What is Alzheimer’s disease?
Alzheimer’s disease is a progressive neurological disorder that leads to loss of memory and other cognitive abilities. It is the most common cause of dementia, accounting for 60-80% of dementia cases. Alzheimer’s disease is characterized by the buildup of abnormal protein deposits called beta-amyloid plaques and neurofibrillary tangles in the brain. These deposits disrupt communication between nerve cells and cause them to die. This leads to shrinkage of key brain regions that are vital for memory, learning, and other functions. As more neurons die, the symptoms of Alzheimer’s gradually worsen over time.
What are the risk factors for Alzheimer’s disease?
The biggest risk factor for Alzheimer’s is increasing age. Most people with Alzheimer’s develop symptoms after age 65. After age 85, the risk reaches nearly one-third. However, Alzheimer’s is not a normal part of aging.
Some of the key risk factors that can increase a person’s chances of developing Alzheimer’s include:
Age:
The risk rises dramatically as people get older, especially after age 65. Nearly one-third of people age 85 or older may have Alzheimer’s.
| Age Range | Percentage with Alzheimer’s |
|---|---|
| 65-74 years | 3% |
| 75-84 years | 17% |
| 85+ years | 32% |
Family history:
People who have a parent, brother or sister with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has it. Genes like APOE-e4 can raise risk.
Mild cognitive impairment (MCI):
People with MCI have more memory and thinking problems than normal for their age, but not as severe as dementia. They have about a 15-20% annual risk of progressing to Alzheimer’s.
Down syndrome:
People with Down syndrome have a higher risk as they age due to an extra copy of chromosome 21, which contains the gene for amyloid precursor protein. By age 60, most people with Down syndrome have Alzheimer’s.
Cardiovascular risk factors:
Heart disease, stroke, high blood pressure, diabetes and high cholesterol in midlife are linked to higher dementia risk. Poor blood flow deprives the brain of oxygen and nutrients.
Lifestyle factors:
Lack of exercise, obesity, smoking, and cognitive inactivity are associated with increased Alzheimer’s risk. A healthy lifestyle helps protect the brain.
Traumatic brain injury (TBI):
Moderate to severe TBI increases risk, especially if the injury involves loss of consciousness.
Female gender:
Women are at higher risk as they have longer lifespans. Alzheimer’s is more prevalent in women than men.
What are the early signs of Alzheimer’s?
Alzheimer’s develops slowly over many years. The earliest symptoms are mild and easily missed. Some common early signs include:
Memory loss:
Forgetting recently learned information or important dates and events. Asking the same questions repeatedly. Increasing reliance on memory aids and reminders.
Difficulty with planning/problem-solving:
Trouble following recipes or managing finances. Poor judgment leading to bad decisions. Inability to complete familiar tasks.
Confusion with time/place:
Losing track of time and dates. Forgetting where they are or how they got there. Wandering aimlessly.
Vision problems:
Difficulty reading, judging distance or determining color/contrast, which may indicate perceptual issues.
Trouble with speech/writing:
Struggling to find the right words. Substituting unusual words, rambling sentences, stuttering or pausing while speaking. Mispronouncing words or using the wrong ones.
Misplacing things:
Putting items in unusual places. Being unable to retrace steps to find things. Accusing others of stealing.
Poor judgment:
Paying less attention to hygiene. Showing poor decision-making and worsening impulse control.
Withdrawal:
Loss of interest in hobbies, social activities or work projects. Increased isolation or apathy.
Mood/personality changes:
Increased anxiety, irritability, depression, insecurity, paranoia or agitation. Behaving uncharacteristically.
What are the stages of Alzheimer’s disease?
Alzheimer’s typically progresses slowly through mild, moderate and severe stages:
Preclinical stage:
No symptoms, but abnormal protein deposits in the brain. This can last for years.
Mild Alzheimer’s (early-stage):
Difficulty remembering recent events and names. May have mood changes. Able to function independently. Lasts 2-4 years on average.
Moderate Alzheimer’s (middle-stage):
Memory gaps increase, even forgetting personal history and family members. Needs help with daily activities. Lasts 2-10 years.
Severe Alzheimer’s (late-stage):
Unable to communicate or respond purposefully. Completely dependent on others for care. Common cause of death is infection like pneumonia. Lasts 1-3 years on average.
The rate of progression varies by person. On average, people live 4-8 years after diagnosis, but some live up to 20 years.
How is Alzheimer’s diagnosed?
There is no single diagnostic test for Alzheimer’s. A physician will evaluate:
– Medical history, including risk factors
– Mental status and mood testing
– Physical and neurological exam
– Brain imaging with MRI or CT scan
– Blood tests to rule out other causes
If Alzheimer’s is suspected, more in-depth neuropsychological tests assess memory, problem solving, language, counting and attention. Changes from past abilities indicate worsening dementia.
A diagnosis can only be made once other potential causes like thyroid problems, vitamin deficiencies, medications, depression, and brain tumors are ruled out.
Can Alzheimer’s be cured or treated?
There is currently no cure for Alzheimer’s, but early diagnosis allows more time to plan care and make lifestyle changes that may slow progression. Four FDA-approved drug treatments temporarily improve memory and thinking by increasing acetylcholine levels, a chemical messenger in the brain that is deficient in Alzheimer’s.
Non-drug therapies aim to maintain mental function and manage behavioral symptoms:
– Cognitive training and social engagement keep the mind active.
– Counseling and support groups help cope with the diagnosis.
– Regular exercise benefits physical and mental health.
– Ensuring safety, adequate nutrition and managing medications are key.
– Caregiver education improves quality of life for both patient and family.
Research on new drug treatments, vaccines and lifestyle prevention continues, bringing hope for the future.
Conclusion
Alzheimer’s disease is a growing public health crisis, affecting over 6 million Americans currently. As the population ages, this number may triple by 2050 unless more effective prevention and treatment options are found. While age, family history and genetics play a role, making smart lifestyle choices and controlling modifiable risk factors like heart disease, obesity and inactivity can lower risk. Staying socially and mentally active also helps strengthen cognitive reserve. Early diagnosis allows more time to adjust care plans and improve quality of life. With a collaborative research effort globally, better understanding of Alzheimer’s disease pathogenesis brings hope for future treatments to slow or stop progression, and ultimately find a cure.