Alzheimer’s disease (A complete guide)

Alzheimer’s disease

Alzheimer’s disease (AD) is an irreversible, progressive disease of the brain that causes gradual cognitive and memory decline. 

In this blog article, you will learn what Alzheimer’s disease is, the common signs and symptoms, potential causes, and current available treatments. 

What is Alzheimer’s disease?

Alzheimer’s disease (AD) is an irreversible, progressive disease of the brain that causes gradual cognitive and memory decline. AD is the most common cause of dementia. 

What causes Alzheimer’s disease? 

It is unknown exactly what causes AD, but experts believe that a small percentage of cases are related to mutations in three different genes, which are passed down from generation to generation. One important gene that is known to increase the risk for development of AD is apolipoprotein E4 (APOE). 

Patients who are diagnosed with AD have plaques and tangles in their brains. These plaques are made up of clumps of a protein known as beta-amyloid, and the tangles are fibrous tangles made up of a protein called tau. These plaques and tangles damage the way that neurons communicate with one another.

Alzheimer’s disease (A complete guide)


What are the signs and symptoms of Alzheimer’s disease? 

Early signs of AD include forgetting recent events or conversations. As time goes on, a person who has AD will lose the ability to carry out day-to-day tasks and function independently. 

Memory loss is the main symptoms of AD. The person may be aware of his or her symptoms, or a family member or friend might notice how the symptoms are progressing.

People with AD may experience the following: 

·      Repeating statements and questions over and over again 

·      Forgetting conversations, appointments, or events and not remembering them later

·      Misplacing items or putting them in odd places

·      Getting lost in places that are familiar 

·      Eventually forgetting the names of family members and objects 

·      Difficulty finding the right words to express thoughts, identify objects, or take part in conversations

·      Difficulty dealing with numbers, multitasking, managing finances, paying bills, etc. 

·      Decline in the ability to make reasonable decisions and judgements (i.e., wearing clothes that are inappropriate for the weather, poor choices in social interactions)

·      Forgetting how to carry out everyday tasks such as planning and cooking a meal, or dressing and bathing 

Personality and mood changes that occur in people with AD include the following: 

·      Depression

·      Apathy

·      Withdrawal from social activities

·      Mood swings

·      Distrust in others 

·      Aggression and irritability 

·      Wandering

·      Loss of inhibition

·      Changes in sleep habits 

·      Delusions, such as believing someone stole something from them 

The following skills are preserved for longer periods because they are controlled by areas of the brain that are affected much later in the disease course: 

·      Reading or listening to books

·      Telling stories

·      Reminiscing

·      Singing

·      Listening to music

·      Dancing, drawing, or doing crafts 

Alzheimer’s disease (A complete guide)

How is Alzheimer’s disease diagnosed? 

Self-report of symptoms is a large part of the diagnosis of AD. Information from a close family member or friend can help provide the physician with potential AD symptoms and how they impact the patient’s daily life. In order to diagnose AD, your doctor will also perform a thorough physical and neurological examination, as well as test memory and thinking skills. 

Laboratory tests and brain imaging can rule out other potential causes of the symptoms, such as a thyroid disorder or vitamin deficiency. Brain imaging can rule out strokes, trauma, or tumors that may be causing changes in cognitive abilities. 

Certain brain imaging techniques can measure specific features in the brain that are specific to AD. These include the following: 

·      Fluorodeoxyglucose (FDG) PET scans. FDG PET scans show the areas in the brain where nutrients are poorly metabolized, which indicates patterns of neurodegeneration. This can help distinguish AD from other types of dementia. 

·      Amyloid PET imaging. Amyloid PET imaging can measure the amount of amyloid deposits in the brain. This is primarily used in research but can be used if a person has unusual or very early onset of dementia symptoms. 

·      Tau PET imaging. Tau PET imaging measures the number of neurofibrillary tangles in the brain, but is only used in research. 

The Physical examination will test things like reflexes, muscle tone and strength, walking, sense of hearing and sight, and balance and coordination. 

Alzheimer’s disease (A complete guide)

What are the current treatments for Alzheimer’s disease? 

There are currently two types of medications that are used to treat the cognitive symptoms of AD: cholinesterase inhibitors and memantine. 

Cholinesterase inhibitors work by increasing the amount of available acetylcholine in the brain, which is a neurotransmitter that is depleted in AD. A neurotransmitter is a chemical messenger that helps neurons communicate with one another. 

Cholinesterase inhibitors such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon), are commonly prescribed to improve the neuropsychiatric symptoms of AD such as agitation or depression. The main side effects of cholinesterase inhibitors are nausea, loss of appetite, and sleep problems. People with cardiac conditions may develop cardiac arrhythmia from cholinesterase inhibitors. 

Memantine, or Namenda, works in another neuron communication network and slows the progression of symptoms in people with moderate to severe AD. It can be used in combination with a cholinesterase inhibitor. Rare side effects of memantine include dizziness and confusion.

Alzheimer’s disease (A complete guide)

How can I support a loved one with AD?

Certain lifestyle changes can help the person with AD and their caregiver manage the difficulties that come with this disease. 

These include the following: 

·     Always keeping the person’s keys, wallet, cell phone, and other valuables in the same place so they do not get lost

·     Keep medications in a secure location and create a daily checklist to keep track of dosages

·     Arrange for finances and deposits to be done automatically 

·     Carry a cell phone with location capability so that a caregiver can track its location

·     Program important numbers into the cell phone 

·     Make sure appointments are on the same day and at the same time as much as possible

·     Use a calendar or whiteboard in the home to track daily schedules and create a habit of checking off completed items 

·     Remove excess furniture, clutter, and rugs 

·     Install sturdy handrails on stairways and in bathrooms

·     Make sure that shoes and slippers are comfortable and provide good traction with the ground

·     Reduce the number of mirrors in the home because people with AD may find images in mirrors confusing or frightening 

·     Make sure the person with AD carries identification or wears a medical alert bracelet

·     Keep photographs and other meaningful objects displayed around the house

Frequently asked questions (FAQs) about Alzheimer’s disease: 

1.   What are the 7 stages of Alzheimer’s?

Prior to diagnosis, there are no signs of Alzheimer’s. 

Stage one: no impairment

Stage two: very mild cognitive difficulties

Stage three: mild cognitive difficulties

Early stage-dementia includes stage four, which is characterized by moderate cognitive decline 

Mid-stage dementia includes stage five, which is characterized by moderately severe cognitive decline. Stage six is also part of mid-stage dementia and involves severe cognitive decline. 

Late-stage dementia includes stage seven, which is characterized by very severe cognitive decline.

2.   What is the main cause of Alzheimer’s? 

Scientists believe that Alzheimer’s disease is caused by a combination of genetic, lifestyle, and environmental factors that affect the brain gradually. In less than 1% of cases, Alzheimer’s disease is caused by specific genes that guarantee a person will develop the disease. 

3.   What are the very first signs of Alzheimer’s?

Early signs of dementia include the following: 

·      Memory loss

·      Difficulty with planning or problem solving

·      Difficulty doing tasks that are familiar 

·      Confusion about time, place, or date

·      Vision loss

·      Problems finding the right words

·      Misplacing things

·      Poor judgement or decision making 

4.   How does Alzheimer’s kill you?

Alzheimer’s disease destroys the connections in the brain between your neurons. This makes it progressively more difficult to do day to day things like move around, swallow, and feed yourself. This disease destroys the brain, but does not itself kill you. Complications of the decline in cognitive capabilities and brain function are what ultimately lead to death. 

5.   How do you talk to someone with Alzheimer’s?

There are several tips for successful communication with people with Alzheimer’s disease. These include the following: 

-Talk to the person in a one-on-one conversation in a quiet place that has little to no distractions

-Speak slowly and clearly

-Maintain eye contact

-Give the person time to respond so he or she can think about what to say

-Be patience and offer reassurance

-Ask one question at a time 

6.   Does Alzheimer’s run in the family?

In less than 1% of cases, Alzheimer’s disease is caused by specific genes that guarantee a person will develop the disease. Those who have an immediate family member (parent, brother, or sister) with Alzheimer’s disease are more likely to develop the disease. The risk increases if more than one family member has the disease. In these cases, either genetic or environmental factors, or both, play a role in the development of Alzheimer’s. 

7.   Is Alzheimer’s curable?

There is no cure for Alzheimer’s or a way to slow its progression, but there are drug and non-drug options that help manage the symptoms. Understanding what these options are can ensure that individuals with the disease or individuals who are caring for someone with the disease can cope as best as possible and improve the quality of life. 

8.   Is Alzheimer’s preventable?

Research suggests that one in three cases of AD are preventable. The main risk factors that are preventable are lack of exercise, smoking, depression, and poor education.

9.   At what age does Alzheimer’s begin?

Early-onset AD strikes people before the age of 65, which occurs in about 5% of cases. The remaining 95% of people will experience AD symptoms after the age of 65. 

10.                 How do doctors test for Alzheimer’s?

Medical tests such as blood and urine tests as well as brain imaging must be performed to rule out other causes of the symptoms. Brain scans include computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). 

Want to learn more about Alzheimer’s disease? Try these books!

When Reasoning No Longer Works: A Practical Guide for Caregivers Dealing with Dementia and Alzheimer’s Care

This book is a must-have for caregivers of family members or close friends with dementia. It explains what dementia does to the brain, how it is diagnosed, and how to best deal with its effects. Certain important aspects of caregiving are explained in great detail such as how to deal with aggressive or disruptive behaviors, ways to diminish wandering, and when to look for outside help. 

Dementia Types, Risk Factors, & Symptoms (2019 edition): Alzheimer’s disease | Vascular | Lewy Body | Frontotemporal | Huntington’s | Normal Pressure Hydrocephalus | Wernicke Korsakoff Dementias

This book explains everything you need to know about the different types of dementia. It translates current scientific research into everyday language so anyone who is dealing with dementia or a loved one with dementia can read this and be as informed as possible. 

References

Alzheimer’s Disease.Mayo Clinic. 2019

Alzheimer’s disease (A complete guide)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.