An Overview of Alzheimer's Disease

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Alzheimer's disease is a progressive neurological disease that, over time, results in the brain's inability to function correctly. The main symptoms are memory loss and confusion. Alzheimer's disease is the most common type of dementia, and it is typically seen in older adults. There is no cure, but symptoms can be managed temporarily using strategies and medications.

Symptoms

Symptoms of Alzheimer's include problems with memory, communication, comprehension, and judgment. Changes in personality may begin to develop as well. As the disease progresses, the ability to function mentally, socially, and physically continues to decline.

Although many people think of Alzheimer's disease as something that only affects older adults, there are actually two types of Alzheimer's disease: late onset (also called typical) Alzheimer's which affects people over the age of 60 and early onset Alzheimer's, which is defined by symptoms that begin before age 60.

While the progression of Alzheimer's disease can vary based on the person, it typically follows a similar pattern which can be categorized into three different stages: early stage, middle stage, and late stage.

  • Early Stage: In the early stages of Alzheimer's, it can be more difficult to learn new information, find the right word to describe something, remember what just happened (short-term memory impairment) or plan and organize an activity- a task that requires executive functioning.
  • Middle Stage: In the middle stages of Alzheimer's, the ability to think clearly becomes more difficult. Long-term memories often fade, and there can be a decline in visual and spatial abilities (which can result in people wandering or getting lost). Emotional and behavioral changes, such as anxiety and agitation, are common in the middle stage, and these can be challenging for both those living with dementia and their loved ones, to handle.
  • Late Stage: In the late stages of Alzheimer's disease, physical functioning declines significantly, making tasks like walking, getting dressed, and eating difficult. Eventually, the person with late-stage Alzheimer's becomes completely dependent upon caregivers to help with their basic needs.

    Causes

    There are characteristic changes to the brain that are seen with Alzheimer's disease, but what causes those changes is not fully determined. It is likely due to a combination of genetic, lifestyle, and environmental risk factors over time.

    Alzheimer's is not part of normal aging; however, as you age, the likelihood of developing Alzheimer's increases. Thirteen percent of individuals over age 65 have Alzheimer's or another form of dementia, while almost 50 percent of individuals over age 85 have Alzheimer's or another kind of dementia.

    There is an increased chance of developing Alzheimer's if you have relatives with the disease. Specific genes have been identified that may increase the risk of Alzheimer's disease.

    Cardiovascular disease or sustaining a head injury or concussion are linked with increased risks. Lifestyle risk factors may be reduced with exercise, healthy diet, avoiding tobacco, and limiting alcohol consumption. Poor sleep habits or sleep apnea can raise your risks.

    Diagnosis

    Diagnosing Alzheimer's disease is done by ruling out other diseases or causes, reviewing family history and conducting a mental exam to see how well the brain is working. Some physicians also conduct imaging tests, such as an MRI, which can show changes in the brain's size and structure that may lead to the conclusion of Alzheimer's. While general practice physicians often diagnose Alzheimer's, you can also seek an evaluation from a psychologist, geriatrician, or neurologist.

    Cognitive declines are caused by other conditions, some of which are potentially reversible, such as normal pressure hydrocephalus or vitamin B12 deficiency. Identifying and treating these conditions as soon as possible is important to increase the chance of improved cognition.

    Alzheimer's disease is the most common cause of dementia, but there are many other kinds including vascular dementia, Lewy body dementia, Parkinson's disease dementia, frontotemporal dementia, Huntington's disease, and Creutzfeldt-Jakob disease.

    Treatment

    Current treatment for Alzheimer's focuses on alleviating the symptoms, including cognitive, behavioral, and emotional concerns, by using drug therapy and non-drug approaches. Alzheimer's has no cure at this time.

    Drug Therapy

    Two types of drugs have been approved by the Food and Drug Administration (FDA) to treat Alzheimer's disease: cholinesterase inhibitors, including Aricept (donepezil), Exelon (revastigmine), and Razadyne (galantamine), and N-Methyl D-Aspartate (NMDA) antagonists, including Namenda (memantine). While these medications do appear to improve thought processes for some people, the effectiveness overall varies greatly. These medications need to be monitored regularly for side effects and interaction with other medications.

    Psychotropic medications can be prescribed to target the behavior and emotional symptoms of Alzheimer's. Psychotropics are medications that address the psychological and emotional aspects of brain functioning. For example, if a person is experiencing distressing hallucinations, a psychotropic medication, such as an antipsychotic medication, can be prescribed and is often helpful in relieving the hallucinations. As with other drugs, psychotropics have the potential for significant side effects and interaction with other medications, so they should be used carefully and be coupled with non-drug approaches.

    Non-Drug Approaches

    Non-drug approaches focus on treating the behavioral and emotional symptoms of Alzheimer's by changing the way you understand and interact with the person with Alzheimer's. These approaches recognize that behavior is often a way of communicating for those with Alzheimer's, so the goal is to understand the meaning of the behavior and why it is present.

    Non-drug approaches include efforts to determine the underlying cause of a behavior or emotion. For example, understanding that restlessness could be triggered by a need to go for a walk or use the bathroom—and then addressing those needs—will result in a far more effective response than asking the person with dementia simply to sit back down.

    Non-drug approaches for Alzheimer's disease should generally be attempted before using psychotropic medications since they do not have the potential for side effects or medication interactions.

    Coping

    It's normal to experience grief, sadness, and worry after a diagnosis of Alzheimer's, although there are occasionally some people who feel relieved at having a reason for the symptoms they (or a loved one) are experiencing. Learning about Alzheimer's disease can be overwhelming. However, what's important to know and remember is that it's still possible to have a full and meaningful life, even while living with Alzheimer's disease.

    Emotional health can be promoted by journaling, seeking social support, and counseling. Maintaining your physical health through exercise, diet, and treating existing and new conditions is very beneficial. The social aspects of coping will often mean dealing with the family's adjustment to the diagnosis.

    Practical ways to cope include developing memory strategies and routines. Home safety is highly important to reduce the risk of falls and prevent wandering. After diagnosis, getting advance directives and financial power of attorney in order can help prepare for the future.

    Prevention

    Currently, there is no proven way to fully prevent Alzheimer's disease. However, you can significantly reduce your risk. A heart-healthy diet, an active lifestyle with plenty of physical exercise, social interaction, and regular mental exercise are strategies that have consistently been shown in research to be effective in reducing the risk of Alzheimer's disease.

    A Word From Verywell

    If you think that you or someone you know may have Alzheimer's, getting an evaluation is the first step to early treatment or addressing a reversible condition. Coping with Alzheimer's is not easy, but it's not something you need to do alone. By being proactive and prepared, you can ease some of the challenges of this disease for both you and your family.

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