As you may have noticed throughout the general news media, trade press and in our own articles here, dementia is becoming a major concern for advisors as clients age. It is also a major concern for clients, most of whom can name one or more people they know who are affected by dementia or are caring for a loved one with it. On top of all the emotional and psychological impacts of a diagnosis, the financial implications are huge.
In this milieu, it is crucial for advisors to have accurate information about dementia that they can explain to their clients and their families. Families who view the advisor as a trusted resource in areas beyond just the numbers become committed and loyal clients. So first, let’s cover some basics and the latest research findings, and then talk about some steps you can take in the office.
One thing many people don’t realize is that “dementia” and “Alzheimer’s disease” are not synonymous. Dementia is the umbrella term for a set of progressive symptoms resulting from deterioration in the brain that gradually interfere with and eventually destroy memory, cognition, emotion and physical capacity, until eventually causing death.
Under this umbrella term lie at least 18 different diseases. The most prominent of these (up to 80% of cases in the U.S.) is Alzheimer’s disease. In other words, everyone with Alzheimer’s has dementia, but not everyone with dementia has Alzheimer’s. Instead, they may have frontotemporal lobe, or Lewy Body, or CTE or one of the other dementia-causing diseases. Although the definitive diagnosis of Alzheimer’s disease is only possible on autopsy, tests are getting more precise and accurate in diagnosis. This allows doctors to better determine which type of dementia a patient has, since the various diseases respond to different types of treatment.
A New Type of Dementia that Mimics Alzheimer’s
Scientists have now isolated a new variation of dementia that mimics Alzheimer’s disease. They call it LATE, because it doesn’t occur until people are in their 80s. (Typically, Alzheimer’s diagnoses occur in the 60s and beyond). LATE dementia is far more widespread than they had expected. In fact, they estimate that up to one-quarter of dementia cases at age 85 are LATE dementia, not Alzheimer’s.
The similarities in the two result from the fact that both types of dementia target the hippocampus first. That is the area of the brain that sends short-term experience into long-term memory. When that stops happening, someone with Alzheimer’s or LATE may remember something from 40 years ago better than they remember what they had for lunch. They simply aren’t forming long-term memories from their present experience.
Despite that similarity, however, the underlying features are different. Alzheimer’s is characterized by two proteins—beta amyloid and tau, which kill brain cells, causing the brain to literally shrink. LATE is characterized by a different protein—TDP-43—that also kills brain cells but by a different mechanism.
Why does this matter? First, we have a set of drugs that are proven to temporarily slow the progression of Alzheimer’s symptoms, but they may do nothing at all for LATE. Second, most of the drugs researched and tested on patients in the past decade target beta amyloid, and all of them have failed to improve cognition even if they successfully decrease that protein. Now that a different protein has been identified, researchers have another target to focus on. Perhaps cases of LATE dementia can be more successfully treated or even cured. In the process, we may learn more about dementia in general that can aid in treatments for other forms of the disease, especially the very similar Alzheimer’s disease.
Steps You Can Take
Given all of this, what can you do for your clients?
- Consider putting something in your regular newsletter about this development, so you can educate your clients about the latest research.
- Subscribe to New Lifestyles. They publish a free brochure four times a year in 47 different regions of the U.S. The brochure gives you a list of the different housing options in your area—from independent senior living to assisted living to nursing homes to memory care facilities. It also includes services that help seniors stay in their homes as long as possible and many other organizations and resources.
- Meet the directors of the memory care facilities in your area. Then, if a client is concerned about a family member’s decline, offer to introduce them to the various directors so they can get a better sense of how each facility operates, their patient-to-staff ratio, turnover rate and cost.
- Continue to keep yourself educated, and strive to discourage untested and unproven “remedies.” Rely on the Alzheimer’s Association, the National Institute on Aging and Alzheimer’s Organization.
- Encourage your clients to get into clinical trials, which exist both for healthy people that scientists want to follow through the years and also for those already in some stage of dementia. If they don’t wish to personally participate, encourage donations to research so we can do more to treat, and hopefully eventually prevent and cure, this awful disease.
When your clients know you stay current with the latest research and resources for a disease that greatly concerns them, you distinguish yourself as an advisor who is on top of the game. Use this education and these skills to let clients know you have their best interests in mind, you care about more than just the money, and you serve them exceptionally well!
Amy Florian is the CEO of Corgenius, combining neuroscience and psychology to train financial professions in how to build strong relationships with clients through all the losses and transitions of life.