What is Alzheimer’s Disease and How is it Treated?

Alzheimer’s disease is a progressive neurological disorder that causes brain cells to degenerate, resulting in memory loss and cognitive decline. It is the most common form of dementia, accounting for 60 to 80% of dementia cases in the U.S. Symptoms of Alzheimer’s usually develop slowly, but get worse over time, and at the end stage the patient forgets how to perform daily tasks such as wearing a shirt or going to the bathroom.

Statistics

Alzheimer’s is the 6thleading cause of death in the U.S. More than 5 million Americans are living with Alzheimer’s disease. The number is believed to rise to nearly 14 million by 2050. Every 65 seconds, someone in the U.S. develops Alzheimer’s.

Globally, every 3 seconds someone develops dementia. In 2015, an estimated 46.8 million people worldwide were living with dementia and this number is projected to rise to 50 million in 2017. Much of the increase will be in developing countries. Low and middle-income countries already have 58% of dementia cases worldwide. China, India, and other South Asian countries will see a dramatic rise in dementia cases because these countries are seeing the fastest growth in their elderly population.

A Short History

Dr. Alzheimer (left), his patient Auguste Deter (right)

The disease is named after German psychiatrist Alois Alzheimer, who first described it in 1901. During the 1890s, Dr. Alzheimer had a female patient named Auguste Deter. Fifty-year-old Deter was showing signs of dementia. She also had trouble sleeping, and she’d drag sheets across the house, and scream for hours in the middle of the night. Deter was admitted to a mental institution in Frankfurt, Germany. When Dr. Alzheimer would ask her to write her name, she’d forget her name and repeat, “I have lost myself.” When she was put in an isolation room for a while and later released, she ran out screaming, “I will not be cut. I do not cut myself.” Dr. Alzheimer called it the “Disease of Forgetfulness.” Deter died in 1906 of “sepsis caused by an infected bedsore” in 1906. Alzheimer decided to examine her brain and upon examination he discovered senile plaques and neurofibrillary tangles. These are the hallmarks of Alzheimer’s disease.

Read more Alzheimer’s memory loss may be reversed by blocking a key enzyme

What Causes Alzheimer’s?

Like all types of dementia, Alzheimer's disease is caused by brain cell death.

Beta Amyloid Plaques

In Alzheimer’s disease amyloid plaques accumulate between nerve cells (neurons) in the brain. Amyloid is a general term for protein fragments thatour body produces naturally. Beta amyloid is a protein piece clipped from an amyloid precursor protein (APP). In the brain of a healthy person, these pieces of protein are broken down and removed. But in Alzheimer's disease, these fragments are not eliminated and they amass to form solid, insoluble plaques.

Neurofibrillary Tangles

These are insoluble twisted fibers found inside the cells of the brain. A protein called tau is the main component of these tangles. Tau builds part of a structure called a microtubule, which aids in transporting nutrients and other vital substances from one part of the nerve cell to another. Inside the brain of Alzheimer's disease patient, the tau protein is abnormal and the microtubule formations collapse.

What are the Risk Factors for Alzheimer’s?

Age. Increased age is the biggest risk factor for Alzheimer’s disease. For most people with Alzheimer’s, they get it after age 65.

Family history. People who have a parentor sibling with Alzheimer’s are more likely to develop the disease.

Gender. Women are at greater risk of developing the disease than men. Out of the 5 million people living with Alzheimer’s in the United States, 3.2 million are women.

Genes. Genes play a big role in the development of Alzheimer’s. According to scientists, two categories of genes – risk genes and deterministic genes – influence whether a person develops a disease. Alzheimer's genes have been found in both categories.

Down syndrome. Scientists do not know why, but people with Down Syndrome often get Alzheimer's disease in their 30s and 40s.

Head injury. Some studies have found a link between Alzheimer's disease and a major head trauma.

Other factors. High cholesterol in blood and high blood pressure may also raise the risk of developing Alzheimer’s disease.

Early-onset Alzheimer’s

Early-onset Alzheimer's can affect younger people with a family history of the disease, normally between the ages of 30 and 60 years. Less than 5% of all Alzheimer’s cases are early-onset.

What are the Symptoms of Alzheimer’s?

The early signs of Alzheimer’s may be forgetting recent events or conversations. The progression of the disease causes the person to develop severe memory impairment, which makes them unable to carry out simple everyday tasks. However, it should be noted that loss of memory doesn’t always mean dementia.

Symptoms of Alzheimer’s disease may include:

• Misplacing personal belongings
• Repetitive questions or conversations
• Getting lost in familiar surroundings
• Forgetting appointments orevents
• Lack of understanding of safety risks
• Unable to make decisions or poor decision-making ability
• Inability to oversee finances
• Inability to recognize faces
• Difficulty finding common words while conversing
• Inability to use simple tools
• Impaired speaking, writing and reading
• Errors in writing, spelling and speaking
• Mood changes, including agitation, apathy and social withdrawal
• Compulsive, obsessive, or socially unacceptable behavior
• Loss of empathy

What are the Stages of Alzheimer’s?

Alzheimer's progression can be broken down into 3 main stages:

Preclinical. It is the stage before symptoms appear

Mild cognitive impairment. Symptoms are mild at this stage

Dementia. This is the stage when the person is believed to have dementia

How is Alzheimer’s Diagnosed?

There is no single test for Alzheimer's, so doctors usually do a check on the person's medical history, history from relatives, and behavioral observations before making a diagnosis. Computed tomography (CT) or magnetic resonance imaging (MRI), Single-photon emission computedtomography (SPECT) or positron emission tomography (PET) are standard procedures, which help to exclude other cerebral pathology or subtypes of dementia.

The person's neurological function may also be checked. It may be done by testing their senses, balance, and reflexes.

Other tests may include a blood or urine test etc.

Sometimes the dementia symptoms may be linked to an inherited disorder such as Huntington's disease, so doctors may do a genetic testing.

Cognitive Assessment

To do a cognitive assessment, the doctor may ask the person following questions:

• What is your first name and last name?
• What is your age?
• What is your spouse’s name?
• What is your date of birth?
• What is the time, to the nearest hour?
• Can you recognize two people, for example, the doctor, nurse, or caregiver?
• What year is it now?
• In which year did (WW II) happen?
• What is the name of the hospital or town we are in?
• Who’s the president?
• Count backward from 20 down to 1

What are the treatments for Alzheimer’s?

There is no known cure for Alzheimer's. Scientists cannot reverse the death of brain cells.

However, therapeutic interventions may ease the symptoms of the disease.

Is Alzheimer’s Preventable?

Alzheimer's isn’t a preventablecondition. But a range of lifestyle risk factors for the condition can be modified. Studies have found that changes in diet, exercise and habits – steps to lower the risk of cardiovascular disease – may also reduce one’s risk of developing Alzheimer's disease and other disorders that cause dementia. The following lifestyle choices may reduce the risk of Alzheimer's:

• Exercise regularly
• Eat lots of fruits and vegetables, healthy oils and foods low in saturated fat
• Follow guidelines to manage diabetes, high blood pressure, and high cholesterol
• Do not smoke

Studies have shown that creating art, participating in social events, reading, playing board games, dancing, playing an instrument, and other activities that require mental activity and social engagement may help keep dementia at bay.

Famous People with Alzheimer’s

Jimmy Stewart in "It's a Wonderful Life"

• Malcolm Young (1953 – 2017). Legendary guitarist of AC/DC
• Glenn Campbell (1936-2017). Country singer and guitarist
• Perry Como (1912-2001). Singer, TV personality
• Charles Bronson (1921 — 2003). Actor, famous for “Deathwish” movies
• Ronald Reagan (1911 – 2004). US president
• Charlton Heston (1923 – 2008). Legendary actor
• Norman Rockwell (1894 – 1978). Famous painter
• Rita Hayworth (1918 – 1987). Famous actress
• Sugar Ray Robinson (1921 – 1989). Famous boxer
• Estelle Getty (1923 – 1998). Actress well-known for “Golden Girls”
• Peter Falk (1927 – 2011). Actor, best known for TV series “Columbo”
• James Stewart (1908 – 1997). Legendary actor famous for “It’s a wonderful life,” “Mr. Smith goes to Washington,” and many other movies
• Rosa Parks (1913 – 2005). Civil rights activist known as “the Mother of the Freedom Movement”
• Robin Williams (1951 – 2014). Famous actor. Although Williams was thought to have Alzheimer’s, it was revealed after his death that he wassuffering from Lewy Body Dementia.
• Casey Kasem (1932 – 2014). Famous for America’s Top 40 Countdown

If you have a loved one who you think might have Alzheimer’s, you may seek help by contacting Alzheimer’s helpline.

Families of Alzheimer’s patients can seek help from senior care referral services such as A Place for Mom to receive care options that’s a good match for their family.