Alzheimer’s and Brain Awareness Month

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive form of dementia. Dementia is a broader term for conditions caused by brain injuries or diseases that negatively affect memory, thinking, and behavior. These changes interfere with daily living.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 early onset Alzheimer’s disease.

There’s no cure for Alzheimer’s, but there are treatments that can slow the progression of the disease.

 

Alzheimer’s facts

Although many people have heard of Alzheimer’s disease, some aren’t sure exactly what it is. Here are some facts about this condition:

  • Alzheimer’s disease is a chronic ongoing condition.
  • Its symptoms come on gradually and the effects on the brain are degenerative, meaning they cause slow decline.
  • There’s no cure for Alzheimer’s but treatment can help slow the progression of the disease and may improve quality of life.
  • 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.
  • Alzheimer’s and dementia aren’t the same thing. Alzheimer’s disease is a type of dementia.
  • 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.

 

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.

 

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.

 

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 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.

 

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 an ability to keep 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

 

Alzheimer’s stages

Alzheimer’s is a progressive disease, which means the symptoms will gradually worsen over time. Alzheimer’s is broken down into seven stages:

  1. There are no symptoms at this stage but there might be an early diagnosis based on family history.
  2. The earliest symptoms appear, such as forgetfulness.
  3. Mild physical and mental impairments appear, such as reduced memory and concentration. These may only be noticeable by someone very close to the person.
  4. Alzheimer’s is often diagnosed at this stage, but it’s still considered mild. Memory loss and the inability to perform everyday tasks is evident.
  5. Moderate to severe symptoms require help from loved ones or caregivers.
  6. At this stage, a person with Alzheimer’s may need help with basic tasks, such as eating and putting on clothes.
  7. This is the most severe and final stage of Alzheimer’s. There may be a loss of speech and facial expressions.

As a person progresses through these stages, they’ll need increasing support from a caregiver.

 

Diagnosing Alzheimer’s disease

The only definitive way to diagnose someone with Alzheimer’s disease is to examine their brain tissue after death. But your doctor can use other examinations and tests to assess your mental abilities, diagnose dementia, and rule out other conditions.

They’ll likely start by taking a medical history. They may ask about your:

  • symptoms
  • family medical history
  • other current or past health conditions
  • current or past medications
  • diet, alcohol intake, or other lifestyle habits

From there, your doctor will likely do several tests to help determine if you have Alzheimer’s disease.

 

Alzheimer’s tests

There’s no definitive test for Alzheimer’s disease. However, your doctor will likely do several tests to determine your diagnosis. These can be mental, physical, neurological, and imaging tests.

Your doctor may start with a mental status test. This can help them assess your short-term memory, long-term memory, and 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, and take your temperature. In some cases, they may collect urine or blood samples for testing in a laboratory.

Your doctor may also conduct a neurological exam to rule out other possible diagnoses, such as an acute medical issue, such as infection or stroke. During this exam, they will check your reflexes, muscle tone, and speech.

Your doctor may also order brain-imaging studies. These studies, which will create pictures of your brain, can include:

  • Magnetic resonance imaging (MRI). 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.
  • Positron emission tomography (PET) scan. PET scan images can help your doctor detect plaque buildup. Plaque is a protein substance related to Alzheimer’s symptoms.

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.

 

Alzheimer’s medication

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 is a type of neurotransmitter that can help aid your memory.

To treat moderate to severe 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, antianxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms include:

  • depression
  • restlessness
  • aggression
  • agitation
  • hallucinations

 

Preventing Alzheimer’s

Just as there’s no known cure for Alzheimer’s, there are no foolproof preventive measures. However, researchers are focusing on overall healthy lifestyle habits as ways of preventing cognitive decline.

The following measures may help:

  • Quit smoking.
  • Exercise regularly.
  • Try cognitive training exercises.
  • Eat a plant-based diet.
  • Consume more antioxidants.
  • Maintain an active social life.

Be sure to talk with your doctor before making any big changes in your lifestyle