Alzheimer’s disease is a progressive neurological(brain) disorder in which the death of brain cells occurs. It slowly destroys memory and thinking ability. It is the most common type of dementia(decline in mental ability). A continuous decline in social, behavioral and regular activities, disrupts the person’s ability to work independently.
It is a chronic neurodegenerative disease that starts slowly and gradually worsens over time. The risk of getting the disease increases with age (mostly seen in older people), it is not a part of aging. At present the exact cause of the disease is unknown and there is no cure.
The most common early symptom of Alzheimer’s is difficulty in remembering the recent events. Later in the advancement of the disease, symptoms may include problems with language, mood swings, behavioral issues and lack of motivation. Gradually body function lost and leads to death.
There is no such treatment available that can reverse or stops its progression, though some may improve symptoms.
Alzheimer’s Symptoms Stages:
There are mainly 3 stages of the disease that are:
- Mild Alzheimer’s disease(Early stage)
- Moderate Alzheimer’s disease(Middle stage)
- Severe Alzheimer’s disease(late stage)
Mild Alzheimer’s disease(Early stage): In the early stage of the disease a person can work independently and even a part of social activities. Despite this, a person may feel some memory lapses such as forgetting the location of the objects or familiar words.
Friends, family or other close to the person start noticing the difficulties. Some difficulties include:
- Problems coming up with the right word or name
- Trouble remembering names
- Challenges performing tasks in social or work settings.
- Forgetting material
- Losing or misplacing a valuable object
- Increasing trouble with organizing
- Reading problem
- Poor direction sense
Moderate Alzheimer’s disease(Middle stage): It is the longest stage that can last for many years. As the disease progress, a person needs very much care. During this stage, dementia is more pronounced. A person may have difficulty in performing the task, like paying bills but they still remember some significant details about their life.
Damage in brain cells makes it difficult to express thought and perform routine work. Mainly symptoms will be noticeable to others. These are:
- Mild Forgetfulness
- Getting frustrated or angry
- Feeling moody or withdrawn from social activities
- Being unable to recall their own address or phone number or even personal history.
- Confusion about where they are or what day it is or confusing words
- They need help choosing proper clothing for the occasion
- Acting in unexpected ways
- Trouble controlling bladder and bowels in some peoples
- Changes in sleep patterns, such as sleeping during the day and becoming restless at night
- Personality and behavioral changes
- Poor judgment
- Short attention
Severe Alzheimer’s disease(late stage): In this stage of the disease, dementia symptoms are severe. Individual needs lot of care and help in daily routine activities. An individual is not able to respond to their environment, to communicate and eventually to control movements. As memory and cognitive ability continuos worsen, personality changes may take place. Individuals may:
- Need 24 hrs assistance with daily activities and personal care
- Lose awareness of recent experiences
- Experience changes in physical abilities, including the ability to walk, sit
- increasing difficulty communicating
- Become more vulnerable to infections
- Visual problems
Symptoms of Disease:
- Memory loss: It is one of the most common signs of Alzheimer’s. It disrupts the daily routine of life. In this individual forget recently learned things. Some other symptoms related to this are:
- Repeat statements or ask something over and over
- Forget appointments or events, and not able to remember them later
- Routinely misplace possessions, often putting them in irrelevant locations
- Get lost in familiar places, not able to recognize the place
- Eventually, forget the names of family members and everyday objects
- Have trouble finding the right words to identify objects or for conversations
- Challenges in solving a problem: Some individuals may experience a change in their ability to work with the numbers or plan something. They may have difficulty concentrating and thinking, taking more time to do the particular work they did before. It is challenging to manage finances, pay bills on time and multitasking is especially difficult.
- Making judgment and decision: Individuals face difficulties while taking the decision for an everyday situation in daily life. It may be more difficult for Alzheimer’s disease people to deal with everyday problems such as food burning on gas, driving, wearing clothes inappropriate to weather and social interaction.
- Difficulty in performing a familiar task: As the disease progress, people find it hard to complete their daily tasks. People with severe Alzheimer’s may forget how to perform tasks such as bathing, cooking a meal, dressing, driving in the same location.
- Trouble understanding visual images: In some peoples problem in vision is a sign of Alzheimer’s disease. They may have difficulty in reading, judging distance and determining the color.
- Changes in personality and behavior: Brain changes that occur during the disease affects mood and behavior. Problems may include:
- Depression
- Apathy or lack of interest
- Social withdrawal
- Mood swings
- Distrust in others
- Irritability and aggressiveness
- Changes in sleeping habits
- Wandering
- Loss of inhibitions
- Delusions, such as believing something that is untrue
These are some symptoms mostly found in the people dealing with Alzheimer’s disease.
Causes:
The damage starts in the region of the brain that controls memory and cognition. The exact cause for Alzheimer’s is not well known, it is believed that proteins in the brain fail to function normally. In a few cases where the genetic difference occurs in disease are identified.
Scientist believes that in most people genetic and environmental factors are the main cause of Alzheimer’s disease.
Genetics or family history: This disease may be inherited from their parents if any of the parents have a history of Alzheimer’s disease. Some have an onset of the disease prior to the age of 65 years. This considers as early onset of the disease.
There are two proteins which have an important role in the development of Alzheimer’s disease are:
- Plaques: Beta-amyloid is a leftover part of a larger protein. When the fragments of protein cluster together, they show a toxic effect on neurons(nerve cells) and to disrupt cell-to-cell communication. These clusters accumulate and form amyloid plaques, that also include other cellular debris.
- Neurofibrillary Tangles: Tau proteins present in a brain. It plays a role in a neuron’s internal support and transport system to carry nutrients and other essential materials. In Alzheimer’s disease, tau proteins change their shape and re-organize themselves into a structure called neurofibrillary tangles. The tangles disrupt the transport system and can damage the cells.
Risk factors
1.Age
Increasing age is the greatest known risk factor for Alzheimer’s disease. Alzheimer’s disease is not a part of normal aging, but as you grow older the chances of developing Alzheimer’s disease increases.
2.Family history and genetics
Your risk of developing Alzheimer’s is somewhat higher if your parent has the disease. Most genetic mechanisms of Alzheimer’s are largely unexplained, and the genetic factors are very complex.
One better understood genetic factor is the form of the apolipoprotein E gene (APOE). A change in the gene increases the risk of Alzheimer’s disease, but not everyone with this change develops the disease.
Scientists have identified rare changes or variations (mutations) in three genes that guarantee a person who inherits one of them will have higher chances to develop Alzheimer’s.
3.Down syndrome
Down syndrome is a genetic disorder, contains three copies of chromosome 21. Many people with Down syndrome develop Alzheimer’s disease. This is likely to relate that subsequently three copies of the gene for the protein that leads to the creation of beta amyloid. Signs and symptoms of Alzheimer’s appear early in people with Down syndrome than the general population.
4.Sex
There are more women with the disease and have a higher risk than men because they generally live longer than men.
5.Mild cognitive impairment
Mild cognitive impairment (MCI) is a decline in memory or other thinking skills. But the decline in memory doesn’t prevent a person from functioning in social or work environments. People who have MCI have a significant risk of developing dementia or Alzheimer’s disease.
When the main cause of MCI is a memory, the condition is more likely to progress to dementia to Alzheimer’s disease.
6.Past head trauma
People who have had severe head trauma are at a greater risk of Alzheimer’s disease.
7.Poor sleep patterns
Research has shown that difficulty in falling asleep or staying asleep, poor sleep patterns is associated with an increased risk of Alzheimer’s disease.
8.Lifestyle
Research has shown that the lifestyle of a person leads to some risk factors associated with heart disease and it may also increase the risk of Alzheimer’s disease. These include:
- Lack of exercise
- Obesity
- Smoking
- High blood pressure
- High cholesterol
- Poorly controlled type 2 diabetes
These factors can be modified by changing your lifestyle. Though changing habits can to some extent alter your risk. By doing regular exercise and a healthy diet rich in fruits and vegetables are associated with a decreased risk of developing Alzheimer’s disease.
Complications:
Memory or language loss and other cognitive impairment caused by Alzheimer’s can complicate treatment for other health conditions. A person with Alzheimer’s disease may not be able to:
- Communicate that person is experiencing pain
- Tell symptoms of another illness
- Follow a treatment plan
- Notice medication side effects
Brain changes as the disease progress to the last stages of Alzheimer’s disease. It begins to affect physical functions such as swallowing, balance, and bowel, bladder control. These effects can increase chances to get other health problems such as:
- Sucking food or liquid into the lungs (aspiration)
- Pneumonia and other infections
- Falls or Fractures
- Bedsores(ulcers that occur at the area of skin under pressure)
- Malnutrition or dehydration
Diagnosis
Alzheimer’s disease is diagnosed on the basis of persons medical history, behavioral changes, and relatives history. A key component of a diagnostic assessment is self-reporting about symptoms, as well as the information that a close family member or friend can provide about symptoms and their impacts on life. Additionally, doctors prescribed some tests to diagnose Alzheimer’s disease.
Laboratory, imaging tests and the entire set of diagnostic tools is designed to detect dementia and determine with relatively high accuracy whether Alzheimer’s disease or other medical condition is the cause.
Tests
Diagnosis of the disease include the following tests:
Physical and neurological exam
Your doctor will perform a physical exam and overall neurological health by testing the following:
- Reflexes
- Muscle tone and strength
- Ability to get up from a chair and walk across the room
- Sense of sight and hearing
- Coordination
- Balance
Laboratory tests
Blood tests may help your doctor to find out other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.
Neuropsychological testing
Your doctor may conduct a mental status test or more neurophysiological tests to assess memory and other thinking skills. Various neuropsychological testing may provide additional details about mental status compared with people of a similar age and education level. These tests are also important to know the starting point of the progression of symptoms in the future.
Brain imaging
Images of the brain are mainly used to pinpoint visible abnormalities related to conditions other than Alzheimer’s disease such as strokes, trauma or tumors that may cause cognitive change. New imaging applications used primarily in medical centers or in clinical trials help doctors to detect specific brain changes caused by Alzheimer’s.
Following tests are used to detect the images of the brain:
- Magnetic resonance imaging (MRI). MRI is used to detect brain images. It uses radio waves and a strong magnetic field to produce detailed images of the brain. MRI scans are used primarily to rule out other conditions. While they may show brain shrinkage the information it provides is not so significant that it can add to the diagnostic tool.
- Computed tomography (CT). A CT scan, a specialized X-ray technology, produces cross-sectional images of your brain. It is currently used to diagnose tumors, strokes and head injuries.
Imaging of Alzheimers’s can be performed with positron emission tomography (PET). In a PET scan, a low-level radioactive tracer is injected into the blood to reveal a particular feature in the brain. PET imaging may include the following:
- Fluorodeoxyglucose (FDG) Positron Emission Tomography: It scans show areas of the brain in which nutrients are poorly metabolized. Identifying patterns of degeneration the areas of low metabolism can help distinguish between Alzheimer’s and other dementia.
- Amyloid Positron Emission Test imaging: It can measure the burden of amyloid deposits in the brain.
- Tau Positron emission test imaging: It measures the neurofibrillary tangles in the brain, is mainly used in research.
Future diagnostic tests
Researchers are working on tests that can measure the biological evidence of the progression of disease in the brain. These tests may improve the accuracy of diagnosis and enable earlier diagnosis before the onset of symptoms.
Genetic testing normally is not recommended for a routine Alzheimer’s disease evaluation. The exception is people who have a family history of early-onset Alzheimer’s disease. Meeting with a genetic counselor to discuss the risks and benefits of genetic testing is recommended before undergoing any tests.
Prevention:
Alzheimer’s disease is not a preventable disease. However, a number of lifestyle pattern risk factors for Alzheimer’s can be changed. Research suggests that changes in diet, exercise, and habits help to reduce the risk of cardiovascular(heart) disease may also lower your risk of developing Alzheimer’s disease and other disorders that cause dementia. Heart-healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following:
- Exercise regularly
- Eat a balanced diet, healthy oils and foods low in saturated fat
- Manage high blood pressure, diabetes and high cholesterol
- Quit smoking
Studies have shown that preserved thinking skills later in life and a reduced risk of Alzheimer’s disease are associated with participating in social events like reading, dancing, playing games, creating art, playing an instrument, and other activities that require mental and social engagement.
Treatments
After a diagnosis of the Alzheimer’s, it is important that patient get better treatment. The disease is not curable but some medications help a patient to live a quality life. If you know more about Alzheimer’s medications, the better you will be discussing them with your physician.
- Medications
- Treating sleep changes
- Alternative treatments
- Research into tomorrow’s treatments
- Participate in clinical trials
Medications
There is no cure so the only way to slow the progression of Alzheimer’s disease is prevention or treatment, there are five prescription medications approved by the U.S. Food and Drug Administration (FDA) to treat its symptoms, that are:
- Donepezil
- Galantamine
- Tacrine
- Rivastigmine
- Memantine
The first four drugs are called cholinesterase inhibitors. These drugs prevent the breakdown of a chemical messenger in the brain important for learning and memory. These medications treat symptoms related to memory, thinking, language, judgment, and other thought processes.
The fifth drug, memantine, regulates the activity of a different chemical messenger in the brain that is also important for learning and memory. Both types of drugs help manage symptoms but work in different ways. These medications help to control behavioral symptoms.
Scientists are still working on the above medicines, how these cholinesterase inhibitors work to treat the disease.
Dosage and Its Side Effects
Doctors prefer to start patients at low drug doses and gradually increase the dosage based on how well a patient is able to tolerate the drug. There is some evidence that certain people may benefit from higher doses of cholinesterase inhibitors. However, the higher the dose, the more likely side effects are to occur.
Patients should be monitored when a drug is started. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, and loss of appetite. Report any unusual symptoms to the prescribing doctor. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements.
Tips from people living with Alzheimer’s: for medication safety purpose
- Keep a calendar and check off each dose as it’s taken.
- Set up a pill box each night for use the next day.
- Set the alarm on your cell phone or schedule dosing around meal times.
Before beginning a new medication, make sure your physician, pharmacist and care team are aware of any over-the-counter and alternative remedies you are taking to prevent drug interactions and unwanted side effects. Be sure to discuss all the medications you take with your doctor to understand why they were prescribed and how to take them.
Treating sleep changes
Alzheimer’s or other dementia may change your sleep patterns. You may have difficulty sleeping, take daytime naps or experience other shifts in your sleep pattern. Researchers are not sure why these sleep changes occur. There are nondrug treatments and medications that may help improve your sleep.
Alternative treatments
There are remedies, supplements and medical foods that are often referred to as alternative treatments. Alternative treatments are not regulated and do not need to adhere to the same standards as FDA-approved treatments. Claims about their safety and effectiveness are based largely on testimonials, tradition or a small body of scientific research.
If you are considering taking an alternative treatment, talk openly with your physician. It is important to be aware of any risks so you can make an informed decision. Even if advertised as natural or alternative treatments can involve potentially powerful substances that have not met the FDA standards for effectiveness or safety, and some alternative medicines can cause unintended reactions when taken with prescription medications.
Alternative Therapies
As researchers continue to search for a cure, many patients and their families are turning to alternative therapies to slow the disease. Some of these alternative treatments are showing great promise in treating symptoms of Alzheimer’s. They are:
- Blood pressure medications
- Diabetes treatments
- Rheumatoid Arthritis drugs
- Cholesterol medications
Here is a list of questions to ask when considering an alternative treatment or supplement:
- Did the FDA test the product? If so, what were the results?
The FDA may have tested a product but found it to be ineffective for the intended purpose. - Has any non-FDA testing been done? If so, what were the results?
Does the testing entity have a vested interest in the outcomes? For example, was testing done only by the company developing the product? If so, the results may not be entirely reliable. - Does the developer of the product or the person recommending it to you have a potential financial gain from the use of the medication?
If so, use extreme caution. Check with your care team to see if they have any questions or concerns with your plan to use it. - Is the product compatible with the other medications you are taking or with your diagnoses?
Be sure to check with your doctor or pharmacist to find out whether the product could cause negative outcomes given your diagnoses and any medications you are taking. - Does the use of the product have any known risks?
Ask your doctor or the pharmacist if the product has any known side effects.
Research into tomorrow’s treatments
Researchers are conducting studies to find new interventions and treatments that can prevent Alzheimer’s, diagnose the disease earlier, slow its progression or stop it in its tracks.
Many drug development aims to interrupt the disease process itself by impacting one or more of the brain changes associated with Alzheimer’s. These changes offer potential targets for new drugs to slow or stop disease progression. These promising targets include beta-amyloid and tau protein (hallmarks of Alzheimer’s brain abnormality) and inflammation.
Researchers believe that a successful treatment will eventually involve a combination of medications aimed at several targets, similar to current treatments for many cancers and AIDS.
Participate in clinical trials
Recruiting trial participants is now the greatest obstacle, other than funding, to developing the next generation of Alzheimer’s treatments. You can help change this by participating in a clinical research study.
Trial Match is a free, easy to use clinical study matching service that connects individuals with Alzheimer’s or another dementia, caregivers, healthy volunteers and physicians with current studies.
Once you qualify for a trial, you will work with the trial research team to understand the benefits and risks of participating before making a final decision and signing an informed consent form. You will be going through this process with the people conducting the study, rather than your doctor.
Many studies require that you bring a family member or caregiver with you to the interview, so make sure to ask the research team about this and any additional questions you may have.
You can ask your doctor that, a clinical trial might be right for you. Your doctor knows you and your health history and can help you gather the information and identify what questions might be important to ask before deciding to participate.
Natural Treatment for Alzheimer’s Disease:
Treatment focuses on creating a better life for people with AD. Doctors recognized symptoms of the disease that can be managed. This can be done with traditional and alternative treatments. If you’re interested in alternative(natural) treatments, it is important to talk with a doctor first.
Coconut oil
Caprylic acid is a fatty acid found in processed coconut oil. The human body breaks down caprylic acid into the protein ketone. Some research has found that people who took Ketasyn had better memory performance and less cognitive decline. Some people are using coconut oil as a cheaper alternative to medicine.
Omega-3 fatty acids
Omega-3 fatty acids may be beneficial in Alzheimer’s disease treatment. Researchers found that regular consumption of omega-3 fatty acids reduced cognitive impairment. This research was conducted in animals, not humans. You can get more omega-3 fatty acids in your diet by eating fish, nuts, and some oils.
Coenzyme Q10
An alternative treatment with vitamins and minerals can prevent or stop Alzheimer’s Disease. One such antioxidant is coenzyme Q10 or CoQ10. Supplements are available in drug stores. This enzyme is important to healthy body functions. It’s now being studied as a possible treatment for AD.
Acupuncture
Acupuncture is an alternative medicine for Alzheimer’s disease, which is believed to promote self-healing by using fine, sterile needles. This therapy is thought to stimulate the body and improve the flow of energy. A study showed that acupuncture improves mood, energy levels, and pain, but more research is still needed.
Aromatherapy
Aromatherapy uses essential oils to enhance well-being. One short-term study tested aromatherapy on a group of older adults, some with AD. At the end of the study, every person involved showed improvement in their thinking abilities. The essential oils used in the study included:
- rosemary
- lemon
- lavender
- orange
Larger studies still need to be conducted over longer periods of time to confirm these findings.
While using it is important to remember to never apply essential oils directly to the skin. Always dilute three to five drops in one ounce of carrier oil such as almond oil.
Bright light therapy
Alzheimer’s disease affects the part of the brain that regulates the circadian rhythm, which tells the body when to sleep and wake up. AD can cause a disruption in your sleep and wake cycle. Some people have problems sleeping, which increases the risk of nighttime wandering. This therapy may help in reducing the symptoms.
Studies have found that light therapy helps restore balance to the sleep-wake cycle. This therapy in the morning improved the night time sleep pattern in some people. It also increased daytime wakefulness.
Herbal medicine
One large study found that ginkgo biloba had no impact on a person’s risk for developing AD. However, several small studies found that gingko biloba may benefit people with cognitive impairment caused by AD.
More research is still needed on whether there’s a positive connection between ginkgo biloba and AD. The current findings are not very convincing. Some herbs are effective in the treatment because of their anti-inflammatory and antioxidant properties.
Choto san is one of the herbal mixture containing 11 medicinal plants. This mixture has been used to treat dementia. Some studies found improvements in memory and learning during its treatment.
According to a small study, the Japanese herb kami-untan to improved nerve growth in rat brain cells. Based on these results, the herb could possibly slow Alzheimer’s disease progression. However, more research is needed for this.
Be sure to report any use of herbs or alternative approaches to your doctor. Many herbs also interact with other medications. Ginkgo biloba, for example, is known to be a blood thinner and can be dangerous for people already on blood thinners.
However, current research does not support alternative treatments as a way to cure Alzheimer’s disease. But your treatment plan is a personal choice. Before taking any of the alternative medicine consult to your doctor. If you are already taking an alternative medicine report to your doctor or physician about it.
Alzheimer’s rehabilitation
The rehabilitation program for persons with Alzheimer’s differs depending upon the symptoms, expression, and progression of the disease, and the fact that making a diagnosis of Alzheimer’s is so difficult. These variables determine the amount and type of assistance needed for Alzheimer’s individual and family.
With Alzheimer’s rehabilitation, it is important to remember that, although any skills lost will not be regained, the caregiving team must keep in mind the following points:
- While managing the disease, physical exercise and social activity are important, as are good nutrition and health maintenance.
- Plan daily activities, keep activities familiar and satisfying.
- To allow the individual to participate in various activities and routines as much as possible.
- Provide cues for behavior. Allow the individual to complete as many tasks by himself or herself if possible. The caregiver may need to start an activity, but allow the individual to complete it as much as he or she can.
- Keep the individual out of harm’s way by removing all safety risks
- As a caregiver, it is important to understand your limitations whether it is physical or emotional.
Prognosis:
There is currently no cure for Alzheimer’s Disease. The average amount of time a person with Alzheimer’s will live is eight years after the onset of symptoms. However, individuals with Alzheimer’s have been known to live anywhere between 3 and 20 years after the first signs of Alzheimer’s disease emerge. The duration of time people will live after diagnosis is highly dependent on their age as well as the severity of their other medical conditions.
People with Alzheimer’s Disease often die of a medical complication such as pneumonia or the flu. If this does not occur, Alzheimer’s Disease is fatal, and the person will die when all body systems fail because of the disease.
How Alzheimer’s are different from other Dementia?
Mostly peoples are confused between these two terms as these terms relate to each other but are totally different. The common thing between these terms is both belong to mental status or behavior. Alzheimer’s disease is a degenerative brain disease and it is the most common form of dementia. Dementia does not come under the term specific disease. It’s an overall term that describes a group of symptoms.
Dementia is a vast term for a set of symptoms including impaired thinking and memory. It is a term that is often associated with the cognitive impairment of aging. However, issues other than Alzheimer’s can cause dementia. Other common causes of dementia are Huntington’s Disease, Parkinson’s Disease and Creutzfeldt-Jakob disease.
According to the Center for Disease Control, Alzheimer’s disease is a common cause of dementia-causing as many as 40 to 70% of all dementia cases. In fact, Alzheimer’s is a very specific form of dementia. Symptoms of Alzheimer’s include, impaired speech, thinking, and confusion. Doctors use a variety of screenings to determine the cause of dementia including blood tests, mental status, and brain scans.
When a person is diagnosed with dementia, they are being diagnosed with a set of symptoms. When someone has dementia they are experiencing several symptoms without being told what is the main cause of those symptoms. Another major difference between the two is that Alzheimer’s is not a reversible disease. It is degenerative and incurable at this time. Some forms of dementia are actually reversible or temporary.
How Long Can a Person Live with Alzheimer’s Disease?
The death of a person due to Alzheimer’s depends upon at what age the disease is diagnosed. It varies as little as 3 or 4 years if the person is older than 80 when diagnosed, to as long as 10 or more years if the person is of a young age.
Alzheimer’s disease is currently the sixth leading cause of death in the United States. Age-specific death rates from Alzheimer’s disease are increasing per year.
Alzheimer’s is a complicated disease in which there are many unknowns. What is known is that the condition worsens over time, but treatment can help delay symptoms and improve your quality of life.
If you think you or a loved one may have Alzheimer’s, your first step is to talk with your doctor. They can help in diagnosis, discuss what you can expect, and help connect you with services and support.
