Regardless of awareness months and educational outreach promotions the fact that Alzheimer's disease is a terminal condition seems to be a difficult concept for the public to grasp.
The recent death of Tom Magliozzi, co-host of NPR's popular "Car Talk," has made headlines. Sadly, Magliozzi's death from the complications of Alzheimer's is a famous example of a common occurrence.
If you asked a friend or neighbor what they think are the most common causes of death in elderly people they'd probably list heart attack, stroke, cancer and pneumonia. Few would say Alzheimer's disease.
One reason for the lack of knowledge, according to Byron D. James, Ph.D. who is a researcher with the Rush Alzheimer's Disease Center, is that "Alzheimer's disease and other dementias are under-reported on death certificates and medical records."
Dr. James led a study for Rush University that was published in the March 5, 2014 print issue of Neurology, the medical journal of the American Academy of Neurology. The study shows that Alzheimer's disease may be an underlying cause of five to six times as many deaths as currently reported.
The Centers for Disease Control and Prevention (CDC) has long considered Alzheimer's disease the sixth leading cause of death in the United States. It's likely that cancer, heart disease and other ailments affecting the elderly are listed as for cause of death because death from Alzheimer's is more complicated to document.
According to Dr. James, attempting to identify a single cause of death does not always capture the reality of the process of dying for most elderly people since multiple health issues often contribute to the death. Yet Dr. James feels that the issue is serious enough to conduct a study that demonstrates the fact that Alzheimer's needs to be considered a cause of death far more often than currently thought.
What complications of Alzheimer's disease contribute to death?
Swallowing becomes a problem with nearly everyone who has Alzheimer's disease. Problems swallowing contribute to death frequently because when a person chokes the chance that he or she will aspirate (inhale) fluid into the lungs are increased. This aspiration can then cause pneumonia.
According to the National Institutes for Health, infections are another common complication for people with Alzheimer's. Urinary tract infections are common and many occur with few identifiable symptoms. The person with the disease is generally unable to self-report symptoms, so the infection can go unnoticed until it becomes a life-threatening condition.
Bed sores from not being able to move enough are another source of infection, as are common germs brought in by visitors, caregivers or facility staff. When someone is advancing into later stages of Alzheimer's, his or her immune system becomes less effective, therefore the chance of infection from common germs becomes greater.
Eventually, a person will die from Alzheimer's disease regardless of complications. The timeframe from the appearance of symptoms to death can be anywhere between two to 20 years however four to eight years is a more common span of time. As Alzheimer's worsens, the organs of the affected person begin to lose function and the body will gradually shut down as it does from many other diseases.
Researchers like Dr. James continue to refine their knowledge of the causes of death from Alzheimer's hoping that the more that is known about the disease the more likely it is that there will be a chance to cure it.
During this month of November, which is National Alzheimer's Awareness Month, more attention will be paid to studies such as those done at Rush University. However, Alzheimer's awareness needs to be a year-around goal if we are to find a way to prevent or cure this cruel disease.
James, B.J. (2014, March 6) Alzheimer's Disease a Much Larger Cause of Death Than Previously Recognized. Rush University. Retrieved from http://www.ehospice.com/usa/ArticleView/tabid/10708/ArticleId/9365/language/en-GB/View.aspx
National Institutes of Health. Causes of death associated with Alzheimer disease: variation by level of cognitive impairment before death. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8014346