The Epidemic

Photographed by: Max whatever


1 in 3 seniors die of Alzheimer’s or other form of dementia in United States alone. An estimated 5.5 million people are affected with the disease today. And more than half of them are unaware of their condition. An estimated 700,000 people are expected to have died of Alzheimer’s or other dementia in 2016. Alzheimer's is the sixth largest cause of death in the United States. Today, Alzheimer’s is the number one feared disease- Americans dread this disease more than they dread cancer. Because every 66 seconds, a new case of Alzheimer's is developed in the US, And by 2050, it would go up to every 33 seconds. 

Photographer Mark Edwards created a photo-series called 'Alzheimer's' after his mother June Edwards (photo) was diagnosed with Alzheimer's. Click here for more photographs in the series. 

What is Dementia and Alzheimer's?

Dementia is characterized by decline in one or more cognitive functions. It may affect memory (the ability to retrieve learned information), learning (the ability to form new memories), language (the ability to articulate or understand speech), problem-solving (the ability to analyze), orientation (the ability to understand the current situation). Alzheimer's is the most common cause of dementia. Alzheimer's is a neuro-degenerative disease, caused by progressive damage to nerve tissue in specific regions of the brain. The symptoms of Alzheimer's will depend on the affected region of the brain. As damage to neural tissues progress, some symptoms might become more pronounced and as other regions of the brain are affected new symptoms may occur. As a result, as the disease progresses, more functions will be impaired. In later stages of the disease, regions of the brain which are involved in the regulation of rudimentary functions (such as walking or swallowing) might get affected. So, in the final stage of the disease patients become bed-bound and succumbs to the disease. Alzheimer's disease is ultimately fatal.

Alzheimer's disease was first described more than 100 years ago by a German psychiatrist and neuropathologist named Alois Alzheimer. However, it was only 3 decades ago that Alzheimer's was recognized as the most common cause of dementia and a major cause of death. The deadly side of Alzheimer's came to light as medical health condition started improving across the globe and the average life expectancy started increasing. Although we have learned a lot about this deadly disease within last three decades, details of biological mechanisms that start degeneration of nerve tissues are yet to be known. The hope is that by knowing about cellular and molecular mechanisms of Alzheimer's we can develop ways to slow down, stop or prevent the disease.

An active field of research is dedicated in finding biomarkers that allow affordable and accurate diagnosis of the disease. Currently, the diagnosis is indirect and costly. The diagnosis process starts with behavioral examinations which test attention, control, language, orientation, memory, learning, reasoning and spatial cognition. Upon observation of impairment in one or more of these areas and ruling out some common causes of selective impairment of those functions Magnetic Resonance Imaging (MRI) of the brain or extraction of Cerebrospinal fluid (CSF) is recommended. MRI techniques allow identification of degeneration in brain regions or even deposits that can cause damage to brain tissues. Examination of CSF can help identify proteins that cause damage to neural tissues. But the whole process of diagnosis begins with cognitive assessments. Take the first step towards early Cognitive Assessment.

Subjective Memory Complaint (SMC)

Photography by: Margaret Sia
Subjective Memory Complaint or SMC is the self-reported perception of memory or cognition problems in older adults. As adults grow older, memory issues often become more frequent. However, either these lapses go unreported, out of pride, or it is relegated to age related memory decline. 

However, research has shown that seniors that complain about memory issues have a higher risk of progression to mild cognitive impairment and, eventually, Alzheimer's disease or other forms of dementia. Multiple studies have shown a direct relationship between SMC and actual cognitive decline, as well as an association with measures of personality and well-being. Now scientists are certain that SMC is a significant sign whose presence should not be simply ignored. 

SMC might or might not be present along measurable changes in cognitive decline. The mildest form of cognitive decline which can be registered through behavioral examinations such as standardized paper tests (e.g. MMSE, MoCA or SLUMS) is known as Mild Cognitive Impairment or MCI. MCI is a stage in which cognitive declined has reached to a measurable degree yet it has not reached to degree that makes the independent life impossible.

For people with SMC with no measurable cognitive impairment the change of developing Alzheimer's is significantly higher than people who do not have memory complaint. Yet, when cognitive decline reaches the a measurable degree the chance of developing Alzheimer's increases substantially. A cognitive impairment assessment can provide helpful indication towards decision making on further medical intervention. It is important to note that MCI is not equivalent to Alzheimer's or dementia. There are subjects with MCI that improve or retain their condition over a long period of time. However, when cognitive decline reaches to a measurable degree the risk is substantial enough to start probing whether Alzheimer's is actual cause of the decline. And since older adults with SMCs are at a higher risk of decline, it is not only wise but also necessary for them to take an early cognitive assessment to assess their mental health. Take the first step towards early Cognitive Assessment.

The Epidemic

Photography by: D. Durrich
Alzheimer's is an Epidemic. 700,000 people with Alzheimer's are expected to have died in US in 2016. California is likely to have recorded the highest number.

Over the next 20 years, the impact of Alzheimer's disease on the State of California and Los Angeles in particular will increase dramatically. Los Angeles has the highest elderly population in the country. This leading edge of baby boomer generation has placed an enormous demographic bulge on the city's future. Since the primary risk factor for Alzheimer's disease is older age, we can expect a substantial increase in the numbers of people who will be living with this disease. Between now and 2030 the number of elderly living with Alzheimer's will nearly double from 147000 to close to 300,000.

The situation is further imperiled by the fact that Los Angeles has the highest concentration of underserved and economically backward communities. In fact, Los Angeles is the poorest big city in the Unites States. In certain areas, there are less than 50 physicians per 100,000 people. Because of these harsh realities of Los Angeles, the city will witness some of the most dramatic growth in the number of individuals and families needing services and supports to deal with the realities of Alzheimer's disease.

Early detection remains the single largest challenge to avail of help for those who are affected. But access to medical facilities for a timely assessment by experts remains beyond the reach of most underserved elderlies in Los Angeles. It could be helpful to get an early cognitive assessment in order to take advantage of available low cost resources. An early assessment followed by a timely diagnosis can enable a patient to reach out for help to various nonprofits and social service providers to get proper care, medical help and help in assisted living. Take The First Step towards early Cognitive Assessment.

Unawareness

Photography by: Alex ten Napel
A new case of Alzheimer's develops every 66 seconds in the US; increasing to every 33 seconds by 2050. And yet more than half of them are unaware of their condition. 

Some changes in the ability to think are considered a normal part of the aging process. Most healthy older adults experience mild decline in some areas of cognition. These changes may occur in the areas of visual and verbal memory, visuospatial abilities, immediate memory or the ability to name objects. However, Dementia is not normal aging. It is characterized by multiple cognitive deficits with memory impairments as a frequent early symptom. But, because of the prevalent association between aging and cognitive impairment, these early signs go unreported or neglected. The complex and expensive diagnostic procedure to determine Alzheimer's or dementia is also a major contributing factor to this cycle of unawareness. But this has to change as the epidemic is growing exponentially. The rate of Alzheimer's disease is projected to be twice as much by the middle of the century. Alzheimer's Association projects 16 million people to be affected with the disease by 2050. Mind LA's fight is against this prevalence of 'unawareness' amongst the demographically high risk individuals. Read more about the power of knowing early.

An estimated 800,000 Americans with Alzheimer's are living alone.

15% of Americans affected by Alzheimer's live alone. Many of these people have no identified caregiver, a situation which puts them at greater risk of social isolation, poor self-care, sudden fall and other medical emergencies, wandering, malnutrition and a range of other issues. But support or not, living alone with a disease that gradually strips people of the ability to know when they need help brings special safety concerns, and loved ones on the sideline agonize over when to step in. Moreover, studies show patients who live alone have a greater risk of injuries, even accidental death, than patients who don't live alone. Too often, those are the people whose dementia is discovered in an emergency, such as when neighbors call police to check on a senior whom no one has seen in days. As the number of people to be affected by the disease is on the verge of explosion, it could be helpful to get an early cognitive assessment to prevent such unfortunate situations. An early assessment followed by a timely diagnosis can help a patient to plan in advance for proper care, medical help and assisted living. Take The First Step towards early Cognitive Assessment.

Early Onset

Photography by : Ian Trayner
Early onset Alzheimer's can develop in people as young as age 30.

It is a common perception that Alzheimer's is a disease associated with old age, but up to 5% of Americans (around 200,000) have been diagnosed with early-onset variety of Alzheimer's. The early onset Alzheimer's is usually detected in one's 40's or 50's, but can start to show symptoms as early as in one's 30s. While the cause of early onset is still unclear, genetic component could be a factor in some of these cases.
Since healthcare providers generally don't specifically look for Alzheimer's in younger people, getting an accurate assessment of early onset Alzheimer's can be a long and frustrating process. Symptoms may be incorrectly attributed to stress or there may be conflicting diagnoses from different health care professionals. People who have early onset Alzheimer's may be in any stage of dementia. The disease affects each person differently and symptoms may vary from person to person. An early cognitive assessment is critical for these demographic group. Take the first step towards early Cognitive Assessment.