Alzheimer’s Disease: Symptoms, Causes, and Treatment

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What is Alzheimer’s disease?

The National Institute on Aging of the US defines Alzheimer’s disease as “an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks.” (National Institute on Aging, 2017)

Alzheimer’s disease is the most common form of dementia, accounting for 60-80% of cases of dementia in the United States. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.

Symptoms usually first appear when the person is in his/her mid-60s. Very rarely, symptoms can occur during the mid-30s to mid-60s as in early-onset Alzheimer’s. At first, symptoms are mild, but they become more severe over time. As symptoms worsen, it becomes harder for people to remember recent events, to reason, and to recognize people they know. Eventually, a person with Alzheimer’s will need full-time assistance (MacGill, 2018).

Alzheimer’s is the sixth-leading cause of death in the United States. On average, a person with Alzheimer’s lives 4-8 years after diagnosis but can live as long as 20 years, depending on other factors. Currently, Alzheimer’s has no cure, but symptomatic treatment is available and research is ongoing (Alzheimer’s Association, n.d.).

Photo of Auguste Deter - the first described case in 1902 of what became known as Alzheimer's disease
The first described case of what became known as Alzheimer’s disease – Auguste Deter in 1902 (By Unknown, Public Domain, https://commons.wikimedia.org/w/index.php?curid=1595297)

Symptoms of Alzheimer’s Disease (Alzheimer’s Association, n.d.) (Mayo Clinic Staff, 2018)

Memory

The most common early symptom of Alzheimer’s disease is difficulty remembering newly learned information. As we age, most of us eventually notice some slowed thinking and occasional problems with remembering certain things, such as where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer’s disease persists and worsens, affecting the ability to function at work or at home. Signs of dementia may be more obvious to family members or friends.

People with Alzheimer’s may:

  • Forget important dates or events
  • Ask the same questions over and over
  • Misplace possessions or put them in unusual places
  • Get lost in familiar places
  • Eventually, forget the names of family members and everyday objects
  • Have trouble expressing thoughts or taking part in conversations
  • Have trouble naming a familiar object or use the wrong name (e.g., calling a “watch” a “hand-clock”).
  • Increasingly need to rely on memory aids or family members

Thinking and Reasoning

Some may experience changes in their ability to concentrate and think, develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. These difficulties may progress to an inability to recognize and deal with numbers.

Difficulty Completing Familiar Tasks

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game. Eventually, people with advanced Alzheimer’s may forget how to perform basic tasks such as dressing and bathing.

Making Judgments and Decisions

Judgment and decision-making are impaired. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean. They may wear clothes that are inappropriate for the weather. They will find it difficult to respond effectively to everyday problems, such as food burning on the stove or unexpected driving situations.

Changes in Personality and Behavior

  • Confused, suspicious, depressed, fearful or anxious
  • Withdraw from hobbies, social activities or other engagements
  • Mood and personality changes
  • Easily upset at home, with friends or when out of their comfort zone
  • Changes in sleeping habits
  • Wandering
  • Loss of inhibitions
  • Delusions, such as believing something has been stolen

The following skills may be preserved longer because they are controlled by parts of the brain affected later in the course of the disease: reading or listening to books, telling stories and reminiscing, singing, listening to music, dancing, drawing, or doing crafts.

Causes of Alzheimer’s Disease

The exact causes of Alzheimer’s disease aren’t fully understood. Microscopic changes in the brain begin long before the first signs of memory loss. Core problems are with brain proteins that fail to function normally, disrupting the work of brain cells (neurons). Neurons are damaged, lose connections to each other and eventually die.

Two abnormal proteins called plaques and tangles are prime suspects in damaging and killing nerve cells. Plaques are deposits of a protein fragment called beta-amyloid that builds up in the spaces between nerve cells. Tangles are twisted fibers of another protein called tau that builds up inside nerve cells. They somehow play a critical role in blocking communication among nerve cells and disrupting processes that cells need to survive, which is responsible for the symptoms of Alzheimer’s disease.

The risk factors of Alzheimer’s disease are:

  • Age: Increasing age is the greatest known risk factor for Alzheimer’s disease.
  • Genetics: Your risk of developing Alzheimer’s is somewhat higher if a first-degree relative has the disease.
  • Down syndrome: Many people with Down syndrome develop Alzheimer’s disease.
  • Mild cognitive impairment: People who have MCI have a significant risk of developing dementia.
  • History of head trauma: People who’ve had severe head trauma have a greater risk of Alzheimer’s disease.
  • Sleeplessness: Insomnia is associated with an increased risk of Alzheimer’s disease.
  • Lifestyle and health factors: Certain lifestyle and other factors increase the risk, which includes lack of exercise, obesity, smoking, high blood pressure, high cholesterol, poorly controlled type 2 diabetes.

Treatment of Alzheimer’s Disease (Mayo Clinic Staff, 2018)

Current approaches help people maintain cognitive function, manage behavioral symptoms, and slow down memory loss.

Drugs

Several drugs are approved by the U.S. Food and Drug Administration (FDA) to treat symptoms of Alzheimer’s disease. These drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms, but don’t change the underlying disease process. They are effective for some but not all people, and may help only for a limited time.

Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne) are used to treat mild to moderate Alzheimer’s.

Memantine (Namenda), the Exelon patch, and Namzaric (a combination of memantine and donepezil) are used to treat moderate to severe Alzheimer’s.

Safe and Supportive Environment

Adapting the living situation, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier for the person with Alzheimer’s disease.

You can take these steps to support a person’s sense of well-being and continued ability to function:

  • Always keep things in the same place at home, so they don’t become lost.
  • Arrange for finances to be on automatic payment and automatic deposit.
  • Carry a mobile phone with location capability.
  • Ensure regular appointments are on the same day at the same time as far as possible.
  • Remove excess furniture, clutter and throw rugs.
  • Install sturdy handrails on stairways and in bathrooms.
  • Make sure that the person with Alzheimer’s carries identification or wears a medical alert bracelet.

Lifestyle and Home Remedies

Healthy lifestyle choices promote good overall health and may play a role in maintaining cognitive health.

  • Exercise: Regular exercise, such as a daily walk, can help improve mood and maintain the health of joints, muscles and the heart. People who develop trouble walking may still be able to use a stationary bike or participate in chair exercises.
  • Nutrition: Buy healthy food options that the person with Alzheimer’s disease likes and can eat. Try to ensure that a person with Alzheimer’s drinks several glasses of liquids every day. Avoid beverages with caffeine. You can supplement milkshakes with protein powders.
  • Social engagement and activities: Social interactions and activities can support the abilities and skills that are preserved. Doing things that are meaningful and enjoyable is important for the overall well-being of a person with Alzheimer’s disease, such as listening to music or dancing, reading or listening to books, gardening or crafts, and social events with other seniors or children.

Alternative Medicine

Clinical trials have produced mixed results with some of these treatments, with no strong evidence to support their use in Alzheimer’s:

  • Omega-3 fatty acids.May lower the risk of developing dementia.
  • This comes from turmeric and might affect chemical processes in the brain.
  • Ginkgo is a plant extract containing several medicinal properties.
  • Vitamin E.Taking 2,000 international units daily may help delay the progression in people who already have the disease.

Coping and Support

If you’re caring for someone with Alzheimer’s, you can help them cope with the disease by being there to listen, reassuring the person, providing support, and helping the person retain dignity and self-respect. A calm and stable home environment can help reduce behavior problems. Avoid the Alzheimer’s patient’s exposure to new situations, noise, large groups of people, being rushed or pressed to remember, or being asked to do complicated tasks, all of which can cause anxiety.

Caring for a person with Alzheimer’s disease is physically and emotionally demanding. So, caregiving can take a toll on the caregiver’s physical health. Pay attention to your own needs and well-being by:

  • Calling on friends or other family members for help when you need it
  • Taking a break every day
  • Spending time with your friends
  • Taking care of your health by seeing your own doctors
  • Joining a support group
  • Making use of a local adult day center, if possible

References

Alzheimer’s Association, n.d. 10 Early Signs and Symptoms of Alzheimer’s. [Online]
Available at: https://www.alz.org/alzheimers-dementia/10_signs
[Accessed 5 Nov 2019].

Alzheimer’s Association, n.d. What Is Alzheimer’s Disease?. [Online]
Available at: https://www.alz.org/alzheimers-dementia/what-is-alzheimers
[Accessed 5 Nov 2019].

MacGill, M., 2018. What to know about Alzheimer’s disease. [Online]
Available at: https://www.medicalnewstoday.com/articles/159442.php
[Accessed 5 Nov 2019].

Mayo Clinic Staff, 2018. Alzheimer’s disease. [Online]
Available at: https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
[Accessed 5 Nov 2019].

National Institute on Aging, 2017. What Is Alzheimer’s Disease?. [Online]
Available at: https://www.nia.nih.gov/health/what-alzheimers-disease
[Accessed 5 Nov 2019].

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Alzheimer’s Disease: Symptoms, Causes, and Treatment
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Alzheimer’s Disease: Symptoms, Causes, and Treatment
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Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks.
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