Understanding Alzheimer’s Disease
Alzheimer’s disease is a progressive form of dementia—a broad term used for conditions that negatively impact memory, thinking, and behavior. Although many people are familiar with Alzheimer’s, understanding the specific facts can be beneficial. Here are some key details about this condition:
- Alzheimer’s disease is a chronic (long-term), ongoing condition and is not a typical sign of aging.
- Alzheimer’s and dementia are not the same; Alzheimer’s disease is a particular type of dementia.
- Its symptoms develop gradually, and its effects on the brain are degenerative, meaning they cause a slow decline.
- While anyone can develop Alzheimer’s disease, certain individuals are at higher risk, including those over age 65 and those with a family history of the condition.
- There’s no single expected outcome for people with Alzheimer’s; some may live a long time with mild cognitive impairment, while others may experience a rapid onset of symptoms and faster disease progression.
- There is currently no cure for Alzheimer’s, but treatments can help slow its progression and may improve the quality of life.
Symptoms of Alzheimer’s Disease
While occasional forgetfulness is common, people with Alzheimer’s disease exhibit specific ongoing behaviors and symptoms that worsen over time. These can include:
- Memory loss affecting daily activities, such as keeping appointments
- Difficulty with familiar tasks, such as using a microwave
- Problems with problem-solving
- Issues with speech or writing
- Disorientation regarding times or places
- Decreased judgment
- Reduced personal hygiene
- Mood and personality changes
- Withdrawal from friends, family, and community
These signs don’t necessarily mean that a person has Alzheimer’s; it’s important to consult a doctor to determine the exact cause.
Symptoms vary depending on the stage of the disease. In its later stages, individuals with Alzheimer’s often have significant trouble with talking, moving, or responding to their surroundings.
Diagnosing Alzheimer’s Disease
The only definitive way to diagnose Alzheimer’s disease is by examining brain tissue post-mortem. However, doctors can employ various assessments and tests to evaluate mental abilities, diagnose dementia, and exclude other potential conditions.
A typical diagnostic process starts with a comprehensive medical history. Your doctor may inquire about your:
- Symptoms
- Family medical history
- Other current or past health conditions
- Current or past medications
- Diet, alcohol intake, and other lifestyle habits
Following this, your doctor will likely recommend several tests to help determine if you have Alzheimer’s disease.
Alzheimer’s Medication
While there is no known cure for Alzheimer’s disease, doctors can suggest medications and other treatments to alleviate symptoms and delay disease progression.
For early to moderate Alzheimer’s, doctors may prescribe medications such as donepezil (Aricept) or rivastigmine (Exelon). These drugs help maintain high levels of acetylcholine in the brain, which can enhance nerve cell communication and alleviate some symptoms of the disease.
A newer medication, aducanumab (Aduhelm), is recommended for individuals with early Alzheimer’s. It is believed to reduce the protein plaques that accumulate in the brain of Alzheimer’s patients. However, concerns exist regarding whether the drug’s potential benefits outweigh its risks.
For moderate to late-stage Alzheimer’s, doctors may prescribe donepezil (Aricept) or memantine (Namenda). Memantine helps block the effects of excess glutamate, a brain chemical released in higher amounts in Alzheimer’s, which can damage brain cells.
In addition to these medications, doctors may recommend antidepressants, anti-anxiety medications, or antipsychotics to manage symptoms related to Alzheimer’s. These symptoms can vary but may include:
- Depression
- Difficulty sleeping at night
- Agitation
- Hallucinations
Although care needs for an individual with Alzheimer’s will increase over time, the specific symptoms can differ from person to person.
Causes and Risk Factors of Alzheimer’s Disease
Experts have not identified a single cause of Alzheimer’s disease, but they have recognized several risk factors, including:
- Age: Most individuals who develop Alzheimer’s disease are 65 years of age or older.
- Family History: If an immediate family member has developed the condition, your likelihood of developing it increases.
- Genetics: Certain genes have been associated with Alzheimer’s disease.
Having one or more of these risk factors doesn’t guarantee that you will develop Alzheimer’s disease; it simply raises your risk level.
Other potential risk factors include a history of:
- Depression
- Smoking
- Cardiovascular disease
- Traumatic brain injury
To learn more about your personal risk of developing Alzheimer’s, consult with your doctor.
Alzheimer’s and Genetics
While there is no single identifiable cause of Alzheimer’s, genetics may play a significant role. One gene, in particular, has garnered the attention of researchers: Apolipoprotein E (APOE). This gene is linked to the onset of Alzheimer’s symptoms in older adults.
Blood tests can determine if you have a specific version of this gene, which increases your risk of developing Alzheimer’s. It is important to note that having this gene does not guarantee that you will develop Alzheimer’s.
Conversely, individuals without this gene may still develop Alzheimer’s. There is no sure way to predict who will develop the disease.
Additionally, other genes could also increase the risk of Alzheimer’s. Several rare genes are linked to certain early-onset cases of the condition.
Stages of Alzheimer’s Disease
Alzheimer’s is a progressive disease, meaning its symptoms will gradually increase over time. The disease is typically divided into seven main stages:
Stages 1–3: Pre-dementia and Mild Cognitive Impairment
- Stage 1: No symptoms are present at this stage. If you have a family history of Alzheimer’s and are symptom-free, discussing strategies for healthy aging with a doctor may be beneficial.
- Stage 2: The earliest symptoms, such as forgetfulness, begin to appear.
- Stage 3: Mild physical and cognitive impairments become evident, such as reduced memory and concentration. Learning new skills may become more challenging. These changes may only be noticeable to someone very close to the individual.
Stages 4–7: Dementia
- Stage 4: Alzheimer’s is often diagnosed at this stage, although it is still considered mild. Memory loss and difficulty managing everyday tasks become noticeable.
- Stage 5: Moderate to severe symptoms emerge, requiring assistance from loved ones or caregivers to ensure daily needs—such as eating and managing the household—are met.
- Stage 6: Individuals will need help with basic tasks, including eating, dressing, and toileting.
- Stage 7: This is the final and most severe stage of Alzheimer’s, characterized by a progressive loss of speech and facial expressions. Movement is likely to become limited.
As individuals progress through these stages, they will require increasing support from their caregivers.
Discuss strategies with your doctor to help manage these changes. Appropriate care can help maintain comfort and quality of life for as long as possible.
It is also essential to discuss your care plan with your loved ones. Individuals with Alzheimer’s will need more assistance with medical decisions as the disease advances.
On average, people with Alzheimer’s live for 4 to 8 years after diagnosis, though some may live up to 20 years.
Younger Onset Alzheimer’s
Alzheimer’s typically affects individuals aged 65 and older. However, it can also occur in people as young as their 30s, 40s, or 50s. This is referred to as younger onset, or early-onset, Alzheimer’s. This form of Alzheimer’s affects fewer than 10 percent of all individuals with the condition.
Diagnosing younger onset Alzheimer’s can be challenging because doctors do not usually look for signs of Alzheimer’s in younger adults. The symptoms of early-onset Alzheimer’s vary depending on the stage of the disease. Early signs may include mild memory loss, difficulty concentrating, and challenges in completing everyday tasks. Individuals may also struggle to find the right words and may lose track of time.
Some studies have found that certain vision and eye changes could indicate early-stage Alzheimer’s disease in people in their 50s and older.
Individuals with a family history of younger onset Alzheimer’s are at a higher risk of developing the condition. Several rare genes, when combined, can result in clusters of cases within some families. Those with a family history of Alzheimer’s should consult with their doctor.
Preventing Alzheimer’s
Just as there is no known cure for Alzheimer’s, there are no foolproof preventive measures. Currently, adopting health-promoting lifestyle habits is the best strategy we have to prevent cognitive decline.
The following steps may help:
- Try to Quit Smoking: If you smoke, quitting offers immediate and long-term benefits to your health.
- Exercise Regularly: Physical activity reduces the risk of many conditions, including cardiovascular disease and diabetes.
- Keep Your Brain Active: Engage in cognitive training exercises.
- Eat Well: Maintain 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.
Alzheimer’s Care
As Alzheimer’s progresses, daily living tasks increasingly require more support. If you have a loved one with Alzheimer’s, it’s essential to begin understanding what to expect and to consider your potential role in their future care. While caregiving can be challenging, 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: Learn about Alzheimer’s, its stages, and typical symptoms. By reading this article, you’re already on the right track.
- Connect with Family: Engage with other family members who can assist with caregiving responsibilities.
- Join a Support Group: Consider joining a support group for dementia caregivers to share experiences and receive support.
- Explore Professional Care Options: Research professional home care, respite care, and adult day care programs available in your area.
- Seek Support: Remember that you will need support, too. Reach out to those close to you and be open to accepting help.
As a caregiver, it’s crucial to take care of yourself as well as your loved one. The demands of caregiving can be tough, and the ongoing responsibilities can negatively impact your health. A comprehensive care plan should include support for you, ensuring you remain well while providing care.