Alzheimer’s disease is a form of dementia. It is the most common form of dementia. Dementia is a term used to describe memory loss and loss of other intellectual capabilities, like reasoning and thinking, that are severe enough to cause problems in daily life. Alzheimer’s disease is named after Dr. Alois Alzheimer, who discovered the disease in 1906.
Alzheimer’s largest risk factor is aging. However, it is not a normal part of aging. While the majority of people who have Alzheimer’s are over the age of 65, it can happen in someone younger. Early-onset Alzheimer’s is when the disease becomes noticeable in someone in their 40s or 50s. About 5 percent of people with this disease are in this age group.
This is a disease that progressively gets worse over time. In late stages, someone with Alzheimer’s may not be able to communicate or reason with those around them. They will also eventually need full-time care for everyday life. According to the Alzheimer’s Association, it is the 6th leading cause of death in the United States. The average life span of someone with the disease is eight years after diagnosis, but they can live up to 20 years depending on other health conditions. There is no cure at this time. However, there are treatments that can slow the progression and improve the quality of life for those with the disease.
Memory problems are usually the first symptoms of Alzheimer’s. Remembering things that have been recently learned is especially difficult. Some other symptoms are:
- confusion about places or times (may be mild at first)
- unable to find words with speaking
- misplacing objects you use regularly
- changes to personality
- new irritability
- making bad decisions
- difficulty organizing thoughts
- repeating things over and over
- forgetting things and not remembering them later
- difficulty with numerical calculations
- difficulty responding to everyday problems
- mood swings
- paranoia and distrust of others (including immediate family or close friends)
This disease does not affect everyone in the same way, so individuals may experience symptoms at different times. If you or a loved one has any of these symptoms and they are causing problems with everyday life, you should talk to your doctor.
The exact cause of Alzheimer’s is not clear, but there are a number of genetic, environmental, and lifestyle factors that can contribute. However, what is known is that Alzheimer’s damages the brain and its brain cells. This leads to the brain shrinking. The brain of someone with Alzheimer’s usually has two types of abnormalities: plaques and tangles.
Alzheimer's Disease is the most common cause of dementia in people older than 65. It usually comes on gradually but eventually affects almost every aspect of brain functioning, from memory and judgment to movement. AD is not yet curable, but researchers are discovering that you can take steps to slow the decline.
The system that carries nutrients through the brain is a protein called Tau. In the brain of someone with Alzheimer’s, threads of this protein (better known as neurofibrillary tangles) collect in the brain cells. These tangles prevent nutrients from being carried through the brain.
The apolipoprotein E gene (APOE) has a part in late-onset Alzheimer’s. However, having this gene does not determine that you will definitely get Alzheimer’s. Most early-onset cases are caused by changes in certain genes. These changes are inherited. However, many cases of both forms of Alzheimer’s occur with no known causes.
Most people with Down Syndrome will eventually develop Alzheimer’s. It is believed to be because of their extra copy of chromosome 21.
There are a number of things that are considered risk factors for Alzheimer’s. The most common of these is aging, as it tends to occur in people over the age of 60. Some other common risk factors are:
- family history (genetics)
- individuals with Down syndrome
- being female (this could be due to the fact that they usually live longer than men)
- mild cognitive impairment, which causes an increased risk but not a certainty of developing the disease
- severe head trauma
There are also a number of heart health issues that scientists believe may be risk factors in the development of Alzheimer’s. Some of these include:
- heart disease
- high blood cholesterol
- high blood pressure
- poor diet
The research continues into how reducing these risk factors may reduce the risk of developing the disease.
There is not currently a way to definitely diagnose Alzheimer’s. However, through tests and information provided to the doctor, they can make a judgement as to whether or not Alzheimer’s is causing symptoms. Some questions and tests the doctor may use in diagnosis are:
- question the patient and family members about changes in behavior, difficulty with daily tasks, medical history, and changes in personality
- test for memory, counting, problem solving, and/or language
- blood and urine tests to rule other conditions out
- brain scans to rule out other possible conditions, which may include CT scan, MRI, or positron emission tomography (PET scan)
- neuropsychological testing
Some or all of these tests may be repeated later to measure how memory and brain functions change over time.
Other conditions that may cause similar symptoms are stroke, tumor, sleep problems, side effects from medications, and others.
Research is ongoing in the field of Alzheimer’s and dementia, and new methods of diagnosing the disease may be on the horizon.
Alzheimer’s disease is complex and there isn’t one form of treatment that will treat it. Doctors treat the symptoms of the disease as well as work to slow its progression.
There are two types of medications that are used to treat mental function. They are cholinesterase inhibitors and memantine (Namenda).
Cholinesterase inhibitors help with cell to cell communication in the brain. These drugs can also help with agitation and depression, which occur with the disease. Some of the common forms of this class of drugs are:
- donepezil (Aricept)
- galantamine (Razadyne)
- rivastigmine (Exelon)
Memantine (Namenda) also helps with cell to cell communication in the brain. It slows the progression of Alzheimer’s symptoms. It is used in moderate to severe forms of the disease. It may also be used in combination with a cholinesterase inhibitor.
There are a number of things you can adopt in your lifestyle or the lifestyle of someone you love that will help manage some of the symptoms of Alzheimer’s. Making the home and surroundings safe and supportive is one of the main changes that can be made. A few of the things that you can do to achieve this are:
- Always keep keys, wallet, etc., in the same place.
- Remove unnecessary mirrors (images in mirrors can confuse or scare those with Alzheimer’s).
- Make sure shoes have good traction to avoid slipping and falling.
- Keep photos and other meaningful things in view.
- Keep a mobile phone in your pocket with GPS to help if you ever get lost.
- Keep medication simple and in a daily container to avoid confusion.
- Keep a routine as much as possible.
As with most health conditions, exercise is an important part of the routine. Even if balance keeps you or a loved one from walking regularly, stationary bike or chair exercises are an option. Nutrition is also important to watch. Healthy shakes and smoothies are good alternatives for meals or snacks, as those with Alzheimer’s may forget if they have eaten. Someone with Alzheimer’s should also be sure to drink lots of liquids to avoid constipation and dehydration.
There are a number of alternative treatments that promote brain health and improved brain function. However, there are no studies that show these to be effective for slowing the progression of Alzheimer’s at this time. Some of those that are currently being studied are:
- omega-3 fatty acids in fish
- vitamin E
It is important to remember that even natural or alternative therapies can interact with medications. Be sure to talk to the doctor before you or a loved one try any alternative methods.
Caring for someone with Alzheimer’s can be a challenge physically, emotionally, and financially. It often involves a major shift in a relationships, when a child begins caring for a mother or a spouse begins caring for their spouse. It can be very challenging to care for someone who can be irritable, paranoid, or not even believe they need care at times. Many caregivers deal with guilt, frustration, and grief over the loss of the relationship. It can also cause social isolation. It is important that you find support. This can be through other family members, friends, or support groups.
Learning all you can about the disease can be very helpful. With research ongoing, it is important to stay up-to-date on new discoveries. There are also classes that can teach you how to cope with the difficult behaviors you will encounter as you care for your loved one.
Caregiver burnout is common in people who care for someone with Alzheimer’s. It can occur when supporting the person with Alzheimer’s overshadows addressing your own needs, either physically, emotionally, or both. Don’t be afraid to ask for help. Many people don’t know enough about what caregiving takes to know how to offer to help. It is up to you to reach out and ask for it. Reach out to friends or family that may be able to give you a break from time to time. Even just 30 minutes to take some time for yourself can help.
Be sure to check in your community for respite care or adult day care facilities that can give you some much needed time off from caregiving. Many of these facilities will also help your loved one to continue social interaction and aid in slowing the progression of the disease.
To help you cope with caregiving responsibilities and to manage your stress, it is important that you remember to take care of yourself. Some ways to do this are:
- Maintain a regular exercise routine.
- Join a support group.
- Take care of your emotional and spiritual needs.
- Take care of your physical health.
- Ask for help.
Research has not yet found a way to prevent Alzheimer’s disease. However, there are some things that research suggests may help. You can do the following to help slow the progression or possibly prevent the disease:
- Keep your mind active with word games, puzzles, and memory games.
- Continue learning new things. This is another way to keep your mind active.
- Stay physically active.
- Be socially active.
- Stop smoking.
- Get adequate sleep.
- Treat high blood pressure.
There is not current proof that any of these will prevent you from getting the disease. However, they all promote good brain health and have many other benefits beyond helping to fight against Alzheimer’s disease.
It is important to talk to a doctor if you notice some of the signs of Alzheimer’s in yourself or someone you care about. There are treatments that can help slow the progression of the disease. The earlier you can start on these, the better your quality of life can be.
Researchers are working right now to better understand Alzheimer’s and its effect on the brain. Once they better understand the disease, it will be easier to research treatments. In the meantime, Alzheimer’s research is one of the leading forms of research being performed today. New information is being learned daily and new treatments are being studied. If you or a loved one is diagnosed with this disease, the best thing you can do is talk to your doctor and start treatment as early as possible.
Written by: Diana K. Wells
Medically reviewed on Mar 09, 2016 by Steve Kim, MD
There are currently no medications that can reverse or halt the progression of most dementias. However, there are drug options for treating Alzheimer's disease. Read