Overview
Alzheimer's disease is a brain disorder characterized by progressive changes that result in the deposit of certain proteins, leading to brain shrinkage and cell death. It is the most common cause of dementia, which involves a decline in memory, thinking, behavior, and social skills. The disease primarily affects individuals aged 65 and older, with more than 6.5 million people in the United States and an estimated 55 million worldwide having Alzheimer's. Early symptoms include forgetfulness and memory loss, which worsen over time, impacting daily functioning. The exact cause of Alzheimer's is not fully understood, but it is believed to result from a combination of genetic, lifestyle, and environmental factors. Researchers focus on two proteins as potential contributors to the disease.
Understanding the disease
Symptoms
The symptoms of Alzheimer's disease include memory loss, difficulty remembering recent events or conversations, repeating statements and questions, forgetting conversations, appointments, or events, misplacing items, getting lost in familiar places, and eventually forgetting the names of family members and everyday objects. As the disease progresses, it affects a person's ability to perform everyday tasks, changes in personality and behavior, and preserved skills. There is no cure for Alzheimer's disease, and it is the most common cause of dementia.
Risk Factors
The risk factors for developing Alzheimer's disease include increasing age, family history and genetics, lack of exercise, obesity, smoking or exposure to secondhand smoke, high blood pressure, high cholesterol, poorly controlled type 2 diabetes, excessive alcohol consumption, poor sleep patterns, and lifestyle factors associated with heart disease. Additionally, air pollution and poor sleep patterns have also been linked to increased risk. The two proteins associated with Alzheimer's disease are plaques and tangles, which are formed by beta-amyloid and tau proteins respectively.
Development
Alzheimer's disease is a brain disorder that progresses over time and is characterized by the buildup of specific proteins: beta-amyloid plaques and tau proteins. The damage begins in the region of the brain that controls memory and spreads to other areas, leading to neuron loss and brain shrinkage. Risk factors include increasing age, genetics, lifestyle factors such as lack of exercise, obesity, smoking, high blood pressure, high cholesterol, and poorly controlled type 2 diabetes. While some risk factors like age cannot be modified, changing lifestyle habits can help reduce the risk. Additionally, lifelong learning and social engagement are thought to lower the risk of Alzheimer's disease. The development of Alzheimer's can be influenced by a combination of these factors, though the exact cause remains unclear.
Assessment and Diagnosis
Triage
You should see a doctor if Alzheimer's disease is suspected, especially if you or someone you know is experiencing persistent memory loss, difficulty with familiar tasks, or significant changes in behavior or thinking abilities. Early diagnosis and intervention can help manage symptoms and provide support for both the individual and their caregivers. It's essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.
Diagnosis
A diagnosis of Alzheimer's disease typically includes a physical and neurological exam, assessment of symptoms, memory and thinking tests, and possibly biomarker tests such as PET scans or blood tests measuring amyloid and tau proteins. Blood and imaging tests are used to rule out other potential causes of the symptoms or to better identify the disease causing dementia symptoms. Brain imaging, such as MRI and CT scans, may also be used to detect specific brain changes caused by Alzheimer's disease or to rule out other conditions.
Management and Treatment
Complications
Complications of Alzheimer's disease may include:
- Inability to communicate: As the disease progresses, patients may have difficulty expressing their needs, pain, or other symptoms, making it harder for them to communicate with others.
- Impaired judgment: Alzheimer's disease can lead to impaired judgment, putting the individual at risk for financial and personal safety issues.
- Inability to follow treatment plans: The cognitive decline associated with Alzheimer's may make it challenging for patients to follow their medical treatment plans, increasing the risk of complications from other health conditions.
- Increased risk of infections: Patients with Alzheimer's disease may have a higher risk of infections due to decreased immunity and poor nutrition.
- Malnutrition and dehydration: In advanced stages, severe loss of brain function can cause difficulty in swallowing, leading to the risk of malnutrition and dehydration.
- Falls and fractures: Alzheimer's patients may experience falls due to impaired balance, coordination, or judgment, resulting in fractures and other injuries.
- Poor hygiene: As the disease progresses, patients may struggle with personal hygiene, increasing the risk of skin infections, pressure sores, and other health problems.
- Behavioral changes: Alzheimer's patients may experience agitation, aggression, or other behavioral changes that can be challenging for caregivers to manage.
- Depression and anxiety: Patients with Alzheimer's disease are at an increased risk of developing depression and anxiety, which can further exacerbate cognitive decline and overall health.
- Caregiver burden: Caring for a loved one with Alzheimer's disease can be physically and emotionally demanding, leading to increased stress and health issues for caregivers. It's important to note that complications can vary from person to person and may not necessarily occur in every case.
Treatment
There is no cure for Alzheimer's disease, but medicines may improve or slow the progression of symptoms. Programs and services can help support people with the disease and their caregivers. Some of the FDA-approved medications for Alzheimer's disease can temporarily improve symptoms, such as memory loss and confusion. These drugs work by increasing the levels of neurotransmitters in the brain or by blocking the effects of certain proteins that harm brain cells. However, these treatments do not halt the disease's progression, and their effectiveness may vary from person to person. As the disease advances, non-pharmacological interventions, including lifestyle changes and support programs, become more crucial in managing symptoms and maintaining quality of life for both the affected individuals and their caregivers.
Preparing for medical consultation
To prepare for an appointment for Alzheimer's disease, you should:
- Write down your medical history, including any past or current diagnoses and family medical history.
- Make a list of all medications, vitamins, and supplements you're taking.
- Invite a close family member or friend to accompany you to the appointment, as they can provide additional information about your symptoms and support you during the appointment.
- Prepare a list of questions to ask your healthcare professional, such as what causes Alzheimer's disease, what tests are needed to confirm the diagnosis, what treatment options are available, and what results you can expect.
- Be prepared to discuss specific examples of changes in memory or thinking skills you have noticed. Provide details about when you first noticed these changes and how they have progressed.
- Encourage the person with Alzheimer's disease to share their own experiences and observations about their symptoms. Remember that being open and honest with your healthcare professional will help them provide the best possible care and support for you or your loved one.