Midwest Mary

When my husband Marshall was experiencing dementia symptoms, diagnosis and treatment was minimal. We had no definitive way to diagnose Alzheimer’s disease until after death through autopsy. Nor did we have means to slow down the progression of the disease. Fortunately, now there is improvement on both points.

According to documentation by the Alzheimer’s Association, an estimated 7.4 million Americans age 65 and older are living with Alzheimer’s disease and other dementias. There also is an estimated 110 of every 100,00 people aged 30 to 64 with younger-onset dementia. I’ve met some of these young people, and it is heartbreaking to see those who have just begun careers and raising families with cognitive decline.

Dementia is considered a syndrome identified by a group of symptoms including memory loss, difficulty with concentration and ability to express thoughts, confusion, struggles with problem-solving, poor judgement, depression, and impulsive behavior. Physical disturbances including walking, speaking, and swallowing typically occur in later stages. There are many types of dementias, perhaps hundreds, that present variations of dementia symptoms, and these specific types are labeled diseases.

Alzheimer’s disease is the most common type of dementia. The majority of people with dementia have additional dementias, as well, in addition to diseases, such as diabetes and hypertension, which makes the need for individualized treatment imperative and often challenging.

Biomarkers are biological markers that can measure the process of an illness, such as Alzheimer’s disease, years prior to symptoms appearing. For example, abnormal levels of beta-amyloid and tau, increased levels of the neurofilament light chain protein, or decreased glucose metabolism may be detected, all of which are more likely to lead to dementia.

Dementia is irreversible. Once brain cells and neural networks are destroyed, they cannot be replaced. This is partly why a cure is unlikely at this point. By the time we are aware of the presence of disease, much destruction has already occured.

Testing, on biomarkers, such as through blood draws, is a recent and important discovery. When testing is done before the onset of symptoms or in its early stages, newly approved treatments have a greater chance of temporarily slowing the cognitive and functional progression of the disease.

Several FDA-approved treatments for Alzheimer’s disease are available. Two drugs change the underlying biology of Alzheimer’s and may slow cognitive and functional decline. The remaining address the symptoms. However, as with all prescription medications, there are side-effects and risks to be considered.

The increasing number of people with Alzheimer’s and other dementias presents a tremendous challenge throughout the world. Every individual with dementia eventually requires 3-5 round-the-clock caregivers. At this time, the Alzheimer’s Association’s statistics state that more than 13 million Americans currently provide unpaid care for a family member or friend with dementia, and nearly 800,000 additional direct care workers are needed in assisted living homes. Our aging society will progressively find it more and more difficult to provide the necessary amount of caregivers.

Prevention measures are imperative. We all can do our best to care for our own health through daily cardiovascular activities such as walking; maintaining a diet that centers on whole grains, fruits, nuts, and vegetables; remaining social; controlling other diseases such as diabetes and hypertension to the best of our ability; engaging in mentally stimulating activities such as reading, playing games, and solving puzzles; and addressing hearing loss, all of which are believed to reduce the risk of dementia.

For more credible information on dementia and caregiving for people with Alzheimer’s, see the Alzheimer’s Association website and read Navigating Alzheimer’s, The Alzheimer’s Wife, and Inspired Caregiving.

©Mary K. Doyle, 2026