This June, Alzheimer's and Brain Awareness Month is bringing attention to the need for more education, support, and research for Alzheimer's disease (AD), which affects an estimated 5.2 million people across the country. At least 44 million people worldwide are living with dementia, and that figure is expected to grow to 76 million by 2030, according to a 2014 report from the Alzheimer's Association. Alzheimer's disease is a devastating progressive condition that causes those affected to lose their memory and reasoning skills and threatens their ability to communicate, recognize family, and care for themselves.
Many adults with dementia and other neurologic conditions rely on help from unpaid caregivers, usually family members, other relatives, or friends. In 2013, more than 15 million such caregivers provided an estimated 17.7 billion hours of care to people with AD and other forms of dementia across the country, according to the Alzheimer's Association. They are our unsung heroes, providing around-the-clock care, or, if they're lucky, working in teams so they can continue to be employed in order to pay the bills. But that won't come as a surprise to many of you, our readers, who generously serve in these roles.
Family members who accompany patients to my office often remark that one of the most difficult aspects of caregiving is managing the behavioral changes that can occur in many brain diseases. These psychiatric manifestations can range from delusions and paranoia to depression, anxiety, and even hallucinations. It's tough enough to see someone you care about deteriorate physically, but it's even worse to watch that person go from being a loving, happy individual to being angry, anxious, or even hostile.
Particularly unsettling are the eruptions of anger and frustration that are not unusual among those diagnosed with dementia and so many other neurologic conditions, including Parkinson's disease, traumatic brain injury, multiple sclerosis, and stroke. It's often the closest person—the caregiver—who serves as the target of those attacks. Recent research suggests that medication, while sometimes helpful, may create even greater problems than it solves because of side effects such as sedation and worsened cognition.
In this issue of Neurology Now, we devote our For the Caregiver column to strategies that can assist you in defusing these emotional outbursts. We hope these strategies will help you de-escalate combative conversations and that you can add them to your arsenal of coping tips.
The Alzheimer's Association, which is sponsoring Alzheimer's and Brain Awareness Month, is asking for your help in honoring those struggling with this disease by mobilizing friends, families, neighbors, and others to bring an end to Alzheimer's. It has designated June 21st as "The Longest Day" in honor of that cause. To that end, I'd like to give a shout out to all the caregivers without whom the fight against neurologic illness would be much, much harder.
We hope this issue offers something of interest to each of you, and, as always, we welcome your suggestions for stories and look forward to hearing from you.
Orly Avitzur, MD, MBA, FAAN
Editor-in-Chief
