Alzheimer’s Disease

Alzheimer’s Disease

Alzheimer’s Disease

Alzheimer’s disease is a chronic (lifelong), progressive disease characterized by degeneration of the brain’s nervous tissue. It sets in gradually and typically presents in older people.

Prevalence

Alzheimer’s disease is the most common cause of dementia globally, accounting for 60 – 70% of all cases. According to the WHO, in 2019 there were 50 million people around the world with dementia, and the annual total for new cases was around 10 million.

Prevention

The factors that can protect against developing Alzheimer’s disease include physical exercise, mental exercises, and breathing exercises that increase oxygen flow to the brain.

Dementia vs Alzheimer’s

Dementia is not a solitary disease but a syndrome—a collection of symptoms that generally occur at the same time.

Dementia Alzhiemers
Dementia is characterized by a progressive, usually irreversible decline in thinking, behavior, feelings, and ability to communicate. Alzheimer’s is a gradual breakdown of brain tissue which affects a person’s mental state and behavior and progresses to affecting speaking, walking, and swallowing.

Alzheimer’s disease is a chronic (lifelong), progressive disease characterized by degeneration of the brain’s nervous tissue. It sets in gradually and typically presents in older people.

Prevalence

Alzheimer’s disease is the most common cause of dementia globally, accounting for 60 – 70% of all cases. According to the WHO, in 2019 there were 50 million people around the world with dementia, and the annual total for new cases was around 10 million.

Prevention

The factors that can protect against developing Alzheimer’s disease include physical exercise, mental exercises, and breathing exercises that increase oxygen flow to the brain.

Dementia vs Alzheimer’s

Dementia is not a solitary disease but a syndrome—a collection of symptoms that generally occur at the same time.

  • Dementia is characterized by a progressive, usually irreversible decline in thinking, behavior, feelings, and ability to communicate.
  • Alzhiemers is a gradual breakdown of brain tissue which affects a person’s mental state and behavior and progresses to affecting speaking, walking, and swallowing.

Symptoms of Alzheimer’s Disease:

Alzheimer’s disease typically starts with the individual experiencing or displaying mild symptoms that often qualify as those expected with older people. As the person continues to age, these symptoms will usually worsen to the point that they impact that person’s ability to function normally in everyday life.

Early indicators typically start out with a person experiencing issues recollecting:

  • Newly learned information that could be a skill needed at work
  • How to operate a new phone or computer
  • Remembering the specifics of an event like a wedding or birthday party

Each person with Alzheimer’s is different, so their dominant symptoms, their severity, and the person’s capability to function will vary. Early on, the symptom most commonly seen with Alzheimer’s disease is a reduction in a person’s ability to remember specifics about recent events, and/or an impairment in regards to storing new details or information.


Typically, once it progresses past the initial stage, different parts of the cerebral cortex will begin to be impacted, which will have ramifications on some or all of the following:

  • Language problems – difficulty understanding others and expressing thoughts
  • Lessening of visual and spatial awareness
  • Less capable of carrying out regular activities of daily living
  • Confusion
  • Behavioral and psychological symptoms – aggression, wandering, depression, anxiety, apathy, irritability, anger, emotional pain
  • Verbal and physical attacks
  • A progression from occasional bouts of forgetfulness to frequent and severe memory impairment
  • Personality and intellectual changes and disintegration
  • Problems sleeping
  • Believing things that are not true
  • Seeing things or people who are not there

Progression

As the disease progresses, there is an accumulation of abnormal structures in the brain called amyloid plaques and neurofibrillary tangles, which are the universal hallmarks of the condition. These interfere with the healthy functioning of the brain and cause irreversible and progressive brain damage.

The disease process also causes breakdown of an important neurotransmitter known as acetylcholine that signals other cells in the parasympathetic nervous system — affecting movement, glands, thinking, memory, blood vessels, and heart rate.

It is not uncommon for people experiencing symptoms of Alzheimer’s to be unaware of the specifics of the challenges they start facing, and it is generally something more likely to be obvious to a family member or a friend. An individual with Alzheimer’s may eventually become totally reliant on their family’s support or require professional residential care. Typical life expectancy following the onset of diagnosis is between three to nine years.

Risk factors for Alzheimer’s Disease:

Environmental, lifestyle, and genetic factors, and an individual’s age all play into increasing one’s risk of developing dementia such as Alzheimer’s.

Factors presenting increased risk for developing Alzheimer’s disease:

  • Gender
  • Genetic history family
  • Age (over 65) – 33% of those over 85 years of age are at risk of having it.
  • Thyroid issues
  • Down syndrome
  • Head injury
  • Race – in research conducted in the US, Latinos were found to be 1.5 times more likely than Whites to develop Alzheimer’s, while Black people were found to be twice as likely. It is believed this is due to the vascular health of each of the three groups.

Diagnosing Alzheimer’s Disease:

Diagnosis of Alzheimer’s relies heavily on documented evidence of an individual’s mental decline, but the hope in the medical community is that methods of diagnosis will become more specific so they don’t have to wait until the irreversible damage has already begun before they can verify its presence.

Included in the testing for Alzheimer’s are the following:

  • Brain scans – the indirect or direct imaging of the brain

    • Molecular – SPECT, fMRI, and PET scans for chemical or cellular changes known for their connection to the disease
    • Functional – fMRI and PET scans for activity levels in cells from different parts of the brain
    • Structural – MRI and CT scans for information about brain tissue, including its position, volume, or shape

    The presence of amyloid plaques is not sufficient to complete a diagnosis because they often don’t cause symptoms of Alzheimer’s or other dementia.

  • Lab work – urine and blood tests check for measurable levels of various proteins associated with neuron damage in the brain in early stages of Alzheimer’s.
  • Lumber puncture or spinal tap – involves collecting and measuring levels of specific proteins in the cerebrospinal fluid. These proteins are responsible for the internal and external damage to neurons, which causes Alzheimer’s.
  • Gene variation analysis – Research has shown that there are a number of genes that contribute to an elevated risk for developing Alzheimer’s and that there are rare variations in three other genes known to cause Alzheimer’s. There is enough of a connection to warrant looking for links as an early detection method.
  • Mild cognitive impairment history – The individual, as well as their family, is aware of the problem. When the impairment is not yet causing severe impact to daily life, it will typically not line up with the criteria for a dementia, including Alzheimer’s. However, when compared to people with no mild cognitive impairment, people who do have MCI have shown a notably increased risk for developing Alzheimer’s in a short number of years.

Work is underway to create more standard definitions for MCI, and to determine which MCI-related biological changes can be detected, and what testing for mental status best serves to provide early detection.

For those or a loved one experiencing questionable symptoms, seeing a doctor sooner rather than later can make a significant quality of life difference, and a nearby chapter of the Alzheimer’s Association can provide guidance.

Treatment for Alzheimer’s Disease:

There is no cure for Alzheimer’s disease, so efforts are focused on managing and slowing symptoms as it progresses. A multidisciplinary team comprised of a psychiatrist, family doctor, speech and language therapist, occupational therapist, and psychologist provide a holistic approach in the management of dementia.

Functional support – is crucial so as to maximize mobility and to encourage independence with basic skills like washing, toileting, and feeding.

Emotional support – for the person includes:

  • Creating a calm environment
  • Reducing or eliminating confrontation
  • Providing familiar items to give the individual security
  • Looking into other potential reasons for the behavior
  • Redirection of attention
  • Consideration of basic needs like hunger, thirst, or bathroom use

Physical support for the person includes:

  • Neurogenesis stimulation through physical exercise
  • Reduction of the neurotoxic impact of cortisol in the brain through effective stress management
  • Exercising the brain through writing, reading, and memorization
  • Contribute to brain health by increasing oxygen flow through practicing deep breathing numerous per day

Medications can be prescribed to help with memory, sleep issues, and behavior. Medications for treating confusion, memory loss, or other cognitive impairments fall into two groups:

  • Acetylcholinesterase inhibitors for early stage treatment

    • Cholinesterase inhibitors such as donepezil can help by halting the breakdown of the acetylcholine neurotransmitters — thus slowing down disease progression and enhancing cognition.
  • Memantine for later state treatment

    • Glutamate is another neurotransmitter connected to the process of memory, and learning, and memantine works through the regulation of glutamate activity. This could be prescribed as part of a treatment plan that also includes cholinesterase inhibitors for some individuals.

The associated potential adverse side effects of both usually require patients to be monitored closely by a psychiatrist.

A doctor could also prescribe other medications for coexisting conditions.

  • Antidepressants – for irritability or depression
  • Anxiolytics – for verbal attacks, unruly behavior, anxiety, and restlessness
  • Antipsychotic medications – for aggression, delusions, hallucinations, aggressive and hostile behavior

Alternative treatments – include medical foods, nutritional supplements, and herbal remedies. Because these are not regulated by the FDA, check the effectiveness and side effects of an item based on reviews from users.

The foods thought to increase acetylcholine production and lower the neurotoxic homocysteine are beef fish, eggs, chicken, dairy products, and some cruciferous vegetables, beans, peas, nuts, and seeds.

The only two supplements that have shown in medical studies to possibly make a small difference are:

  • Omega-3 fatty acids – might help prevent memory loss and lower risk of heart disease or stroke
  • Caprylic acid – might provide extra energy for brain cells

Self-Care for Caregivers

Recent advances have dramatically improved intervention methods as well as early diagnosis, and there are tremendous benefits from tools like:

  • ALZConnected – the Alzheimer’s Association’s online support forum for individuals and caregivers, and
  • the Alzheimer’s Navigator – the Alzheimer’s Association’s tool to create personalized action plans for caregivers.

Symptoms of Alzheimer’s Disease:

Alzheimer’s disease typically starts with the individual experiencing or displaying mild symptoms that often qualify as those expected with older people. As the person continues to age, these symptoms will usually worsen to the point that they impact that person’s ability to function normally in everyday life.

Early indicators typically start out with a person experiencing issues recollecting:

  • Newly learned information that could be a skill needed at work
  • How to operate a new phone or computer
  • Remembering the specifics of an event like a wedding or birthday party

Each person with Alzheimer’s is different, so their dominant symptoms, their severity, and the person’s capability to function will vary. Early on, the symptom most commonly seen with Alzheimer’s disease is a reduction in a person’s ability to remember specifics about recent events, and/or an impairment in regards to storing new details or information.


Typically, once it progresses past the initial stage, different parts of the cerebral cortex will begin to be impacted, which will have ramifications on some or all of the following:

  • Language problems – difficulty understanding others and expressing thoughts
  • Lessening of visual and spatial awareness
  • Less capable of carrying out regular activities of daily living
  • Confusion
  • Behavioral and psychological symptoms – aggression, wandering, depression, anxiety, apathy, irritability, anger, emotional pain
  • Verbal and physical attacks
  • A progression from occasional bouts of forgetfulness to frequent and severe memory impairment
  • Personality and intellectual changes and disintegration
  • Problems sleeping
  • Believing things that are not true
  • Seeing things or people who are not there

Progression

As the disease progresses, there is an accumulation of abnormal structures in the brain called amyloid plaques and neurofibrillary tangles, which are the universal hallmarks of the condition. These interfere with the healthy functioning of the brain and cause irreversible and progressive brain damage.

The disease process also causes breakdown of an important neurotransmitter known as acetylcholine that signals other cells in the parasympathetic nervous system — affecting movement, glands, thinking, memory, blood vessels, and heart rate.

It is not uncommon for people experiencing symptoms of Alzheimer’s to be unaware of the specifics of the challenges they start facing, and it is generally something more likely to be obvious to a family member or a friend. An individual with Alzheimer’s may eventually become totally reliant on their family’s support or require professional residential care. Typical life expectancy following the onset of diagnosis is between three to nine years.

Risk factors for Alzheimer’s Disease:

Environmental, lifestyle, and genetic factors, and an individual’s age all play into increasing one’s risk of developing dementia such as Alzheimer’s.

Factors presenting increased risk for developing Alzheimer’s disease:

  • Gender
  • Genetic history family
  • Age (over 65) – 33% of those over 85 years of age are at risk of having it.
  • Thyroid issues
  • Down syndrome
  • Head injury
  • Race – in research conducted in the US, Latinos were found to be 1.5 times more likely than Whites to develop Alzheimer’s, while Black people were found to be twice as likely. It is believed this is due to the vascular health of each of the three groups.

Diagnosing Alzheimer’s Disease:

Diagnosis of Alzheimer’s relies heavily on documented evidence of an individual’s mental decline, but the hope in the medical community is that methods of diagnosis will become more specific so they don’t have to wait until the irreversible damage has already begun before they can verify its presence.

Included in the testing for Alzheimer’s are the following:

  • Brain scans – the indirect or direct imaging of the brain

    • Molecular – SPECT, fMRI, and PET scans for chemical or cellular changes known for their connection to the disease
    • Functional – fMRI and PET scans for activity levels in cells from different parts of the brain
    • Structural – MRI and CT scans for information about brain tissue, including its position, volume, or shape

    The presence of amyloid plaques is not sufficient to complete a diagnosis because they often don’t cause symptoms of Alzheimer’s or other dementia.

  • Lab work – urine and blood tests check for measurable levels of various proteins associated with neuron damage in the brain in early stages of Alzheimer’s.
  • Lumber puncture or spinal tap – involves collecting and measuring levels of specific proteins in the cerebrospinal fluid. These proteins are responsible for the internal and external damage to neurons, which causes Alzheimer’s.
  • Gene variation analysis – Research has shown that there are a number of genes that contribute to an elevated risk for developing Alzheimer’s and that there are rare variations in three other genes known to cause Alzheimer’s. There is enough of a connection to warrant looking for links as an early detection method.
  • Mild cognitive impairment history – The individual, as well as their family, is aware of the problem. When the impairment is not yet causing severe impact to daily life, it will typically not line up with the criteria for a dementia, including Alzheimer’s. However, when compared to people with no mild cognitive impairment, people who do have MCI have shown a notably increased risk for developing Alzheimer’s in a short number of years.

Work is underway to create more standard definitions for MCI, and to determine which MCI-related biological changes can be detected, and what testing for mental status best serves to provide early detection.

For those or a loved one experiencing questionable symptoms, seeing a doctor sooner rather than later can make a significant quality of life difference, and a nearby chapter of the Alzheimer’s Association can provide guidance.

Treatment for Alzheimer’s Disease:

There is no cure for Alzheimer’s disease, so efforts are focused on managing and slowing symptoms as it progresses. A multidisciplinary team comprised of a psychiatrist, family doctor, speech and language therapist, occupational therapist, and psychologist provide a holistic approach in the management of dementia.

Functional support – is crucial so as to maximize mobility and to encourage independence with basic skills like washing, toileting, and feeding.

Emotional support – for the person includes:

  • Creating a calm environment
  • Reducing or eliminating confrontation
  • Providing familiar items to give the individual security
  • Looking into other potential reasons for the behavior
  • Redirection of attention
  • Consideration of basic needs like hunger, thirst, or bathroom use

Physical support for the person includes:

  • Neurogenesis stimulation through physical exercise
  • Reduction of the neurotoxic impact of cortisol in the brain through effective stress management
  • Exercising the brain through writing, reading, and memorization
  • Contribute to brain health by increasing oxygen flow through practicing deep breathing numerous per day

Medications can be prescribed to help with memory, sleep issues, and behavior. Medications for treating confusion, memory loss, or other cognitive impairments fall into two groups:

  • Acetylcholinesterase inhibitors for early stage treatment

    • Cholinesterase inhibitors such as donepezil can help by halting the breakdown of the acetylcholine neurotransmitters — thus slowing down disease progression and enhancing cognition.
  • Memantine for later state treatment

    • Glutamate is another neurotransmitter connected to the process of memory, and learning, and memantine works through the regulation of glutamate activity. This could be prescribed as part of a treatment plan that also includes cholinesterase inhibitors for some individuals.

The associated potential adverse side effects of both usually require patients to be monitored closely by a psychiatrist.

A doctor could also prescribe other medications for coexisting conditions.

  • Antidepressants – for irritability or depression
  • Anxiolytics – for verbal attacks, unruly behavior, anxiety, and restlessness
  • Antipsychotic medications – for aggression, delusions, hallucinations, aggressive and hostile behavior

Alternative treatments – include medical foods, nutritional supplements, and herbal remedies. Because these are not regulated by the FDA, check the effectiveness and side effects of an item based on reviews from users.

The foods thought to increase acetylcholine production and lower the neurotoxic homocysteine are beef fish, eggs, chicken, dairy products, and some cruciferous vegetables, beans, peas, nuts, and seeds.

The only two supplements that have shown in medical studies to possibly make a small difference are:

  • Omega-3 fatty acids – might help prevent memory loss and lower risk of heart disease or stroke
  • Caprylic acid – might provide extra energy for brain cells

Self-Care for Caregivers

Recent advances have dramatically improved intervention methods as well as early diagnosis, and there are tremendous benefits from tools like:

  • ALZConnected – the Alzheimer’s Association’s online support forum for individuals and caregivers, and
  • the Alzheimer’s Navigator – the Alzheimer’s Association’s tool to create personalized action plans for caregivers.