Averting Dementia of the Alzheimer's Type in Women: Can Counselors Help?.

Alzheimer's disease (AD) is the most common cause of dementia in late life, taking its greatest toll on women over age 80. This article provides an overview of AD, including risk factors and counseling strategies targeting risk. Counseling strategies address stress, cardiovascular health, social integration, depression, and holistic wellness. ********** The life experiences of women, their educational and vocational opportunities, their access to health care, medications, and disease exposures may affect their risks of Alzheimer's Disease in ways that current research is only beginning to comprehend. --Lerner, 1999, p. 1831 Among the many challenges encountered in late life, a diagnosis of dementia is particularly devastating. Not only does the diagnosis represent a personal tragedy for those with dementia, it portends a harrowing experience for families and other caregivers. One of the best known forms of dementia, dementia of the Alzheimer's type (DAT), is a disorder that, as its name indicates, is an outcome of the Alzheimer's disease (AD) process. As is the case for all dementias, DAT presents affected individuals with an array of cognitive deficits and emotional struggles. Unlike most other forms of dementia, however, the impact of DAT is greater on women than it is on men (Baum, 2005). Although DAT remains an incurable, dreaded disorder, contemporary research in the biomedical sciences suggests that there is some hope that the disease can be averted. There are, in fact, a host of strategies, many falling within the purview of counseling practice, which may be able to alter the progression of the AD process. This article explores the role of counseling in averting the devastating effects of DAT, giving particular attention to how counselors can help women in the fight against AD. It begins with an overview of the statistics, symptoms, etiology, pathology, and risk factors related to the disorder. Strategies for controlling the symptoms of DAT are then considered and are followed by a discussion of how counselors are uniquely positioned to assist in initiatives targeting control of women's brain health in late life. Finally, the role of holistic wellness counseling as a lifelong prevention strategy is considered. AN OVERVIEW OF DAT Statistics Data provided by the Alzheimer's Association (2006a) on late-onset AD indicate that the disorder doubles every 5 years in individuals over 65 years of age and that "by age 85, the risk reaches nearly 50 percent" (p. 1). Late-onset AD is the most common form of the disorder and by definition includes cases that begin after age 65. The incidence of AD developing before age 65, a form of the disease termed early onset, is more rare, tends to run in families, and accounts for less than 5% of all AD cases (Alzheimer's Disease Education and Referral Center, 2004). A report commissioned by the Alzheimer's Association estimates that AD costs businesses in the United States $61 billion per year. This figure includes $36.5 billion to cover productivity loss, absenteeism, and worker replacement for caregivers and $24.6 billion to provide health care to AD patients (Kopel, as cited in Alzheimer's Association, 2006b). The estimated average lifetime cost to care for an individual with AD ranges from $200,000 to $400,000 (Shankle & Amen, 2004). The Symptoms of DAT The Diagnostic and Statistical Manual of Mental Disorder (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) states that "the essential feature of a dementia is the development of multiple cognitive deficits that include memory impairment and at least one of the following cognitive disturbances: aphasia, apraxia, agnosia, or a disturbance in executive functioning" (p. 147). To meet the criteria for a diagnosis of dementia, cognitive deficits must be severe enough to cause problems in occupational or social activities and "must represent a decline from a previous level of functioning" (p. …