Human brainAccording to the Alzheimer’s Association, as of 2015, Alzheimer’s disease is the only top 10 cause of death in America that cannot be prevented, slowed, or cured. It is the 6th leading cause of death in the United States. The Alzheimer’s Association reports that 1 in 3 seniors will die with Alzheimer’s or another form of dementia.

These shocking statistics show how serious dementia and Alzheimer’s are and why these illnesses should be a concern for the elderly and their family members, as well as attorneys and anyone dealing with seniors.

There is even extra cause for concern because those with dementia are sometimes the victims of abuse, neglect or financial exploitation.  And, those conditions often leave the senior susceptible to manipulation and undue influence in property transfers and the preparation of their trust, last will and testament or other estate planning documents.  Indeed, the probate, trust and estate disputes that we handle in Arizona routinely involve individuals with dementia or Alzheimer’s disease.

So, we will address some key questions in this article: How will dementia or Alzheimer’s disease affect my loved one? What warning signs can I look for? Are there treatments available?  How do these conditions lead to probate, trust and estate litigation, based upon our experience in Arizona.

Key Statistics

Current statistics show that approximately 5.3 million Americans suffer from Alzheimer’s disease. The majority of those afflicted are age 65 and older.  A small percentage are individuals under the age of 65 who are afflicted with younger-onset Alzheimer’s. Two-thirds of people with Alzheimer’s are women.

The Alzheimer’s Association projects that, by 2025, the number of Americans with Alzheimer’s disease will rise to an estimated 7.1 million. By 2050, the figure could be as high as almost 14 million, assuming there are no medical breakthroughs to prevent or cure the disease.

An estimated 700,000 Americans with Alzheimer’s will die in 2015. In Arizona, this disease was the 5th leading cause of death in 2012 and the state has the 7th highest Alzheimer’s death rate in America. With such high instances of Alzheimer’s in Arizona, it is important for caregivers and family members to become educated and look for warning signs that may indicate a loved one has dementia or Alzheimer’s.  Read more facts and figures about Alzheimer’s disease.

What is Alzheimer’s?

Alzheimer’s disease is the most common form of dementia.  Dementia is a general term for memory loss and loss of other intellectual abilities that interfere with daily life, such as thought, memory and language.  Alzheimer’s disease typically affects the elderly.  Increasing age is the greatest known risk factor. This disease gradually worsens over time.

There is no cure for Alzheimer’s.  Scientists have yet to discover a way to prevent or even slow the disease, although there are some methods to attempt to mitigate the symptoms. Individuals with Alzheimer’s typically live an average of eight years after their symptoms become noticeable to others, but may live up to 20 years, depending upon age and other health conditions, according to the Alzheimer’s Association.

The cause of Alzheimer’s is unknown, though several factors seem to play a role in the development of the disease. These factors include lifestyle, genetics, diet and cardiovascular health.

Alzheimer’s disease appears to present as an abnormal buildup of two proteins in the brain. The first protein, beta-amyloid, forms clumps of plaque in and around brain neurons while the second protein, tau, creates tangles that choke the neurons.  This disease can have devastating effects, such as the progressive loss of memory and thinking skills. For more information about Alzheimer’s disease, visit the Alzheimer’s Association.

Warning Signs of Alzheimer’s

Alzheimer’s disease has 10 distinct warning signs and symptoms that most individuals may experience in different degrees. The Alzheimer’s Association lists these 10 warning signs in full detail.  In short, the warning signs include:

  • Memory loss that disrupts daily life
  • Challenges in planning or solving problems
  • Difficulty completing familiar tasks at home, at work or at leisure
  • Confusion with time or place
  • Trouble understanding visual images and spatial relationships
  • New problems with words in speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment
  • Withdrawal from work or social activities
  • Changes in mood and personality

What should you do if you notice these symptoms in yourself or a loved one?  Don’t ignore them. Schedule an appointment with a physician. Early detection allows you or a loved one to receive maximum benefits from available treatments. Early detection also gives more time to plan for the future, whether decisions need to be made about care, transportation or living options or if legal and financial matters, such as estate planning, need to be addressed.

Diagnosis and Treatments

Alzheimer’s disease cannot be diagnosed through any one single test. Physicians must carefully evaluate patients who may have Alzheimer’s by conducting a thorough medical history, mental status testing, physical and neurological examinations and other tests, such as blood tests and brain imaging. The Alzheimer’s Association recommends visiting with a specialist, such as a neurologist, psychiatrist or psychologist in order to receive an accurate diagnosis.

Several treatment options are available, but currently Alzheimer’s cannot be cured, prevented or slowed through the use of these treatments. To address the symptoms, two types of medications are available: cholinesterase inhibitors (Aricept, Exelon, Razadyne) and memantine (Namenda). These medications have been approved by the Food and Drug Administration to treat the cognitive symptoms of Alzheimer’s disease, such as memory loss and confusion.

Typically, cholinesterase inhibitors are used to treat cases of early to moderate stage Alzheimer’s and memantine is used to treat moderate to severe stages. Physicians may also prescribe Vitamin E to treat some symptoms of Alzheimer’s disease.

Aside from the symptoms of the disease, Alzheimer’s can also affect an individual’s behavior.  Common behavioral and personality changes include irritability, anxiety, depression, agitation, aggression and anger. If you or a loved one experiences any of these changes, consult a physician right away. These changes could also be the result of a drug side effect or other issue.

More information and tips about these changes can be found here.   You can also learn about alternative treatments discussed by the Alzheimer’s Association, but caution should be used when evaluating these treatments and determining if they are right for you or your loved one, as claims about the effectiveness of these treatments is based largely on testimonials.

Hope on the Horizon

Currently, the only drugs available for Alzheimer’s disease focus on treating the symptoms. However, researchers are working on determining the cause(s) of Alzheimer’s disease.  If that can be determined, new medications can be made to prevent the accumulation of the proteins or break down existing accumulations. Neurologists are now comparing the treatment of Alzheimer’s to the treatment of cancer in that different medications and treatments for different forms of the disease may be necessary.

Since Alzheimer’s is a growing concern for Americans, the government has created a program to assist with funding. The “National Plan to Address Alzheimer’s Disease” contributes funds toward research, testing and treatment.  That Plan was adopted in order to carry out the National Alzheimer’s Act (NAPA), which President Obama signed in to law in January 2011.  The National Plan’s number one goal is to develop a plan to prevent and effectively treat Alzheimer’s disease by 2025.  Hopefully, progress will be made in creating new medications that will target the causes of Alzheimer’s, in order to prevent or at least slow this progressive disease.

Advance Directives

As the title implies, advance directives are legal documents that allow a person to decide about end-of-life care before the care is necessary. These directives specify desired medical care and treatment should different situations arise.  Individuals with Alzheimer’s disease or dementia are able to create advance directives, but must do so at a time when they still have legal mental capacity, or the level of decision-making ability required to sign official documents and make these types of important decisions.

With such a large number of Americans suffering from Alzheimer’s, a new interest has formed in a type of advance directive called voluntarily stopping eating and drinking, or VSEDs. VSEDs are a way to quicken death for patients who suffer from terminal illnesses and are now being considered humane exit plans for individuals with late-stage Alzheimer’s (Jackson, L.J. “Directing Death.” ABA Journal June 2015: 12). So far, VSED requests for Alzheimer’s patients are uncommon and could prove to be problematic from a legal and practical perspective (Jackson, L.J. “Directing Death.” ABA Journal June 2015: 12). However, with the expected increase in the number of people being diagnosed with Alzheimer’s in the future, it is likely that VSEDs will become more popular in cases of late-stage Alzheimer’s. Like any other advance directive, VSEDs should carefully document an individual’s wishes.  Individuals should consult with a knowledgeable attorney before making these important decisions.

Dementia or Alzheimer’s Disease and Arizona Probate, Trust or Elder Litigation

In light of the prevalence and effects of dementia and Alzheimer’s disease it is easy to see how those conditions are often involved in probate, trust and estate disputes.  Indeed, our Arizona probate attorneys regularly handle probate and trust matters that involve questions over the validity of an estate plan because the person had dementia or some other mental disorder.  For example, a person who lacks testamentary capacity may not adopt a valid will and a will that is the product of undue influence may be set aside.  Similarly, our elder law attorneys regularly investigate allegations of financial exploitation, abuse or neglect of vulnerable or incapacitated adults in Arizona.

Help is Available

If you have questions regarding the validity of a will or trust or believe that your senior loved one has been financially exploited, abused or neglected in Arizona, we are here to help.  Please do not hesitate to give us a call or send us an email to schedule a consultation.

Photo credit Fred Hossler/Getty Images via National Geographic