Overcoming your Fear of Alzheimer's Disease

About Juliet Holt Klinger

Senior Director of Dementia Care

Juliet is a passionate advocate for people living with dementia and their families. She is deeply committed to improving the cultural acceptance of those with cognitive differences. As our gerontologist and Senior Director of Dementia Care, Juliet develops person-centered care and programming for Brookdale’s dementia care communities. But if you ask her, Juliet says she continues to learn every day from the true experts, those living with dementia and their care partners. Juliet believes we need to move beyond the concept of caregiving, which implies a one-sided relationship, and embrace the idea of care partnering. Care partnering is about relationships built on cooperation—a two-way street promoting person-centered care and mutual feelings of purpose, where the person living with dementia also plays a strong role in shaping their care and daily routine. We are here to partner, learn and grow with our residents and families to make aging a better experience. After volunteering in nursing homes in high school, Juliet knew she wanted to work with older adults. While working on her bachelor’s degree in social work at the University of Iowa, she completed an Aging Studies Certificate program, before there were formal gerontology programs available. At Iowa, Juliet also had the chance to study with pioneers in the field of dementia care, an opportunity that shaped her passion for caring for those living with dementia. Trained as a gerontologist, with a master’s degree from the University of Northern Colorado, Juliet joined Brookdale in 2004. She is a seasoned senior living executive with more than 30 years of experience designing and executing innovative Alzheimer's and dementia care programs and living environments in both assisted living and skilled settings.

Like many women my age, I spent my elementary school years fawning over David Cassidy—my Partridge Family lunchbox was a prized possession. His talents and songs are timeless, which makes the news of his dementia diagnoses even more heartbreaking.

Cassidy revealed his dementia diagnoses to People Magazine earlier this week. He was diagnosed with the progressive disease six months ago. The former teen idol is all too familiar with this disease – it struck both his mother and grandfather. After his mother lost her battle to the disease, he became an advocate for the Alzheimer’s Association and tirelessly raised funds for the organization.

When Cassidy discussed his diagnoses he said, “I was in denial, but a part of me always knew this was coming.”

Anxiety around Alzheimer’s can be especially keen for those whose blood relatives have been diagnosed with Alzheimer’s and who have heard that this puts them at higher risk. Cassidy himself is quoted as saying “I feared it would end up that way” when speaking about the death of his mother contributing to his own risk.

Understanding the genetics and taking control of lifestyle factors linked to the disease can help fight the fear of this disease. Experts do believe that family history is a risk factor for Alzheimer’s disease. Research shows that anyone who has a parent, sibling or child with Alzheimer’s is more likely to develop it. The risk increases if more than one family member has Alzheimer’s disease.

There are two types of genes present in Alzheimer’s, according to the Alzheimer’s Association. One type is considered risk genes, which increase the likelihood but does not guarantee the disease will develop. The other type is deterministic genes, which directly cause the disease and guarantee that anyone with them will develop the disease. The latter, the deterministic genes, are very uncommon. Most people don’t realize how very rare they are.

These genes were identified in only a few hundred extended families globally. Causing early-onset dementia, that becomes apparent between one’s late 30s and mid-50s, they are believed to account for under five percent of Alzheimer’s cases.

Regarding risk genes, which increase likelihood but don’t make dementia a certainty, there are several types. APOE-e4 was the first one identified and is still believed to be the one with the most impact. We all inherit APOE genes, in versions e2, e3, and e4, from each parent. Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimer’s.

Two copies of APOE-e4 mean higher risk, but still not a certainty, according to the Alzheimer’s Association, noting that APOE-e4 may cause symptoms to manifest at an earlier age than is usual. The gene is implicated in about a quarter of all Alzheimer’s cases.

Experts now agree that Alzheimer’s is like a lot of other chronic conditions and our lifestyle has a large impact as well. Fortunately, unlike our genes, many of the lifestyle factors are controllable. They include a healthy diet, staying socially connected and controlling risks for co-morbidities such as heart disease and high blood pressure.

Hearing David Cassidy state that he has simple desires post-diagnosis—“I want to love, I want to enjoy life”—reminds us that a diagnosis of dementia does not change our basic human need to live a good life surrounded by those who love us. As one of my generation's beloved heartthrobs, I know Mr. Cassidy will have millions of fans supporting him as he travels his journey living with dementia.

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