• Spring Hatfield, RDH

Alzheimer's Disease Awareness Month


November is Alzheimer’s disease awareness month. Alzheimer’s disease is the most common cause of dementia. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. An estimated 5.7 million Americans of all ages have Alzheimer’s, 1 in 3 seniors die with Alzheimer’s or another form of dementia. Alzheimer’s disease was first discovered in 1906, by German psychiatrist and neuropathologist, Dr. Alois Alzheimer. Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior.

Barry Reisberg, M.D., Department of Psychiatry at the New York University Langone Medical center, developed a system that outlines key symptoms characterizing seven stages ranging from unimpaired function to very severe cognitive decline.

· Stage one symptoms: No impairment, normal function

· Stage two symptoms: Very mild cognitive decline, may be normal age-related changes or earliest signs of Alzheimer’s disease. Individuals may forget familiar words or names, or the location of everyday items, such as keys and eyeglasses.

· Stage three symptoms: Mild cognitive impairment, at this stage friends, family and co-workers begin to notice deficiencies. Common difficulties include problems remembering words or names, inability to remember names when introduced to new people, performance issues in social or work settings, decline in reading comprehension, losing or misplacing valuable objects, and decline in the ability to plan or organize.

· Stage four symptoms: Moderate cognitive impairment (mild or early-stage Alzheimer’s disease). At this stage, a medical interview can detect deficiencies. Symptoms include decreased knowledge of recent occasions or current events, impaired ability to perform mental arithmetic, decreased ability to perform complex tasks, such as paying bills and managing finances, reduced memory of personal history, and the individual may seem subdued or withdrawn.

· Stage five symptoms: Moderately severe cognitive impairment (moderate or mid-stage Alzheimer’s disease). At this stage assistance with day to day activities becomes essential. Symptoms include being unable to recall address and telephone number, becoming confused about date, time and location, trouble with simple mental arithmetic, need help choosing proper clothing for the season. At this stage individuals will still retain the ability to recognize close family members, and usually do not require assistance with eating or using the toilet.

· Stage six symptoms: Severe cognitive decline, memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. Symptoms include lose most awareness of recent experiences, recollect their personal experiences imperfectly, occasionally forget the names of spouse, children or primary caregiver, need help getting dressed, disruption of their normal wake/sleep cycle, need help handling details of toileting, increased episodes of incontinence, significant personality changes, and tend to wander and get lost.

· Stage seven symptoms: Very severe cognitive decline, this is the final stage of the disease. Symptoms include loss of the ability to respond to their environment, the ability to speak and ultimately, the ability to control movement, individuals will need help with eating and toileting, general incontinence, loss of ability to walk without assistance which will lead to loss of the ability to sit without support.

How can dental professionals help? There are so many ways, to start we should take notice of any cognitive changes. If you observe changes in behavior or homecare, discussing these changes with a spouse, child, family member or friend listed on their HIPAA release form may be crucial to assist in the patient's diagnosis. Don’t ignore obvious signs or changes in behavior. Treatment for Alzheimer’s disease is typically most effective when started early in the disease process.

When treating these patients, healthcare providers in dentistry need to be helpful and patient with these individuals and their caregivers. Treating patients with Alzheimer’s can be difficult, it is important to recognize they are not choosing to be difficult. I’m sure this disease is quite frustrating for the individual and the caregiver, having patience and being kind will help make the situation less stressful. In my early years in dentistry, as a dental assistant, I had a patient that had this terrible disease, he had a toothache, but was unable to articulate what he was feeling, or even which tooth was affected. Though it took several patient visits and a lot of frustration on his caregiver, together we were able to ascertain which tooth was the problem and treat it accordingly.

I’m certainly no expert on this subject, however I would like to introduce you to Sonya Dunbar, aka The Geriatric Tooth fairy, she spends her time treating these patients, and educating healthcare providers on the aging population. She has written a book “Golden Nuggets for Life” you can order from her website If you would like to learn more on this subject she is a wealth of knowledge and I would encourage you to check out her website and follow her on Facebook and Twitter.

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