DEAR DR. ROACH: I know you’re not a psychiatrist, but I hope you can help. My dad was a single parent raising us kids, and he was always clean when it came to housework. Every room in our house was almost spotless.
But lately, we have noticed him becoming a hoarder and being more disorganized. By that, I mean keeping weeks-old newspapers on the floor, the kitchen table, everywhere, and he gets upset if we try to help him clean. He’s 79. Could it be a sign of senility or Alzheimer’s disease? — R.S.
ANSWER: Hoarding behavior can have several psychiatric causes, and, indeed, a psychiatrist may be necessary to make the diagnosis. However, odds are that your dad always had some form of obsessive-compulsive disorder, and with age has become worse.
There are other possibilities. Fronto-temporal dementia, a type of dementia that is distinct from Alzheimer’s disease, has a variant in which personality and behavior changes are prominent, but given the history of what sounds like unusual cleanliness habits, I would suspect that OCD is the most likely diagnosis. There usually is a long delay from the time symptoms begin until the time the diagnosis is made. A diagnosis needs to be made before treatment — be it medications, psychotherapy or some combination — can begin. Treatment can improve not only the hoarding behavior, but also the distress your dad is feeling. A psychiatrist or psychologist is the expert in making the diagnosis and for treatment.
The new booklet on Alzheimer’s disease gives a detailed presentation of this common illness. Readers can obtain a copy by writing: Dr. Roach — No. 903W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: In discussing treatment of nail fungus, you did not mention newer laser treatments that I see advertised by podiatrists in my area. Are they effective? — J.F.
ANSWER: We don’t really know if they are effective, since well-done studies haven’t yet proven it; however, preliminary evidence is suggestive. This would be a great addition to treatment, since the only currently accepted highly effective treatments are oral medications, which have risk of liver damage. Even more exciting is the idea of combining a topical antifungal agent, amorolfine, with laser. This medication is not available in the U.S., but a study in Korea showed a 50 percent effectiveness rate (which is pretty good for this difficult-totreat condition).
Since I last wrote about this condition, I heard from a lot of readers. Some mentioned cures from Vicks Vapo Rub, but the only study I found on that showed a 22 percent cure rate. One person asked about surgery, but since the fungus gets into the nail bed, the infection often recurs after removing the nail. Listerine and white vinegar mixed half and half cured one couple, and several people had success with Dr. Paul’s Piggy Paste, which also is vinegarbased. None of these has good data to support its use, but all likely are safe.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
©2017 North America Synd.