personalized for people with dementia to help combat memory loss and a restore a sense of self to those suffering from it. This allows people to express emotions they might have trouble expressing. In some dementia patients, the parts of the brain that process art and music are more intact than those used for speech.
Contact Wyoming Dementia Care
David B. Wheeler, M.D., Ph.D, is board certified in neurology and clinical neurophysiology. He is a Rhodes Scholar and was the 2010 Wyoming Medical Center Physician of the Year. He serves on the boards for Wyoming Medical Center, Wyoming Dementia Care and the American Heart Association (Southwest Affiliate.) He practices at Wyoming Neurologic Associates, 1020 E. Second St., Suite 100 in Casper. For a referral or an appointment, call (855) 39-BRAIN.