Megan is a sought-after national speaker on Alzheimer's. She is
also the Executive Director of Balfour Cherrywood Village, a memory
care and Alzheimer's secure facility, located in Louisville,
A Place for Mom is happy to have Megan as an expert so that she
can provide Alzheimer's insight and advise to individuals and
families suffering from the challenging disease.
Below are Megan's answers to some of the top questions we've
received about Alzheimer's disease...
Q: I have heard that all
dementia is not Alzheimer's. Is this true? If so, what's the
A: It is true there is a level of
confusion about the word dementia and how it is different from an
Alzheimer's diagnosis. Dementia is considered an umbrella term
under which specific types of diseases that alter cognitive
function fit. Over the last century and into present time,
researchers, scientists and physicians have been working to
understand the brain-and what changes when disease occurs. With
increasing technologies-especially in the area of scans and
imaging-we are able to see more deeply into what is changing in the
brain. We now understand there are many different types of
dementia. There have been other common terms in the past. Senility
was used when someone appeared confused and forgetful in their
elder years but this is now considered outdated as we know there is
damage occurring to the brain that aging alone does not
Dr. Alzheimer had a patient that was far too young to be having
symptoms of senility, but was clearly suffering a related
condition. This led him to follow the patient's progression, and
with permission, perform an autopsy after her death. He found three
distinct anomalies in her brain:
- An excessive atrophy or shrinkage of the size and volume of her
- A proliferation of a specific protein plague
- neural synapse fibers in tangles
In 1906, after a presentation of his findings at a medical
conference, Alzheimer's disease was given his name as he had
identified the unique conditions characteristic of this form of
Now to give a little history lesson on Alzheimer's disease after
the initial unveiling of the disease…While Alzheimer's disease has
been around since the turn of the last century, it wasn't until the
1970s that we started seeing an increase in the numbers of people
being diagnosed. This is because we finally had some less-invasive
ways to look at the brain with the advent of CT scans and MRIs.
Since these advances in technology we have seen a steady increase
in the numbers of people getting diagnosed with Alzheimer's. There
are a few reasons why we are seeing this:
- There is an age correlation to an increased vulnerability for
getting Alzheimer's. For example, when a person is 85 years old,
they have a 50 percent chance of getting Alzheimer's.
- We have a large number of people living longer and moving into
the vulnerable years, making diagnosis more likely. This large
group-who are on the cusp of reaching these senior years-are known
as The Baby Boomers.
- There is an increased awareness about Alzheimer's disease.
In 1980 the Alzheimer's Association was founded by
families who joined together to support each other and their loved
ones to raise awareness for further research; and to create
advocacy for those suffering from the disease. This has improved
the chances that people suffering from memory loss are more likely
to get checked by their physician.
We now understand that there are many different types of
dementia-and Alzheimer's is one of the types. Today, Alzheimer's
accounts for fifty to sixty percent of all dementia diagnoses.
There is a prediction that it will be reaching epidemic proportions
in the next 15 to 20 years, as baby boomers get older.
Unfortunately, there is no cure at this time-and it is a
progressive, debilitating disease. This prognosis concerns everyone
as it is both challenging for patient and caregiver. On a national
level, Alzheimer's presents an economic challenge. More for us to
ponder at another time…
Q: I've heard about
early-onset Alzheimer's. What does this mean?
A:Early-onset Alzheimer's occurs as
a diagnosis when someone is under the age of 65. This is still
considered rare and occurs in about five percent of all Alzheimer's
cases. It is difficult to get a proper diagnosis at times because
clinicians don't typically look for this disease when trying to
figure out what is causing problems for this younger individual.
Sometimes psychiatric approaches are attempted before a proper
diagnosis is reached. Symptoms can start occurring between the ages
of 45 to 55, in some cases. The youngest reported case of
Alzheimer's was 29 years of age. However this person had Downs
Syndrome, which can cause an increased risk for Alzheimer's
Researchers have been studying genetic correlations, by mapping
family histories for incidences of the disease; and have identified
specific genetic markers. Different chromosomes can trigger
different ages of onset. One family may have triggers for early
onset; whereas another family may have triggers in their mid-70s or
80s. Because Alzheimer's disease can occur repeatedly in a family
group, or only one individual may have it, there is still a lot of
research occurring to understand this more. Geneticists hope to one
day be able to create an inoculation. Because changes occur to the
brain prior to seeing outward symptoms, researchers would want the
inoculation given perhaps ten to twenty years before a family's
known age of onset. Therefore if a family was having early onset at
65, and if research could halt the triggers by inoculating at 45,
that would be their hope.
This does not resolve family situations right now,
unfortunately. This disease is challenging and early-onset can be
particularly devastating to the hopes and dreams one had for the
expected life plan. In some instances, the following problems can
- Wage earners are not ready for retirement.
- Jobs may have been lost due to poor performance prior to
understanding what was happening.
- Children may not be raised.
- Families may also be caring for parents in their senior
- Young individuals don't qualify for Medicare, causing financial
stress to families.
- Powers of attorney, wills and plans for end-of-life need to be
pulled together, if not already done so.
In this field, our clinical experience with this process is that
it tends to move faster for individuals who are diagnosed with
early-onset than their older counterparts. We do not know why this
is but recent research about brain plasticity and development of
new neural pathways may shed some light. For example, given an
extra thirty to forty years of life, with extra coping and
learning, there must be increased mapping in the brain. As a brain
is affected by this disease, the more neural pathways one has
developed through a lifetime, take longer to affect. And the more
options for compensation and alternative pathways can help someone
cope outwardly longer, even as the disease is progressing inside
Because of the typical health and vitality of the body in
younger years, early onset can be particularly stunning with
balance changes or functional changes occurring within days- rather
that than weeks and months. I have worked specifically with
dementia since 1989 and the hardest cases I have worked with by far
are early-onset situations. I do not mean to create a sense of
fear, but planning is key. Families need to talk about difficult
'what-ifs' to help everyone determine the most positive process and
plan properly-especially if early-onset is a genetic condition.
Early-onset Alzheimer's can be devastating, to say the least.
The Alzheimer's Association host early-onset support groups and
social activities for families working through the diagnosis, in
some areas of the country. Helping families find these supports is