We had a chance to zoom interview Dr. Worawan Rattanasamphan, M.D., the Geriatric Medicine Doctor at Overlake Medical Center – Senior Health Clinic in Bellevue, Washington to learn about typical care and treatment of Alzheimer’s. The summary of our interview is below.
Tara: Thank you for this opportunity to share the knowledges about basic knowledge about Alzheimer’s that will benefit teens or young generations like us. First of all, could you explain what a geriatrician does and why you choose to be a geriatric doctor?
Dr. Rattanasamphan: Geriatricians are specialist doctors in internal medicine who are trained to treat the older patients. A geriatrician needs to understand the illnesses that are common in older people and provide the care and treatment on overall health of these elderly patients. I decided to become a geriatrician because I felt I could make a difference in patients’ life. It can be personal sometimes, since you have to be in partnership with their children or relatives in which you become part of their life.
Tara: How would you advise about the lifestyles that could prevent Alzheimer’s disease?
Dr. Rattanasamphan: Promoting healthy lifestyle is the key to avoid the need for hospitalization. Elderly patients experience more uncomfortableness and risks, when become hospitalized. We encourage the healthy habits in their nutrition, exercising, and stress management.
Hana: We researched and found that the number of people with Alzheimer’s disease has increased over the past years. Have you experienced an increase in the number of patients with this disease?
Dr. Rattanasamphan: I think the number of Alzheimer’s patients are not increasing but they become more recognizable. There has been an increase in public awareness of how this disease could become devastating to the families of losing the loved ones gradually. Impacts of Alzheimer’s are significant in both social economics and people psychology. Currently, there is no effective medical cure or treatment. The primary focuses are on prevention and providing cares with the Alzheimer’s patients.
Hana: What would you advise to people to prevent or slow down the risk of Alzheimer’s disease?
Dr. Rattanasamphan: When people or their families suspect to have this disease due to changing of behaviors, I would advise them to seek the diagnosis first. Then we can identify their risk factors such as diabetes, vascular heart issues, high blood pressure, or high cholesterol. These factors can become an issue with the blood flow and accelerate the Alzheimer’s symptom. Treatment of these factors, along with heathy diets, exercise, and social interaction, could slow down the symptoms of Alzheimer’s.
Tara: Does the patients’ social economic class play a role in Alzheimer’s disease?
Dr. Rattanasamphan: From my experiences, the disease occurs in people across races and social economic. However, caring for these patients requires extensive resources including nursing, home health services, social workers, physical/occupational/speech therapists, which could become an issue for those, who do not have an access to these resources.
Hana: What are the early symptoms you often see in patients with Alzheimer’s disease?
Dr. Rattanasamphan: The common signs of this disease include change in personality, forgetfulness, lose in ability to perform daily tasks. Frequently these behaviors are brought up by their spouses or family members rather than the patients themselves.
Hana: How does Alzheimer’s affect the family of the patients? What do you usually recommend the caretakers such as the patient’s spouse, children, or close relatives, to do?
Dr. Rattanasamphan: It becomes challenging for families of the Alzheimer’s patients. They have dual roles as a spouse or child and the caretaker. As you can imagine, there could be a conflict when children become caretakers who have authority over their parents for providing the care or making decision over their health. People now become aware of the need to support these family members, and the services such as counseling or support group become more available for these families.
Hana: What is the difference between dementia and Alzheimer’s disease?
Dr. Rattanasamphan: Alzheimer’s a subset of dementia. Dementia is a general broad term of irreversible declining in cognitive of brain functions such as memory loss, personality changes, neurological abnormality. Dementia affects patient the ability to maintain daily living like changing clothes in which he/she needs to seek help from other people on simple tasks.
Alzheimer’s is a type of dementia. It is believed to be caused by a change in brain cells by having plaques that are built up in brain cells, which result in memory loss. Alzheimer’s can be linked to genetic or certain lifestyles. It also links to brain injuries or cardiovascular risk factors, especially when diabetes or high blood pressure are not well controlled. The difference can be identified by brain autopsy when you can see the build-up plaques that could contribute to Alzheimer’s disease.
Hana: From your experiences, have you seen more women or men with Alzheimer’s?
Dr. Rattanasamphan: I don’t see gender as a factor. It can occur to both genders.
Hana: So when diagnose a patient for Alzheimer’s disease, do you need to refer them to a neurologist and what role of the neurologist?
Dr. Rattanasamphan: It depends, not all the cases. Usually geriatricians or internal medicine doctors are trained to perform the diagnosis for Alzheimer’s. However, for cases with unique symptoms, we would seek a consultation from the neurologist or neuropsychiatrist to help on the testing.
Hana: For those Alzheimer’s patients who are still working or having a career, how would you advise them so they can continue keep up with their jobs?
Dr. Rattanasamphan: Alzheimer’s patients most of the times are retired from their works, so keeping up with work typically is not an issue. For some who are still working, they should participate in social activities such as volunteering in the community. It would benefit them greatly to performing some daily tasks.
Tara: Are there FDA-approved medicine that can be effective to slow down the symptoms of Alzheimer’s disease?
Dr. Rattanasamphan: Unfortunately, there are no effective Alzheimer’s medicine at the current stage. Some patients may take some medication to slow down the declining conditions, but these medications do not seem to make much difference. The social supports are probably more effective such as social interaction, meeting with other people, or playing games.
Tara: Do you have any advice for people who have genetic linked to Alzheimer’s?
Dr. Rattanasamphan: Some people who have family members with Alzheimer’s may have a higher risk of developing the disease, but it does not mean they will have the disease. The unhealthy life styles play more role in developing the Alzheimer’s disease.
Hana: I read that learning new things could help preventing the Alzheimer’s by creating new synapses in the brain. Could you explain more about this?
Dr. Rattanasamphan: Absolutely, learning new things such as playing games, puzzles, or learning music would benefit greatly on Alzheimer’s symptoms. These activities now become part of the care management to slow down the declining of the patients’ conditions.
Hana: Do people who smoke or drinking alcohols heavily have affect their chance of having Alzheimer’s?
Dr. Rattanasamphan: That is correct. Any damages to brain or heart would contribute to the risk of Alzheimer’s. Smoking can cause a risk of cancers, heart diseases, and Alzheimer’s. Overconsumption of alcohols can have an effect on brain, memory, and balance. Patients with Alzheimer’s would be first advised to quit smoking and drinking.
Hana: About using music to help Alzheimer’s patients, do you have any suggestion on what kind of music should be used for this therapy?
Dr. Rattanasamphan: We recommend to the patient family to involve the patients in the music as it could be helpful. The music that patients love or had listened in the past certainly has an impact on their memories. There is a documentary called Alive Inside, which I recommend you to watch. It confirms the impact of music to improve the memory loss.
Tara : We observed that when we played 19’s century, old folk, or hymn songs at the Alzheimer’s nursing home, the audiences seem to really enjoy it more than when we played the classical pieces that are not in their time.
Hana: It’s very interesting that they some audiences can sing along to certain songs or remember the songs that we played last time.
Dr. Rattanasamphan: That is very lovely project that you do and I believe your music is helping them. Keep up the good work and good luck.