Alzheimer’s disease is a progressive form of dementia that interferes with behavior, memory, and thinking. Dementia is a broader term for memory loss and cognitive deficits that interfere with daily activities of living. Most individuals with the condition are diagnosed after the age of 65, but it is possible to be diagnosed earlier; this is called early-onset Alzheimer’s. According to the Alzheimer’s Association, Alzheimer’s disease makes up 50 to 80 percent of cases of dementia (Alzheimer’s Association).
While there has not been a single cause identified for Alzheimer’s disease, certain risk factors have been identified. Having one or more risk factors does not necessarily mean you will get the disease; talk with your doctor about your specific risk of developing the condition.
Three of the major risk factors for Alzheimer’s are described below:
- Age: The most important risk factor is age. Most individuals who have this condition are 65 years of age or older.
- Family history: Individuals with an immediate family member who has the condition are more likely to develop the disease than those who do not. Scientists think both genetics and environmental factors play a role in this phenomenon.
- Genetics: Certain genes called risk genes and deterministic genes have been linked to developing Alzheimer’s disease
While everyone has episodes of forgetfulness, people with Alzheimer’s display certain ongoing behaviors that disrupt and impact daily functioning.
Symptoms may include:
- memory loss affecting daily life activities, such as keeping appointments or remembering newly learned directions
- difficulties with problem solving
- disorientation to time or place
- trouble with familiar tasks, such as using a microwave
- speech and writing difficulties
- poor or decreased judgment
- decreased grooming or personal hygiene
- isolation, withdrawal from friends, family, and community
- mood and personality changes
The only definitive way to diagnose an individual with Alzheimer’s disease is upon autopsy, by looking at brain tissue, but there are tests a doctor can do to rule out other conditions and diagnose dementia.
The doctor will take a medical history, including any illnesses of family members, medications you have taken and are taking currently, and any past illnesses you have had. Questions about diet and alcohol use are also asked.
A physical exam is typically done, including a blood pressure check, and the patient’s temperature is taken, along with the pulse. If necessary, your doctor might ask for urine or blood samples, but not necessarily.
A neurological exam is done to exclude any other possible diagnoses. Reflexes, muscle tone, speech, and sensation are all tested. This is to check for conditions like Parkinson’s or stroke. Sometimes brain imaging studies, such as magnetic resonance imaging (MRI), are performed.
Mental status tests are done, including asking the patient what day and year it is, who the President is, remembering a short list of words, and so forth. This helps determine short and long-term memory and orientation to place and time.
There is no cure for Alzheimer’s disease, but there are medications and behavior modifications that can help ease symptoms. Before going on any medications, it is best to talk with your healthcare professional to see what treatment plan is best for you, since each patient is different.
For early to moderate stage Alzheimer’s, medications like donepezil (Aricept) or rivastigmine (Exelon) are commonly used. These keep high levels of the neurotransmitter acetylcholine in the brain, to aid with memory.
Moderate to severe Alzheimer’s is medically treated with memantine (Namenda) or the aforementioned donepezil, which helps moderate glutamate and slows down symptom progression in some people.
Vitamin E has been suggested to help individuals with Alzheimer’s, but should only be taken under the supervision of a healthcare professional, since it can interfere with common medications taken for the disease.
Antidepressants, anti-anxiety medications, and antipsychotics have also been used in the treatment of Alzheimer’s to ease depressed moods, restlessness, aggression, agitation, and hallucinations.
Non-drug treatments involve redirecting the patient’s attention to the task at hand, avoiding confrontation, ensuring a calm and reassuring environment, and building in rest time each day.
Before deciding on a treatment, it is best to fully review your options and talk with your healthcare provider about the choices available to you and when you can chose to change course of treatment.
Written by: Jaime Herndon
Medically reviewed by George Krucik, MD, MBA