Alzheimer’s Disease

What is Alzheimer’s disease?

Alzheimer’s disease is a type of dementia. Dementia is a condition that describes a wide range of symptoms. The symptoms are associated with physical and functional changes in the brain. Dementia usually affects a person’s memory, thinking abilities, and personality. In the later stages, a person who has dementia has difficulty caring for themselves.

Alzheimer’s disease is the most common cause of dementia among older persons. However, other things can also cause dementia. Alzheimer’s disease most commonly affects people older than 65 years of age. People who are younger than 65 years of age can also have Alzheimer’s disease. This is called early onset Alzheimer’s disease. Early onset Alzheimer’s disease is not very common.

What are the symptoms of Alzheimer’s disease?

If you are worried you or a loved one may have Alzheimer’s disease, there are 10 primary symptoms to consider. Every person is different and may have more or fewer than these 10 symptoms. Talk to your doctor if you notice 1 or more in yourself or a loved one.

• Memory loss that affects daily life: Forgetting important dates or things you just learned or asking the same question over and over. Or you may rely more on reminder notes, technology, or other family members to remember things.
• Changes in the ability to follow a plan or solve a problem: This may include having trouble focusing on a problem. It could also mean trouble following a plan, such as a recipe. Or keeping track of regularly scheduled tasks, such as paying monthly bills.
• Changes in the ability to complete familiar tasks: Alzheimer disease can make it hard to do the things that you used to do all the time. For example, it might be hard to do chores at home, run errands, or finish a routine task at work.
• Confusion about time or place: Losing track of how much time has passed, the date or the day of the week, or forgetting where you are and how you got there.
• Problems with vision or understanding visual information: Examples include trouble with reading comprehension, identifying colors, judging distances, or getting confused about what you see.
• Problems with words: This may include forgetting words in the middle of a conversation, repeating parts of a conversation, or calling things by the wrong names.
• Misplacing things: This could mean putting things in unusual places, losing things often, being unable to retrace steps to find a lost object, and even accusing others of stealing.
• Poor judgment: Examples include paying less attention to appearance or cleanliness. It could also mean using poor judgment with money, such as giving large amounts of money to solicitors.
• Withdrawal from activities: This could include withdrawing from social activities, work projects, or family gathering. It may also mean abandoning a hobby, sport, or favorite activity.
• Changes in mood and personality: Becoming unusually confused, suspicious, upset, depressed, fearful, or anxious. This may happen when in new or unfamiliar places.

Alzheimer’s disease is called a progressive disease. This means that its symptoms usually start slowly and are mild. A person’s cognitive (brain) and functional (self-care) abilities get worse over time. In the later stages of the disease, a person who has Alzheimer’s disease is no longer able to communicate and depends entirely on other people for care.

As the disease progresses, a person can experience health complications, including:

• Depression
• Unreported pain, illness, or medicine side effects (due to the inability to communicate)
• Falls
• Pneumonia or other infections
• Malnutrition or dehydration

If you think that a loved one might be experiencing any of the complications listed above, talk to their doctor. He or she can provide medicine or other treatments to help keep your loved one comfortable.

What causes Alzheimer’s disease?

Doctors don’t know what causes Alzheimer’s disease. One theory is that the disease develops when clumps of abnormal proteins grow in the brain. This growth likely begins with many small changes in the brain. This typically starts long before any symptoms are noticeable. Over time, these changes add up. Eventually, brain cells become damaged and die.

Also, doctors believe certain things increase a person’s risk for developing Alzheimer’s disease. Those risks factors include:

• Age: The older you are, the greater your risk of developing Alzheimer’s disease. After age 65, your chance of developing Alzheimer’s disease doubles every 5 years.
• Genetics and family history: You are more likely to get Alzheimer’s disease if you have a family history of it. Scientists also think that certain genes in your DNA may increase your risk for Alzheimer’s disease..
• Down syndrome: People who have Down syndrome have a much higher risk for Alzheimer’s disease than the general population.
• Environmental/lifestyle factors: It is likely that your environment and your lifestyle habits also affect your risk for Alzheimer’s disease. A history of head trauma, cardiovascular or heart problems, diabetes, and obesity appear to increase your risk. To help prevent these health problems, wear a helmet when riding a bicycle, always buckle your seat belt when in the car, establish a regular exercise routine, eat right, and avoid tobacco products.

Alzheimer’s disease also appears to be more common in women than in men. Nearly two-thirds of people who have Alzheimer’s disease are women.

How is Alzheimer’s disease diagnosed?

An Alzheimer’s disease diagnosis may take some time. There is no test that can tell your doctor whether you have the disease. Give your doctor plenty of information to help determine the cause of your symptoms. Your doctor may want to evaluate the following in you or your loved one:

• Current health and medical history
• Daily routine and any changes in your behavior
• Memory, problem-solving, attention, and language abilities
• Lab tests, such as blood or urine tests
• Brain scans to look for problems, such as stroke, that may be causing symptoms

Based on this information, your doctor can almost always tell whether you have dementia. Your doctor will likely be able to tell whether Alzheimer’s disease is the cause. Alzheimer’s disease can only be diagnosed with certainty after death. That is when the brain is examined under a microscope. The brain will show distinct changes that only happen when Alzheimer’s disease is the cause.

If you are worried that you or a loved one might have some of the warning signs of Alzheimer’s disease, talk to your doctor. An early diagnosis will help you get treatment sooner. Also, it will give you time to address questions of care, finances, and legal issues with your family.

Can Alzheimer’s disease be prevented or avoided?

No one knows how to prevent or avoid Alzheimer’s disease. However, doctors believe that healthy living and keeping your brain active can help lower your risk. Or it may delay its onset and progression.   That means eating a healthy diet, low alcohol consumption, not smoking, staying physically, socially, and mentally active.

Screening may be valuable in early detection for many diseases. However, the American Academy of Family Physicians (AAFP) states that there is not enough current evidence to show that routine screening for cognitive impairment is helpful.

Alzheimer’s disease treatment

There is no cure for Alzheimer’s disease. Instead, treatment may focus on:

• Slowing the progression of symptoms, such as memory loss
• Addressing behavior changes, such as depression and aggression
• Helping to relieve other symptoms, such as sleep problems

Some medicines are currently being used to treat memory and behavior symptoms of Alzheimer’s disease. These medicines do not stop the disease. They may not work for every person or may help for only a short time. They include:

• Cholinesterase inhibitors are approved to treat early and moderate stages of Alzheimer Dementia. Typical side effects of this medicine include diarrhea, nausea, and vomiting.
• Memantine is a drug approved to treat moderate to severe Alzheimer’s disease. It may be used alone or in addition to a cholinesterase inhibitor. It may cause side effects such as dizziness and headaches.

Your doctor may recommend or prescribe medicine for behavioral changes. The type of medicine will depend on the behavior and the severity of the problem. Over-the-counter medicine might include pain relievers. Prescription medicine might include antidepressants, anti-anxiety medicines, and sleep medicines.

Drugs don’t always help relieve the symptoms of Alzheimer’s disease. Non-drug treatments for a person who has Alzheimer’s disease often include managing your loved one’s environment and establishing a routine to help reduce stress and anxiety.

Some commonly used medications can worsen the symptoms of dementia. Review your medications with your doctor to see if any may need to be changed or stopped.