Fans of The Price Is Right were saddened when news broke recently that iconic host Bob Barker had died at the age of 99. Recently a cause of death was reported for Barker: Alzheimer's disease.
The devastating illness, which is the most common cause of dementia, was listed on Barker’s death certificate, according to NBC News, and it was a condition that Barker did not publicly disclose that he had. But Barker’s death has raised a lot of questions about Alzheimer’s disease, in particular, how someone can die of the condition. Doctors explain.
How common is it for someone to die of Alzheimer's disease?
It's actually more common than most people think. Alzheimer’s disease is the seventh leading cause of death in the U.S., behind illnesses including heart disease, cancer, COVID-19 and stroke.
“When we list causes of death in death certificates, we often list the immediate cause of death first but we will list the contributing features that lead to the circumstances around death next,” Dr. Amit Sachdev, medical director in the neurology department at Michigan State University, tells Yahoo Life. “Alzheimer’s is often listed as a contributing feature.”
How does someone actually die of Alzheimer’s disease?
Alzheimer's disease is a brain disorder that slowly destroys memory and cognitive skills, and eventually, the ability to carry out the simplest tasks, according to the National Institute on Aging (NIA). Early symptoms can include getting lost, trouble handling money and taking longer than usual to complete normal daily tasks. But eventually the disease progresses to where a patient with Alzheimer’s disease can no longer communicate and is completely dependent on others for care.
“As the disease progresses, it involves most of the brain, causing a wider array of symptoms, including trouble walking or swallowing, which can lead to immobility and malnutrition,” Dr. Matthew Schrag, assistant professor of neurology at Vanderbilt University School of Medicine, tells Yahoo Life. “Most people who die from Alzheimer’s disease develop complications like aspiration pneumonia or other infections.”
But people don’t typically die of Alzheimer’s disease — instead, they die of complications related to the condition, Sachdev explains. “Alzheimer’s is not a disease that directly causes death,” he says. “Instead, Alzheimer’s impairs the ability to care for yourself. Self-care is important for nutrition, hygiene and physical safety. In Alzheimer’s, the risk of accidents or infections goes up significantly. With poor nutrition, the body is less resilient.”
Dr. Scott Kaiser, director of geriatric cognitive health for the Pacific Neuroscience Institute in Santa Monica, Calif., tells Yahoo Life: “Ultimately, the progression of Alzheimer’s disease puts people at risk for these complications, which are fatal.”
As somebody goes into the final stages of dementia, they have limited mobility, are unable to speak and they can have eating problems that affect overall nutrition and the ability to swallow. All those factors can contribute to the common complications that can occur.
How long would someone typically have Alzheimer's disease before it turns fatal?
It depends. “The life expectancy of individuals following an Alzheimer’s disease diagnosis varies widely based on socioeconomic factors and access to medical care,” Dr. Michal Schnaider Beeri, director of the Alzheimer's Center of the Brain Health Institute at Rutgers University, tells Yahoo Life. “In regions with poverty and limited health care services, some patients may survive as briefly as four years after diagnosis, whereas others can live with the disease for over two decades.”
How can you help keep a loved one with Alzheimer’s as healthy and safe as possible?
Alzheimer’s disease is a progressive illness, meaning symptoms get worse over time. “I advise my patients and their families to plan how they will respond to symptom progression in advance, especially related to issues like driving or navigating stairs or getting additional help, either in the home or in an assisted living setting,” Schrag says.
It's also important for patients to dictate how they want to be cared for going forward. “Having clear advanced directives can help keep somebody as healthy and safe as possible at the end of life,” Kaiser says.
The best care ultimately depends on the stage of the disease, Sachdev says. “Early in the disease, consider overall body health, mental health and new medications to slow the disease down,” he says. “These medicines are not right for all people, but a patient with Alzheimer’s disease should have a discussion about them.”
As the disease progresses, Sachdev says it’s important to “be honest about the right setting of care and the magnitude of memory loss that is present.”
For overall safety, Schnaider Beeri says that “ongoing supervision is crucial, particularly as the disease progresses.”
She explains that it’s “essential to create a safe environment by securing potentially hazardous items, supervising medication administration and installing safety devices on doors. Given that Alzheimer’s patients may wander and lack the ability to find their way home, it is advisable to provide them with identification bracelets for added safety.” (The NIA has a home safety checklist to help, Kaiser points out.)
If a family member cannot be home any longer and needs to be cared for in a facility specializing in Alzheimer’s care, “then be a strong advocate for the basics — nutrition, mobility, socialization, sleep, [avoiding] over-medication, physical safety, kindness in staff interactions and staffing,” Kaiser says.