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This incurable disease affects mainly people over 65 years of age and is characterized clinically by a persistent and progressive decline in cognitive ability, and most commonly in memory loss, confusion, irritability violent and changing behaviour, language problems; pathologically by neuronal loss in select brain regions, neurofibrillary tangles and senile plaques.

IMAGE SOURCE: http://www.alzheimer.ca/english/alzheimer_brain_mini_site/09.htm

About the aetiology of AD, the primary hypothesis is that accumulation of amyloid-β (Aβ) peptide, a product of amyloid precursor protein (APP) processing, is the causative constituent of AD pathogenesis. The accumulation of proteins is cause of alterations related to reactive processes and losses of neurons.

IMAGE SOURCE: http://www.nature.com/nature/journal/v423/n6938/fig_tab/423392a_F1.html

Extracellular Ab accumulation occurs in the parenchyma as diffuse, focal or stellate deposits. It may involve the vessel walls of arteries, veins and capillaries.

A variety of clinico-pathological kinds of Alzheimer disease have been reported, according to the type of the lesions (plaque only and tangle predominant), the type of onset (focal onset), the cause (genetic or sporadic) and the associated lesions bodies, vascular lesions, hippocampal sclerosis, inclusions and argyrophilic grain disease).

                My mother went for years without speaking to my current husband because he once, twenty years ago, cussed in her house. There are blessings to memory loss. She now likes him. She laughs and jokes with him. I am still working, but he is home most of the day with her and does a lot of the cooking. She thinks he is a great cook. So after twenty years of a strained relationship, she can’t remember that she doesn’t like him.  I think it is hilarious.

                Yes, losing one’s memory is sad, but there is always a funny side to anything in life if you just look for it. My mother always said she hated chicken and would not eat it; she now eats chicken that my husband cooks, and enjoys it.  Can you see the irony? She is eating a food she hated cooked by a man she would not speak to for twenty years and is enjoying it. Life is funny.

                My mother sits all day long in her recliner in my living room surrounded by her chocolate bars, tic tac, Chap Stick, tissues, crossword books and the daily newspaper. She still insists she can live alone without any help from me or my sister, but doesn’t lift a finger to do anything. She then complains that she is getting stiff and can’t walk because she isn’t getting enough exercise. If I tell her to get up and take care of herself, she quickly changes the subject.

                She can’t remember the last time she ate or what she had to eat, but she will argue the point that she is perfectly capable of living alone. She needs help getting up and down stairs, opening a can of soda or a can of soup, but is upset that we got rid of her car. I offered her my car keys and told her to go where ever she wants to go, but she just laughed at the situation.

                She still knows all of us, thanks goodness, but I am dreading the day when she looks at me and wonders who I am. My sister is an avoidance freak, this is why after all the years of being the favorite, I am now the one taking care of momma. She could not face watching her condition deteriorate each month or even be the one to find her past away.

                As a nurse practitioner, I have counseled many families taking care of loved ones with ALZ. It never gets easier. There is a great book entitled The 36 Hour Day by Nancy L. Mace, M.A., and Peter V. Rabin, M. D., M.P.H. It is an excellent guide for families caring for persons with Alzheimer, or related dementing illnesses and memory loss in later life. I highly recommend it for all of us with aging parents.

                No matter what state of decline your loved one is in, there is still a person lost somewhere inside the physical shell.  We don’t understand this disease so I will offer my own personal theory. I believe the mind of the person has moved on to another dimension and is waiting for their body to join them. This would account for all the frustration, aggression and confusion we see in these patients. Someday soon I hope we will understand this separation of the mind and body and be able to reconnect the two parts into a whole person again. Until such a time only prayer, patience and perseverance will help.