Questions & Answers

It can be very difficult to speak openly with a beloved family member who is suffering from Alzheimer's disease. However, if this diagnosis has been confirmed by a doctor, then I feel you have a moral obligation to tell your husband. If you prefer not to be the bearer of bad news (or if you do not think he will believe what you say), either ask his doctor to speak to him or to be present when you talk to your husband. Your husband will have to come to terms with this in his own time and in his own way, and it will undoubtedly be difficult for him, but you can be there to provide him with plenty of patience, understanding, love and support. Our organization provides information that you can download and print, such as "Symptoms and Stages of Alzheimer's Disease," which details the progression of Alzheimer's and may be useful in talking with your husband. If you have not already done so, both you and your spouse may also want to consider joining an Alzheimer's support group in your community.

Please consult the patient’s physician and/or eye care specialist to determine if there are other glaucoma medications that could be tried to help reduce intraocular eye pressure.

You are right to be concerned about how a future move will affect your mother-in-law, as patients with advanced dementia sometimes become quite upset by radical change and never really adapt to their new environments. However, this is not to say that it cannot be done. Dementia patients often need to be moved from home to a facility or from one facility to another, and if the move is handled in a way to minimize stress, then it can be successful. It is impossible to predict how your mother-in-law will react should she become a widow, because it will truly depend on what her mental status is at that time.

My best advice is to sit down with the family – as many of them as possible – and discuss what is best for your mother-in-law. It is not uncommon for family members to be in denial over a loved one’s dementia diagnosis, but they will have to accept that this is fact and that there are hard decisions to be made. If you are to be the primary caregiver for your mother-in-law in the event of your father-in-law’s passing, then it may be warranted to consult with an attorney specializing in elderly issues regarding any legal documents you will require (such as a power of attorney, etc.) In the meantime, if your father-in-law is capable of providing adequate care for his wife and if she is happiest in her own home, then it should be fine to leave her where she is and deal with moving her later should the need arise.

As a health care provider for Alzheimer’s disease patients, you have a great deal of experience in being able to assess your father-in-law’s current abilities. Explain to his family that it is often better (both mentally and physically) for Alzheimer’s patients to be encouraged to do things for themselves as much as they are able. This gives them a sense of purpose and control over their lives, and may help to decrease the occurrence of depression or other negative behaviors. You can use brochures from our organization, such as "Symptoms and Stages of Alzheimer's Disease," which details the progression of Alzheimer's, as aids in discussing your father-in-law’s situation with his family.

Of course, you will all have to use common sense in determining when the time is right for you to step in and help him. For example, at some point it will be unsafe for him to drive, at which point he will have to be chauffeured by you or other family members. However, he should be encouraged to continue his daily grooming routine on his own (or with limited assistance), any small household chores, and daily physical activity for as long as possible.

The emerging field of nanotechnology offers promising new functional approaches to the development of molecular-size solutions to problems in medicine and engineering. In Alzheimer’s research, nanotechnology is being explored as a way to improve diagnostic and therapeutic techniques. For example, scientists have developed a bio-barcode assay that may help in the early diagnosis of Alzheimer’s disease, which would allow patients to seek treatment earlier. Nanotechnology applications may also aid in the treatment of Alzheimer’s disease, such as by providing protection to neurons against oxidative stress, stimulating neuronal growth and repair, and improving therapeutic drug delivery to the brain. However, it is impossible to say for certain whether nanotechnology research alone will eventually lead to an effective therapy for Alzheimer’s disease and an absolute cure for Alzheimer’s disease is still a long way off. More likely, advances in nanotechnology will be used in conjunction with other research techniques to improve existing diagnosis and treatment of Alzheimer’s disease.

In general, vitamin supplementation can be useful for helping to maintain proper nutrition in an Alzheimer's disease patient, particularly if they are unable to consume a wide range of foods. Vitamin B12 deficiency is actually quite common in the elderly and can cause symptoms of dementia. Overdoses of vitamin B12 are rare, and the vitamin can be safely taken daily. That being said, vitamin B12 works best when it is taken with folic acid (these are often found together in the same vitamin supplement). Also, it is best to give B12 supplements sublingually (i.e., drops given under the tongue) because they are better absorbed and may help to prevent a condition called pernicious anemia, which is basically an anemia caused by the inability to absorb vitamin B12 through the gastrointestinal tract.

There do not appear to be any drug contraindications between vitamin B12 and the most commonly-prescribed Alzheimer’s disease medications, such as Namenda or any of the cholinesterase inhibitors (Razadyne, Exelon, Aricept, or Cognex). However, as I do not know the exact medications your mother is taking, I have no way of knowing if something else may be problematic. It is important to talk with your mother’s physician before giving her any vitamin supplements because they may be contraindicated for certain medical conditions or may react negatively with other medications that are being taken.

Prior to the German psychiatrist Alois Alzheimer’s first description of the disorder in 1906, the disease was referred to as presenile dementia (or in the case of elderly individuals, senile dementia), or most commonly just dementia.

There are no studies in the scientific literature or in medical reports indicating that hearing loss contributes to the development of Alzheimer's disease. In fact, in a recent study conducted in China comparing the hearing capabilities of Alzheimer's disease patients and age-matched control subjects, no correlation was found between hearing ability and mental status. It is not uncommon to find both conditions together, however, as both are more common in aged individuals. Nevertheless, hearing loss is not routinely associated with early symptoms of Alzheimer’s disease.