Alzheimer’s disease is a progressive neurological disorder that causes the brain to shrink (atrophy) and cause brain neurons to die. Alzheimer’s disease is the most common cause of dementia, a continuous decline in thinking, behavior, and social skills that affects a person’s ability to live independently.
In the United States, about 5.8 million people 65 and older are living with Alzheimer’s disease. Of these, 80% are 75 years or older. Of the approximately 50 million people with dementia worldwide, an estimated 60% to 70% have Alzheimer’s disease.
Early signals of the condition include forgetting about the latest events or conversations. As the disease progresses, a person with Alzheimer’s disease will experience severe memory impairment and lose the ability to carry out daily tasks.
Medications can temporarily improve symptoms or slow their progression. These treatments can help people with Alzheimer’s disease to maximize their function and function independently for a time. There are different programs and services to support people with Alzheimer’s disease and their caregivers.
No treatment cures Alzheimer’s disease or alters the course of the disease in the brain. In the advanced stages of the condition, problems from severe loss of brain function (such as dehydration, malnutrition, or infection) lead to death.
Symptoms of Alzheimer’s Disease
Memory loss is a key symptom of Alzheimer’s disease. The first signs include difficulty remembering recent events or conversations. As the condition progresses, memory problems worsen and other symptoms develop.
At first, a person with Alzheimer’s disease may be aware that he has trouble remembering things and organizing thoughts. A family member or friend is more likely to notice symptoms worsening.
The changes that Alzheimer’s disease makes in the brain lead to growing problems that affect the following:
Everyone has occasional blackouts, however, the memory loss connected with Alzheimer’s disease persists, worsens, and influences the opportunity to function at the job and home.
People with Alzheimer’s disease may exhibit the following behaviors:
- Repeat affirmations and questions over and over again
- Forgetting about conversations, appointments, or events, and not remembering them later
- Systematically placing personal items in the wrong place, often in absurd places
- Get lost in places they already know
- Finally, forgetting the names of relatives and everyday objects
- Have trouble identifying objects with the correct words, expressing thoughts, or participating in conversations
Thinking and reasoning
Alzheimer’s disease causes problems concentrating and thinking, especially about abstract concepts, such as numbers.
Multitasking is also particularly difficult, and managing finances, bringing bills up to date, and paying bills on time are all tasks that can be challenging. Ultimately, a person with Alzheimer’s disease cannot recognize and handle numbers.
Make assessments and make decisions
Alzheimer’s disease causes a decline in the ability to make reasonable decisions and judgments in everyday situations. For example, a person may make bad or unusual choices in social interactions or wear inappropriate clothing for the weather. It can be more difficult to respond effectively to everyday problems, such as food being burned on the stove or faced with an unforeseen situation while driving.
Plan and do family activities
As the disease worsens, activities that were once part of the routine and that required sequential steps, such as planning and preparing a meal or playing a favorite game, become difficult. Over time, people with advanced Alzheimer’s disease often forget how to do basic tasks, such as dressing and bathing.
Changes in personality and behavior
The brain changes that occur in Alzheimer’s disease can affect mood and behavior. Problems can include the following:
- Social isolation
- Humor changes.
- Mistrust in others
- Irritability and aggressiveness
- Changes in sleep patterns
- Loss of inhibition
- Delusions, like believing that you were robbed
Many crucial skills are preserved for extended periods even while symptoms worsen. Preserved abilities can include reading or hearing books, telling reports and remembering, singing, hearing music, dance, drawing, or carrying out crafts.
These capabilities could be preserved longer because they’re managed by an area of the mind that is afflicted later throughout the disease.
When to see a doctor
Some disorders, including treatable disorders, can cause memory loss or other symptoms of dementia. If you’re concerned about your memory or other reasoning skills, talk to your doctor for a comprehensive evaluation and diagnosis.
If you are concerned about the reasoning skills you observe in a family member or friend, talk about your concerns and ask them to go to a doctor’s appointment together.
Causes of Alzheimer’s Disease
The precise factors behind Alzheimer’s disease aren’t fully understood. But at a simple level, brain proteins usually do not function normally, disrupting the task of mind neurons and creating several toxic occasions. Neurons become damaged, drop connections with one another, and eventually die.
Scientists believe that, in most cases, Alzheimer’s disease is caused by a combination of genetic, environmental, and lifestyle factors that affect the brain over time.
Less than 1% of the time, Alzheimer’s disease occurs from specific genetic changes that virtually guarantee that a person will develop the disease. These rare circumstances usually bring about the onset of the condition in middle age.
Damage most often commences around the mind that controls memory, however, the process begins years before the first symptoms. The increased loss of neurons spreads in a relatively predictable pattern to different parts of the brain. In the advanced stage of the disease, brain tissue is considerably reduced.
Researchers trying to understand the cause of Alzheimer’s disease focus on the role of two proteins:
- Plates. Amyloid beta is a fragment of a larger protein. When these fragments clump jointly, they appear to possess a toxic influence on neurons and disrupt conversation between cells. These clumps form larger deposits called amyloid plaques, which also include other cellular debris.
- Balls. Tau proteins play a role in a neuron’s internal support and transport system for transporting nutrients and other essential materials. In Alzheimer’s disease, tau proteins change shape and organize themselves into structures called neurofibrillary tangles. The tangles disrupt the transport system and are toxic to neurons.
Old age is the risk factor that most affects Alzheimer’s disease. Alzheimer’s is not part of normal aging, but as you get older the likelihood of Alzheimer’s disease increases.
For example, according to one study, each year there were four new diagnoses for every 1,000 people aged 65 to 74, 32 new diagnoses for every 1,000 people aged 75 to 84, and 76 new diagnoses for every 1,000 people aged 85 and over.
Family history and genetics
The risk of developing Alzheimer’s disease is slightly higher if a first-degree relative (father or brother) has the disease. Most of the genetic mechanisms of Alzheimer’s disease within the family group are still unknown, and the genetic factors are likely to be complex.
A more studied genetic factor is a form of the apolipoprotein E (APOE) gene. A variation of the APOE e4 gene increases the risk of Alzheimer’s disease. About 25 to 30% of the population carries an APOE E4 allele, but not all people with this variation of the gene develop the disease.
Scientists have identified rare changes (mutations) in three genes that virtually guarantee that a person who inherits one of them will develop Alzheimer’s disease. However, these mutations represent less than 1% of people with Alzheimer’s disease.
Many people with Down syndrome develop Alzheimer’s disease. This is probably related to having three copies of chromosome 21 and subsequently three copies of the gene for the protein that leads to the creation of beta-amyloid. The signs and symptoms of Alzheimer’s disease usually appear 10 to 20 years earlier in people with Down syndrome than in people in the general population.
There appears to be little difference in risk between men and women, but overall, more women have the disease as they tend to live longer than men.
Mild cognitive impairment
Mild cognitive impairment is a stage that affects memory or other thinking skills to a greater extent than normal for a person’s age but does not prevent the sufferer from functioning in social or work settings.
People with mild cognitive impairment are at significant risk for dementia. When the primary deficit of mild cognitive impairment in memory, the patient is more likely to have dementia caused by Alzheimer’s disease. The diagnosis of mild cognitive impairment encourages the patient to focus more on healthy lifestyle changes, create strategies to compensate for memory loss, and schedule regular doctor appointments to manage symptoms.
People who have suffered a severe head injury are at higher risk of developing Alzheimer’s disease. Several large studies found that in people 50 and older who had a traumatic brain injury, the risk of developing dementia or Alzheimer’s disease is higher. The risk is increased in people with multiple and more severe traumatic brain injuries. Some studies indicate that the risk may be highest within the first six months to two years after traumatic brain injury.
According to animal studies, air pollution particles can accelerate the degeneration of the nervous system. And, according to individual studies, exposure to polluting of the environment, particularly from exhaust fumes from visitors and burning real wood, is connected with an increased threat of dementia.
Excessive alcohol consumption
Drinking large amounts of alcohol has long been known to cause changes in the brain. Several large studies and reviews discovered that alcohol use disorders were associated with an increased threat of dementia, particularly early-onset dementia.
patterns According to research, poor sleep patterns, such as difficulty falling asleep or staying asleep, are associated with an increased risk of Alzheimer’s disease.
Lifestyle and heart health
Research has shown that the same risk factors associated with heart disease can also increase the risk of Alzheimer’s disease. Some of them are the following:
- Lack of exercise
- Smoking or second-hand smoke
- High blood pressure
- High cholesterol
- Poorly controlled type 2 diabetes
All of these factors can be modified. Therefore, changing your lifestyle can, to some extent, change your risk. For example, exercising regularly and eating a healthy diet that is low in fat and rich in fruits and vegetables are associated with a lower risk of developing Alzheimer’s disease.
Permanent education and participation in social activities
According to the studies carried out, there is an association between permanent participation in mental and social stimulation activities and a lower risk of suffering from Alzheimer’s disease. Low educational levels, below secondary education, appear to be a risk factor for Alzheimer’s disease.
Memory and language loss, impaired judgment, and other cognitive changes caused by Alzheimer’s disease can complicate treatment for other diseases. A person with Alzheimer’s disease may not be able to do the following:
- Express that you feel pain
- Report symptoms of another illness
- Follow an indicated treatment plan
- Report medication side effects
As Alzheimer’s disease progresses into the later stages, alterations in the brain get started to affect physical capabilities, such as swallowing, equilibrium, and bowel and bladder control. These results can enhance vulnerability to other health issues, like the following:
- Inhaling food or liquids into the lungs (aspiration)
- Flu, pneumonia, and other infections
- Malnutrition and dehydration
- Constipation or diarrhea
- Dental problems such as mouth sores or cavities
Alzheimer’s disease is a disease that cannot be prevented. However, numerous risk factors could be modified inside our lifestyle for Alzheimer’s disease. Evidence shows that changes in diet plan, exercise, and habits (methods to lessen the risk of coronary disease) may also decrease the risk of developing Alzheimer’s disease and additional disorders that trigger dementia. Options for a heart-healthy lifestyle that can reduce the risk of Alzheimer’s disease include the following:
- Get regular exercise
- Eat a diet of fresh products, healthy oils, and foods low in saturated fat, such as the Mediterranean diet
- Carry out treatment guidelines to regulate high blood circulation pressure, diabetes, and raised cholesterol
- If you smoke, ask your doctor to help you quit
Studies have shown that participating in social events, reading, dancing, playing board games, creating art, playing musical instruments, and other activities that require mental and social engagement help maintain intellectual abilities in adulthood and reduce the risk of developing Alzheimer’s disease.
An important component of diagnosing Alzheimer’s disease includes having the ability to clarify the symptoms, in addition to a relative or close friend’s point of view about them and their effect on daily life. Also, a diagnosis of Alzheimer’s disease is based on tests your doctor performs to assess memory and thinking skills.
Laboratory and imaging tests can rule out other potential causes or help your doctor better identify the disease-causing your dementia symptoms.
Alzheimer’s disease could be safely diagnosed only after the loss of life, of which point microscopic study of the mind reveals the feature plaques and tangles.
A diagnostic physical exam usually includes the following tests:
Physical and neurological examination
Your doctor will perform a physical exam and will likely assess your general neurological health using the following tests:
- Muscle tone and strength
- Your ability to get up from a chair and walk around the room
- Sense of sight and hearing
Blood tests can help your doctor rule out other possible causes of memory loss and confusion, such as thyroid disease or vitamin deficiencies.
Neuropsychological and mental state analysis
Your doctor may give you a brief mental status test to assess your memory and thinking skills. Longer forms of neuropsychological analysis can provide additional details on mental function compared to other people of a similar age and level of education. These tests can help establish a diagnosis and serve as a starting point to follow the progression of symptoms in the future.
Imaging of the brain is now used primarily to detect visible abnormalities related to diseases other than Alzheimer’s disease, such as strokes, trauma, or tumors, which can cause cognitive changes. New imaging applications, currently in use in major medical centers or clinical trials, may allow doctors to detect specific changes in the brain caused by Alzheimer’s disease.
Images of brain structures include the following:
- Magnetic resonance imaging. Magnetic resonance imaging uses radio waves and a powerful magnetic field to produce detailed images of the brain. While they may show a brain shrinkage of brain regions associated with Alzheimer’s disease, MRI scans also rule out other conditions. Magnetic resonance imaging is generally preferred to computed tomography for evaluation of dementia.
- Computed tomography. A CT scan, a specialized x-ray technology, produces cross-sectional images (slices) of the brain. It is often used to rule out tumors, strokes, and head injuries.
Imaging of disease processes can be done with positron emission tomography. During a positron emission tomography scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature of the brain. Images from a positron emission tomography scan may include the following:
- Positron emission tomography scans with fluorodeoxyglucose show areas of the brain where nutrients are poorly metabolized. Identifying habits of degeneration (regions of low metabolism) might help distinguish between Alzheimer’s disease and other styles of dementia.
- Amyloid positron emission tomography images can gauge the load of amyloid deposits on the brain. These images are mainly used in research but can be used if a person has unusual or very early onset symptoms of dementia.
- Tau imaging by positron emission tomography, which measures the load of neurofibrils balls in the brain, is generally used in the field of research.
In special circumstances, such as rapidly progressive dementia, dementia with atypical features, or early-onset dementia, other tests may be used to measure abnormal levels of beta amyloids and tau in the cerebrospinal fluid.
Future diagnostic tests
Researchers are working to create tests that measure the biological signs of disease processes in the brain.
These tests, including blood tests, may improve the accuracy of diagnoses and allow a diagnosis to be made earlier, before the onset of symptoms. Currently, there is a blood test for Aβ plasma that was recently certified in the United States by the Centers for Medicare and Medicaid Services for distribution in the market.
Generally speaking, genetic testing is not recommended as part of a routine assessment of Alzheimer’s disease, except for people with a family history of early-onset Alzheimer’s disease. It is recommended to talk to a genetic counselor about the risks and benefits of genetic testing before undergoing any testing.
Current medications to treat Alzheimer’s disease may be helpful for a while for symptoms that affect memory and for other cognitive changes. Currently, two types of medications are used to relieve symptoms that affect the cognitive system:
- Cholinesterase inhibitors. These drugs increase levels of communication between cells by preserving a neurotransmitter that is depleted in the brain by Alzheimer’s disease. These are usually the first medications to be tested and most people see modest improvements in symptoms.Cholinesterase inhibitors may also improve neuropsychiatric symptoms, such as agitation or depression. Frequently prescribed cholinesterase inhibitors are donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). The main side effects of these medications are diarrhea, nausea, loss of appetite, and sleep disturbances. People with certain heart disorders may experience serious side effects, such as cardiac arrhythmia.
- Memantine (Namenda). This medication works in another brain cell communication network and slows the progression of symptoms in moderate to severe Alzheimer’s disease. It is sometimes found in a mixture with a good cholinesterase inhibitor. Relatively uncommon side effects consist of dizziness and disorientation.
Other medications, such as antidepressants, may sometimes be prescribed to help control behavioral symptoms associated with Alzheimer’s disease.
Creating a security and containment environment
Adapting living conditions to the needs of a person with Alzheimer’s disease is an important part of any treatment plan. Developing and reinforcing habits that are part of the routine and minimizing memory-demanding tasks are measures that can greatly facilitate the life of a person with Alzheimer’s disease.
You can take the following steps to help a person not lose the sense of well-being or the continuous ability to develop:
- In your home always keep keys, wallets, cell phones, and other valuables in the same place so you don’t lose them.
- Keep medications in a safe place. Use a daily checklist to keep track of doses.
- Organize financial transactions so that they are by automatic payment or deposit.
- Make sure the person with Alzheimer’s disease carries a location-capable cell phone so a caregiver can track their location. Program important phone numbers on the phone.
- Install alarm sensors on doors and windows.
- Make sure that regular medical appointments, as far as possible, are on the same day and at the same time.
- Use a calendar or whiteboard at home to keep track of daily tasks. Get used to crossing out the tasks performed.
- Remove over-furniture, clutter, and rugs.
- Place strong railings on the stairs and in the bathrooms.
- Make sure the footwear is comfortable and provides good traction.
- Reduce the number of mirrors. People with Alzheimer’s disease may feel fear or confusion when looking at images in mirrors.
- Make sure the person with Alzheimer’s disease carries an ID or wears a medical alert bracelet.
- Leave photographs and other significant objects in different parts of the house.
There are a variety of herbal remedies, vitamins, and supplements that are widely touted as products that may be beneficial to cognitive health or prevent or delay Alzheimer’s disease. Clinical trials have produced mixed results with little evidence to support them as effective treatments.
Some of the treatments that were studied in the last time are the following:
- Vitamin E. While vitamin E does not prevent Alzheimer’s disease, taking 2,000 units internationally per day can help slow the progression of the disease in people who already have mild to moderate disease. However, the results of the study yielded mixed results, with only a few indicating modest benefits. More research on the safety of consuming 2,000 international units per day of vitamin E in people with dementia must be conducted before it can be systematically recommended.
Supplements touted for cognitive health may interact with medications you take for Alzheimer’s disease or another health condition. Work with your health care team to create a safe treatment plan with any prescriptions, over-the-counter medications, or dietary supplements.
- Omega-3 fatty acids. Omega-3 fatty acids from fish or supplements may reduce the risk of developing dementia, but clinical studies showed no benefit for treating the symptoms of Alzheimer’s disease.
- Curcumin. This medicinal herb comes from turmeric and possesses anti-inflammatory and antioxidant properties that could affect the chemical processes of the brain. So far, clinical trials have shown no benefit in the treatment of Alzheimer’s disease.
- Ginkgo. Ginkgo is a plant extract that contains several medicinal properties. According to an extensive study funded by the National Institutes of Health, it does not affect the prevention or delay of Alzheimer’s disease.
- Melatonin. This is a supplement to a hormone that regulates sleep and is being studied to determine if it offers sleep control benefits in people with dementia. But some analysis has indicated that melatonin may worsen mood in a few persons with dementia. More research is needed.
Lifestyle and folk remedies
Healthy lifestyle choices promote good overall health and can play a role in maintaining cognitive health.
Regular exercise is an important part of a treatment plan. Activities such as a daily walk can improve mood and maintain the health of joints, muscles, and heart. Exercise can also promote restful sleep and prevent constipation and is also beneficial for companions involved in care.
People with Alzheimer’s disease who have trouble walking can still use a stationary bike with elastic bands or exercise in a chair. You can find exercise programs designed by older adults on TV or DVD.
People with Alzheimer’s disease may forget that they have to eat, lose interest in preparing meals, or do not eat a combination of healthy foods. They may also forget to hydrate well, and this causes dehydration and constipation.
It offers the following:
- Healthy choices. Buy your favorite foods that are healthy and easy to eat.
- Water and other healthy drinks. Encourage plenty of fluids every day. Avoid caffeinated beverages, which can increase agitation, interfere with sleep, and cause the need to urinate frequently.
- Healthy smoothies with a high contribution of calories. Enrich milk smoothies with protein powder or prepare fruit smoothies with your favorite ingredients, especially when it’s hard to eat.
Participate in social events and other activities
Social interactions and activities can support the skills and abilities that are preserved. Performing important and enjoyable activities is important for the overall well-being of a person with Alzheimer’s disease. These may include the following:
- Listen to music or dance
- Read or listen to books
- Gardening or crafts
- Participate in social events in care centers for the elderly or memory
- Perform planned activities with children
Coping strategies and support
People with Alzheimer’s disease experience a mixture of emotions, such as confusion, frustration, anger, fear, uncertainty, grief, and depression.
If you are responsible for caring for a person with Alzheimer’s disease, you can help them cope with the disease by listening to them, assure them that they can still enjoy life, give them your support, and do everything you can to keep them from losing dignity or self-esteem.
A quiet and steady home environment might help reduce behavioral problems.
New situations, noise, large groups of people, rushing or pressuring the sick person to remember something, or asking them to do complicated tasks can cause anxiety. When the person with Alzheimer’s disease is altered, the ability to think clearly decreases further.
Care for the person with Alzheimer’s disease
Providing care to a person with Alzheimer’s disease can be a physical and emotional demand. Feelings of anger, guilt, stress, disappointment, worry, grief and social isolation are common.
Providing care to people with Alzheimer’s can even affect the physical health of the person responsible for care. One of the most important things for you and the person with Alzheimer’s is that you pay attention to your own needs and well-being.
If you are responsible for caring for someone with Alzheimer’s, you can help yourself as follows:
- Learn as much as you can about the disease
- Ask questions of doctors, social workers, and others involved in your loved one’s care
- Call friends and family for help when you need it
- Take a break every day
- Spend time with your friends
- Take care of your health respecting your own medical consultations, eating healthily, and exercising
- Join a support group
- Use an adult day center in your locality, if possible
Many people with Alzheimer’s disease and their families benefit from local counseling or support services. Contact your local Alzheimer’s Association affiliate to contact support groups, doctors, occupational therapists, resources and referrals, home care agencies, residential care centers, a helpline, and educational seminars.
Preparing for the consultation
Medical care for the loss of memory or other intellectual abilities often requires a team strategy or a collaborator. If you’re concerned about memory loss or related symptoms, ask a family member or close friend to accompany you to a doctor’s appointment. In addition to providing support, your collaborator can help answer questions.
If you’re accompanied to a doctor’s appointment, you may need to report changes you’ve seen, or comment on them. This teamwork is a very important part of medical care both at initial appointments and during the treatment plan.
Your family doctor may refer you to a neurologist, psychiatrist, neuropsychologist, or other specialists for further evaluation.
What you can do
You can prepare for your appointment by noting as much information as possible to share. This information may include the following:
- Medical history, including past or current diagnoses and family medical history
- Medical equipment, including the name and contact information of any doctor, mental health professional, or therapist currently caring for you
- Medicines, including prescription, over-the-counter, vitamins, herbal medicines, or other dietary supplements
- Symptoms, including specific examples of changes in memory or thinking abilities
What to expect from the doctor
Your doctor will probably ask you several of the following questions to understand changes in memory or other thinking skills. If you’re accompanying someone to a doctor’s appointment, be prepared to give your opinion as needed. Your doctor may ask you these questions:
- What types of memory problems and mental slips do you have? When did you first notice them?
- Are you continually getting worse, or sometimes you feel better and sometimes worse?
- Did you stop doing certain activities, such as managing finances or shopping, because they were complex for you?
- How is your mood? Do you feel depressed, with more sadness or anxiety than usual?
- Have you got lost in a path or situation that is usually familiar to you?
- Has anyone expressed unusual concern to you about the fact that you’re driving?
- Have you noticed any changes in the way you tend to react to people or events?
- Do you have more energy than normal, less energy than normal, or about the same energy?
- What medicines are you taking? Do you take any vitamins or supplements?
- Do you drink alcohol? How much?
- Have you noticed tremors or trouble walking?
- Having trouble remembering doctor’s appointments or medication times?
- Have you had an ear and eye analysis recently?
- Is there anyone else in your family who has ever had memory problems? Was anyone in your family diagnosed with Alzheimer’s disease or dementia?
- Do you physically represent dreams while you sleep (such as punching, shaking your body, or screaming)? Snore?