What is Alzheimer’s disease?
Alzheimer’s disease is a progressive form of dementia. Dementia is a broader term for conditions that negatively affect memory, thinking, and behavior. The changes interfere with daily living. Dementia can have a range of causes, such as brain injuries or diseases. Sometimes the cause is unknown.
According to the Alzheimer’s Association, Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. Most people with the disease get a diagnosis after age 65. If it’s diagnosed before then, it’s generally referred to as “younger onset” or “early onset” Alzheimer’s disease.
There’s no cure for Alzheimer’s, but there are treatments that can slow the progression of the disease.
Although many people have heard of Alzheimer’s disease, it’s helpful to know the facts. Here are some key details about this condition:
- Alzheimer’s disease is a chronic (long-term), ongoing condition. It is not a typical sign of aging.
- Alzheimer’s and dementia aren’t the same thing. Alzheimer’s disease is a type of dementia.
- Its symptoms come on gradually, and the effects on the brain are degenerative, meaning they cause slow decline.
- Anyone can get Alzheimer’s disease, but certain people are at higher risk for it. This includes people over age 65 and those with a family history of the condition.
- There’s no single expected outcome for people with Alzheimer’s. Some people live a long time with mild cognitive damage, while others experience a more rapid onset of symptoms and quicker disease progression.
- There’s no cure for Alzheimer’s yet, but treatment can help slow the progression of the disease and may improve quality of life.
Each person’s journey with Alzheimer’s disease is different.
Symptoms of Alzheimer’s disease
Everyone has episodes of forgetfulness from time to time. But people with Alzheimer’s disease display certain ongoing behaviors and symptoms that worsen over time. These can include:
- memory loss affecting daily activities, such as keeping appointments
- trouble with familiar tasks, such as using a microwave
- difficulties with problem-solving
- trouble with speech or writing
- becoming disoriented about times or places
- decreased judgment
- decreased personal hygiene
- mood and personality changes
- withdrawal from friends, family, and community
These signs don’t always mean that a person has Alzheimer’s. It’s important to see a doctor to determine the cause.
Symptoms change according to the stage of the disease. In later stages, people with Alzheimer’s often have significant trouble with talking, moving, or responding to what’s happening around them.
The only definitive way to diagnose someone with Alzheimer’s disease is to examine their brain tissue after death. But a doctor can use other examinations and tests to assess your mental abilities, diagnose dementia, and rule out other conditions.
The doctor will likely start by taking a medical history. They may ask about your:
- family medical history
- other current or past health conditions
- current or past medications
- diet, alcohol intake, and other lifestyle habits
From there, your doctor will likely request several tests to help determine if you have Alzheimer’s disease.
There’s no definitive test for Alzheimer’s disease. However, mental, physical, neurological, and imaging tests can help your doctor reach a diagnosis.
Your doctor may start with a mental status test. This can help them assess your:
- short-term memory
- long-term memory
- orientation to place and time
For example, they may ask you:
- what day it is
- who the president is
- to remember and recall a short list of words
Next, they’ll likely conduct a physical exam. For example, they may:
- check your blood pressure
- assess your heart rate
- take your temperature
- request urine or blood tests, in some cases
Your doctor may also conduct a neurological exam to rule out other possible diagnoses, such as acute medical issues like infection or stroke. During this exam, they will check your:
- muscle tone
Your doctor may also order brain imaging studies. These studies, which will create pictures of your brain, can include:
- Magnetic resonance imaging (MRI) scan. MRIs can help pick up key markers, such as inflammation, bleeding, and structural issues.
- Computed tomography (CT) scan. CT scans take X-ray images, which can help your doctor look for abnormal characteristics in your brain.
Other tests your doctor may do include blood tests to check for genes that may indicate you have a higher risk of Alzheimer’s disease.
There’s no known cure for Alzheimer’s disease. However, your doctor can recommend medications and other treatments to help ease your symptoms and delay the progression of the disease for as long as possible.
For early to moderate Alzheimer’s, your doctor may prescribe medications such as donepezil (Aricept) or rivastigmine (Exelon). These drugs can help maintain high levels of acetylcholine in your brain. This can help the nerve cells in your brain send and receive signals better. In turn, this may ease some symptoms of Alzheimer’s.
A newer medication called aducanumab (Aduhelm) is recommended only for those with early Alzheimer’s. It is thought to reduce the protein plaques that build up in the brain with Alzheimer’s. However, there are some concerns about whether the drug’s potential benefits outweigh its risks.
To treat moderate to late stage Alzheimer’s, your doctor may prescribe donepezil (Aricept) or memantine (Namenda). Memantine can help block the effects of excess glutamate. Glutamate is a brain chemical that’s released in higher amounts in Alzheimer’s disease and damages brain cells.
Your doctor may also recommend antidepressants, anti-anxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms vary based on the progression of the disease, and can include:
- difficulty sleeping at night
Although the care needs of a person with Alzheimer’s will increase over time, the exact symptoms will be different from person to person.
Other Alzheimer’s treatments
In addition to medication, lifestyle changes can help you manage your condition. For example, your doctor might develop strategies to help you or your loved one:
- simplify tasks
- limit confusion
- get enough rest every day
- use relaxation techniques
- create a calming environment
Along with your doctor, a team of healthcare professionals can help you maintain your quality of life at all stages along the Alzheimer’s journey. A care team for Alzheimer’s may include a:
- physical therapist, to help with staying active
- dietician, to maintain a balanced, nutritious diet
- pharmacist, to help with monitoring medications
- mental health professional, who may work with the person with Alzheimer’s as well as their caregivers
- social worker, to help with accessing resources and support
- respite care center, to provide short-term care for someone with Alzheimer’s when their caregivers are temporarily unavailable
- hospice care center, to manage symptoms in a comfortable and supportive setting at the end of life
Some have suggested that vitamin E could help slow the loss of functioning in Alzheimer’s, especially when taken with medications like donepezil that increase acetylcholine in the brain. But other research found no benefits when taking vitamin E for Alzheimer’s disease. Overall, more evidence is needed.
Be sure to ask your doctor before taking vitamin E or any other supplements. It can interfere with some of the medications used to treat Alzheimer’s disease.
In addition to lifestyle changes, there are several alternative and complementary therapies you can ask your doctor about.
Dementia vs. Alzheimer’s
The terms “dementia” and “Alzheimer’s” are sometimes used interchangeably. However, these two conditions aren’t the same. Alzheimer’s is a type of dementia.
Dementia is a broader term for conditions with symptoms relating to memory loss, such as forgetfulness and confusion. Dementia includes more specific conditions, such as Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, and others, which can cause these symptoms.
Causes, symptoms, and treatments can be different for these conditions.
Alzheimer’s disease causes and risk factors
Experts haven’t determined a single cause of Alzheimer’s disease, but they have identified certain risk factors, including:
- Age. Most people who develop Alzheimer’s disease are 65 years of age or older.
- Family history. If you have an immediate family member who has developed the condition, you’re more likely to get it.
- Genetics. Certain genes have been linked to Alzheimer’s disease.
Having one or more of these risk factors doesn’t mean that you’ll develop Alzheimer’s disease. It simply raises your risk level.
Other possible risk factors include a history of:
- cardiovascular disease
- previous traumatic brain injury
To learn more about your personal risk of developing Alzheimer’s, talk with your doctor.
Alzheimer’s and genetics
While there’s no one identifiable cause of Alzheimer’s, genetics may play a key role. One gene in particular is of interest to researchers. Apolipoprotein E (APOE) is a gene that’s been linked to the onset of Alzheimer’s symptoms in older adults.
Blood tests can determine if you have a particular version of this gene, which increases your risk of developing Alzheimer‘s. Keep in mind that even if someone has this gene, they may not get Alzheimer’s.
The opposite is also true: Someone may still get Alzheimer’s even if they don’t have the gene. There’s no way to tell for sure whether someone will develop Alzheimer’s.
Other genes could also increase the risk of Alzheimer’s. Several rare genes are linked to certain younger onset cases of the condition.
Alzheimer’s is a progressive disease, which means the symptoms will gradually increase over time. There are seven main stages:
Stages 1–3: Pre-dementia and mild cognitive impairment
- Stage 1. There are no symptoms at this stage. If you have a family history of Alzheimer’s and no symptoms, you may wish to talk to a doctor about strategies for healthy aging.
- Stage 2. The earliest symptoms appear, such as forgetfulness.
- Stage 3. Mild physical and cognitive impairments appear, such as reduced memory and concentration. Learning new skills may become harder. These changes may only be noticeable by someone very close to the person.
Stages 4–7: Dementia
- Stage 4. Alzheimer’s is often diagnosed at this stage, but it’s still considered mild. It’s common to notice memory loss and to have difficulty managing everyday tasks.
- Stage 5. Moderate to severe symptoms will require help from loved ones or caregivers. This is necessary to ensure that daily needs are being met, such as eating meals and managing the home.
- Stage 6. At this stage, a person with Alzheimer’s will need help with basic tasks, such as eating, dressing, and toileting.
- Stage 7. This is the most severe and final stage of Alzheimer’s. There is usually a progressive loss of speech and facial expressions. Movement is likely to become limited.
As a person progresses through these stages, they’ll need increasing support from their caregivers.
Talk with your doctor about strategies to help you manage these changes. Appropriate care can help you maintain comfort and quality of life for as long as possible.
It’s also important to discuss your care plan with your loved ones. People with Alzheimer’s will need more assistance with medical decisions as the disease progresses.
People with Alzheimer’s typically live for 4 to 8 years after diagnosis, though some live for up to 20 years.
Younger onset Alzheimer’s
Alzheimer’s typically affects people ages 65 and older. However, it can occur in people as early as in their 30s, 40s, or 50s. This is called younger onset, or early onset Alzheimer’s. This type of Alzheimer’s affects fewer than 10 percent of all people with the condition.
Because doctors aren’t always looking for signs of Alzheimer’s in younger adults, getting a diagnosis can take a long time. Symptoms of early onset Alzheimer’s depend on the stage of the disease. Early signs can include mild memory loss and trouble concentrating or finishing everyday tasks. It can be hard to find the right words, and you may lose track of time.
Some studies have found that certain vision and eye changes could indicate early stage Alzheimer’s disease for people in their 50s and older.
People with a family history of younger onset Alzheimer’s are at greater risk of developing this condition. There are several rare genes that, together, cause groups of cases in some families. People with a family history of Alzheimer’s should talk with their doctor.
Just as there’s no known cure for Alzheimer’s, there are no foolproof preventive measures. For now, health-promoting lifestyle habits are the best tools we have to prevent cognitive decline.
The following steps may help:
- Try to quit smoking. If you smoke, quitting benefits your health both immediately and in the long term.
- Exercise regularly. Getting active reduces the risk of many conditions, such as cardiovascular disease and diabetes.
- Keep your brain active. Try some cognitive training exercises.
- Eat well. Eat a balanced diet with plenty of fruits and vegetables.
- Maintain an active social life. Friendships, volunteering, and hobbies are likely to benefit your overall health.
Be sure to talk with your doctor before making any big changes in your lifestyle.
As Alzheimer’s progresses, the tasks of daily living require more support. If you have a loved one with Alzheimer’s, it’s important to start learning about what to expect and what your role may be in your loved one’s future care. Caregiving is a role that’s typically not easy, but it can also be very rewarding.
If your loved one has Alzheimer’s, here are some ways to plan and prepare for caregiving:
- Educate yourself about Alzheimer’s, its stages, and its typical symptoms. By reading this article, you’re already on the right track.
- Connect with family members who can step in to help.
- Consider joining a support group for dementia caregivers.
- Look up professional home care, respite care, and adult day care programs in your area.
- Remember that you’ll need support too. Reach out to the people you’re close to, and be open to accepting help.
As a caregiver, it’s important to take care of yourself as well as your loved one. Caregiving has its difficult moments, and the strain of ongoing responsibilities can start to negatively affect your health. As much as possible, a robust care plan should include support for you, too.
Alzheimer’s is a complicated disease, and scientists are working on unlocking its secrets. Living a healthy lifestyle may help prevent it. If you have a family history of Alzheimer’s, it’s important to discuss it with your doctor.
By the time Alzheimer‘s is diagnosed, the progression of the disease can’t be stopped. But treatment can help delay symptoms and improve your quality of life.
If you think you or a loved one may have Alzheimer’s, talk with a doctor. They can help make a diagnosis, discuss what you can expect, and help connect you with services and support. If you’re interested, they can also give you information about taking part in clinical trials.
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