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 is typically seen in older adults. There is no cure, but symptoms can be managed through the use of behavioral strategies and medication.

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.

While the progression of Alzheimer's disease can vary based on the person, it typically follows a similar pattern that can be categorized into three different stages:

  • 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 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.

Alzheimer's is not part of normal aging; however, as you age, the likelihood of developing Alzheimer's increases. About 13% of individuals over age 65 have Alzheimer's or another form of dementia, while about 30% of individuals over age 85 have Alzheimer's or another kind of dementia.

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 65, and early-onset Alzheimer's, which is defined by symptoms that begin before age 65.

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 the disease.

Cardiovascular disease and sustaining a head injury 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 risk as well.

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 suggest the diagnosis 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 can also be caused by other conditions, some of which are potentially reversible, so an early and accurate diagnosis is necessary.

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.

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.

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 the behavioral and psychological symptoms of Alzheimer's disease should generally be attempted before using medications since they do not have the potential for side effects or interactions.

Drug Therapy

Two types of drugs have been approved by the U.S. Food and Drug Administration (FDA) to treat Alzheimer's disease are:

  • Cholinesterase inhibitors, including Aricept (donepezil), Exelon (revastigmine), and Razadyne (galantamine)
  • N-Methyl D-Aspartate (NMDA) antagonists, including Namenda (memantine)

While these medications do appear to improve thought processes and potentially slow decline for some people, their effectiveness overall varies greatly.

Psychotropic medications can be prescribed to target the behavior and emotional symptoms of Alzheimer's.

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.

Seek social support and counseling, if needed. Maintain your physical health as best as possible, and follow through with practical ways to improve your memory (such as setting routines), stay safe, and set yourself up to receive the best care now and down the road by establishing powers of attorney and assessing your finances.

Taking charge of your future as best you can can help you better manage the lifestyle and emotional challenges that can come with this diagnosis.

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 that might instead be behind symptoms). 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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