© 2017, GENASSIST, Inc.     

By Keith S. Wexler, MBA, Maternal Fetal Medicine, Prenatal Diagnosis and Biotech/Life Sciences Consultant, GENASSIST, Inc.

Paul Wexler, M.D., F.A.C.O.G., Medical Director, GENASSIST, Inc.

Clinical Professor, Department of OB/GYN, University of Colorado Health Sciences Center

Clinical Professor, Division of Genetics/Dept. of Pediatrics, Univ. of Colorado/The Children’s Hospital

Background: We received a call from a patient who was extremely upset because her father (diagnosed with dementia – there are at least 10 types – *see chart below) who was in a single room in an Assisted Living facility, was immediately being moved to a double room in the more secure totally Assisted Living quarters because he had wandered off. This was the first time he had wandered off.

The Assisted Living Program gave our patient who lives in a different state from her father three hours to get his affairs in order before they moved him since her father had placed the Assisted Living Program and the entire staff at risk.

The patient, who works with cancer patients including end of life and hospice was unable to get back to the Director of the Assisted Living Program before her dad was moved. She left a message for the Director telling him that she would pay for a live in nurse to keep her dad in his private quarters while they sorted out her father’s move. 

Our patient was also told by the head nurse that a single room was available for her dad to move into in the Totally Assisted Living but the Director gave his room to another tenant before listening to her message or returning her phone call.

The staff packed up all of her father’s belongings, put them in boxes and moved him to his new room with a new roommate without explanation. When our patient did finally reach the Assisted Living Director and listened to her concern about her father being upset and confused, the Director casually implied over the phone that since her father had Dementia he would not remember when or why he was moved. 

The Assisted Living personnel treated this problem as an “emergency” not allowing the family to help their father peacefully transition into the new living situation.

She kept asking herself – “Have We Lost All of Our Compassion for the Aging? Did it really need to be handled in this way?”

Dementia: A chronic or persistent disorder of the mental processes caused by brain disease or injury or marked by memory disorder, personality change or impaired reasoning.

  • Cortex: The outer layer of the cerebral cortex composed of folded gray matter
  • Subcortex: Tissue lying immediately below the cortex

Types of Dementia:

  • Cortical Dementia: Alzheimer’s, Creutzfeldt-Jakob Disease, Frontotemporal Dementia, Wernicke-Korsakoff Syndrome [alcohol, Vitamin B1 (thiamine) deficiency, AIDS (Acquired Immune Deficiency Syndrome), excessive dieting, severe vomiting, infection, starvation, dialysis and cancer].
  • Subcortical Dementia: Huntington’s Disease Parkinson’s Disease, Vascular Dementia

Incidence:

  • Approximately 1 in 14 after 65 years of age
  • Approximately 1 in 8 after 80 years of age

Many risk factors increase likelihood of Dementia:

  • Increasing age
  • High blood pressure
  • Stroke
  • Heart disease
  • Diabetes
  • High cholesterol
  • Smoking
  • Decreased exercise
  • Alcohol
  • Depression

*There are at least 10 “Patterns” of Dementia:

  • Alzheimer’s after age 65 years
  • Alzheimer’s (Early Onset)
  • Creutzfeldt-Jakob Disease
  • Down Syndrome
  • Fronto-Temporal Dementia
  • Huntington’s Disease
  • Lewy Body Dementia
  • Parkinson’s Disease
  • Vascular Dementia
  • Wernicke-Korsakoff Syndrome

Mutations in at least 25 genes have been implicated as having a role in the various types of dementia. The types of genes involved are often described as:

  • “Causative”,
  • “Susceptibility”
  • “Associated”
  • “Modifying”
  • “Protective”

The combination of roles for the various genes help to explain the variability in the onset, severity, ethnic, geographical and sexual differences, the risk to other family members and the risk to a specific individual of ever developing dementia or a specific type of dementia.