Alzheimer's disease was first described in 1907 by a German neuro-psychiatrist, Alois Alzheimer. Alzheimer's disease (AD) is a debilitating, life-altering disease that attacks the brain. Its primary symptom is progressive memory loss, but difficulties with vision, language skills, and emotional control are also common. It is not a normal part of aging. It is a disease in which nerve cells in the area of the brain that control memory, thinking and judgement are damaged.
About 4 million Americans have Alzheimer's disease. Age is the major risk factor for Alzheimer's disease. Five percent of persons over the age of 65 have AD, while almost 50% of persons age 85 and older suffer from AD.
Genetics play an important role. A variation on chromosome 19, called APOE-e4, appears to be a risk factor for Alzheimer's. This gene variation is present in about 15% of the general population, but occurs in 50% of those with late-onset Alzheimer's disease. Presence of APOE-e4 is three times more common in AD patients than in people without this gene. Presence of the gene may mean an increased susceptibility is possible, not a definite probability of getting Alzheimer's.
The course of Alzheimer's disease varies tremendously, but it is always progressive. It is the fourth leading cause of death among adults in the US, claiming more than 100,000 lives a year.
The symptoms of Alzheimer's Disease appear in stages. Symptoms usually begin with loss of recent memories. For example, you may unknowingly repeat stories in the same conversation. Or you may forget certain events. Other symptoms include:
Over time, people forget how to perform even the simplest tasks. They are often unable to recognize faces and use common objects. Even the names of their own children or grandchildren are forgotten. Personality changes can occur, including:
- Trouble learning new information
- Gradually increasing confusion and disorientation
- Trouble speaking in conversations
- Personality and behavioral changes
- Misplacing objects or becoming lost in familiar neighborhoods
- Problems with judgment and common sense
- Slow movement
Unfortunately, in early stages, many people fail to see these symptoms as something wrong. They may think that such behavior is a normal part of getting older. It is not. Symptoms may develop gradually and go unnoticed for a long time. And some people do not act even when they know something is wrong.
- Loss of appetite
- Loss of interest in usual activities
- Progressive tameness or passivity
- Agitation and restlessness
- Suspiciousness and distrust of caregivers or family members
It is important to see a doctor when you suspect Alzheimer’s disease symptoms. Only a doctor can diagnose your condition correctly. Symptoms may be due to a form of dementia that can be treated with drugs. Even if your doctor says you have Alzheimer’s disease, there are new treatments.
At this point, there is no proven way to prevent Alzheimer’s disease. But researchers believe there are several things that you can do to help keep your brain healthy:
10 Warning Signs of Alzheimer’s Disease
The American Academy of Neurology dementia guidelines recommend early recognition and diagnosis of Alzheimer’s disease. The Alzheimer’s Association has created a list of warning signs that include common symptoms of the disorder. People who show several of these symptoms should see a doctor for a complete examination.
- Memory loss that affects job skills. It’s normal to sometimes forget an assignment, deadline, or colleague’s name. But frequent memory problems or unexplainable confusion at home or at work may mean that something is wrong.
- Difficulty performing familiar tasks. Busy people get distracted from time to time. For example, you might leave something on the stove too long or forget to serve part of a meal. People with Alzheimer’s disease might make a meal and not only forget to serve it, but also forget they made it.
- Problems with language. Everyone has trouble finding the right word sometimes. A person with Alzheimer’s disease may forget simple words or substitute wrong words. This may make his or her sentences difficult to understand.
- Disorientation to time and place. It’s normal to momentarily forget the day of the week or what you need from the store. But people with Alzheimer’s disease can become lost on their own street. They don’t know where they are, how they got there, or how to get back home.
- Poor or decreased judgment. Choosing not to bring a sweater or coat along on a chilly night is a common mistake. A person with Alzheimer’s disease, however, may dress incorrectly in more obvious ways, wearing a bathrobe to the store or several blouses on a hot day.
- Problems with abstract thinking. Balancing a checkbook can be hard for many people. For someone with Alzheimer’s disease, recognizing numbers or doing basic math may be impossible.
- Misplacing things. Everyone temporarily loses a wallet or keys from time to time. A person with Alzheimer’s disease may put things in wrong places – such as an iron in the freezer or a wristwatch in the sugar bowl – and then forget how they got there.
- Changes in mood or behavior. Everyone feels a wide range of emotions – it’s part of being human. People with Alzheimer’s disease tend to show fast mood swings more often for no known reason.
- Changes in personality. People’s personalities may change a bit as they age. But a person with Alzheimer’s disease can change in a big way, either suddenly or over a period of time. Someone who is usually easy to get along with may become angry, suspicious, or fearful.
- Loss of initiative. It’s normal to get tired of housework, business events, or social commitments. But most people keep, or get back, their interest. The person with Alzheimer’s disease may stay uninterested and detached from many or all of his usual activities.
Although a lot of time and money goes into research, we are still trying to understand the cause of Alzheimer’s disease. Inherited or genetic factors and aging seem to play an important role. We do know it is not contagious; you can’t catch it from another person.
- Avoid harmful substances Drinking too much alcohol and abusing drugs are thought to damage brain cells.
- Challenge yourself. Read books, newspapers, and magazines. Keep your brain active and learn new skills. This strengthens the brain connections and promotes new ones.
A brain affected with Alzheimer’s disease is filled with deposits of a waxy substance. This is called “amyloid” or “plaque.” Affected nerve cells are filled with tangles of stringy material. As these tangles spread, the brain’s nerve cell connections are reduced. This usually begins in the areas of the brain that store short-term memories. Then it works into areas that control other intellectual and physical functions.
Some of these changes happen in normal aging. A much greater amount of change is found in people with Alzheimer’s disease.
If you are a person with Alzheimer’s disease and have at least one other relative with the disorder, the condition is called “familial.” This does not necessarily mean that is it genetic. Family members may have been exposed to something in their environment that caused the disorder. If you have the condition and no other family members are known to have been affected, you have “sporadic” Alzheimer’s disease.
There is no single test to diagnose Alzheimer's disease. It is often diagnosed by ruling-out many other potential causes of the symptoms. Illnesses like depression, hypothyroidism, vitamin B12 deficiency, hydrocephalus, cerebral vasculitis, neurosyphilis, stroke, ischemia, and some medications as well as alcohol can cause many of the symptoms attributed to Alzheimer's.
To obtain a complete and accurate diagnosis, it is important to have a complete physical exam, health history, neurological and mental status exams and laboratory analysis of blood and urine. Your physician may order additional tests such as computerized tomography (CAT) scan, electroencephalography or magnetic resonance imaging (MRI).
Documenting symptoms and behaviors over time in a diary can be very helpful in contributing to information that may lead to a diagnosis. Tests that assess memory and cognitive abilities such as The Mini Mental Status Exam as well as other cognitive tests can help establish the extent of memory loss.
There is no simple test to diagnose Alzheimer’s disease. Doctors only know for sure by examining brain tissue. This usually happens after the person has died. When Alzheimer’s disease is suspected, it is important to have a complete medical and neurological evaluation. The proper evaluation may include:
- A complete health history and physical examination.
- Neurological and mental status tests.
- Tests of blood and urine.
- Electrocardiogram and chest X-rays.
- Looking at pictures of the brain using computerized tomography scan (CT), electroencephalography (EEG), or magnetic resonance image scan (MRI).
There is currently no cure for Alzheimer's Disease, but there are new medications available for the treatment of symptoms.
The US Food and Drug Administration has approved four drugs for Alzheimer’s disease:
Many drugs can reduce behavior changes caused by the disorder. These changes include depression, insomnia, agitation, restlessness, nervousness, hallucinations, and delusions or false beliefs.
- Donepezil hydrochloride
Research provides great hope. Studies of animals that model the disorder have led to discoveries in our understanding of Alzheimer’s and possible new treatments. The effects of hormones, anti-inflammatory drugs, vitamin E, and other common drugs are also being examined.
Researchers are testing experimental treatments in clinical drug trials. Promising therapies include a drug that might clear out the chemical deposits inside the affected brain. Other research seeks to prevent the start of dementia in people at risk for Alzheimer’s disease. Participation in these studies by people with the disorder is needed to prove their usefulness as quickly as possible.