What Is Alzheimer’s Disease?
Alzheimer’s is a disease that robs people of their memory. At first, people have a hard time remembering recent events, though they might easily recall things that happened years ago.
As time goes on, other symptoms can appear, including:
- Trouble focusing
- A hard time doing ordinary activities
- Feeling confused or frustrated, especially at night
- Dramatic mood swings — outbursts of anger, anxiety, and depression
- Feeling disoriented and getting lost easily
- Physical problems, such as an odd walk or poor coordination
- Trouble communicating
People with Alzheimer’s might forget their loved ones. They might forget how to dress themselves, feed themselves, and use the toilet.
The disease makes brain tissue break down over time. It usually happens to people over age 65.
A person can live with Alzheimer’s disease for just a few years or for a few decades. More often, however, people live with it for about 9 years. About 1 in 8 people age 65 and over has the disease. Women are more likely to have it than men.
What Causes Alzheimer’s Disease?
People who get Alzheimer’s disease are usually older, but the disease isn’t a normal part of aging. Scientists aren’t sure why some people get it and others don’t. But they do know that the symptoms it causes seem to come from two main types of nerve damage:
- Nerve cells get tangles, called neurofibrillary tangles.
- Protein deposits called beta-amyloid plaques build up in the brain.
Researchers aren’t sure what causes this damage or how it happens, but it could be a protein in blood called ApoE (for apolipoprotein E), which the body uses to move cholesterol in the blood.
There are a few types of ApoE that may be linked to a higher risk of Alzheimer’s. It could be that certain forms of it cause brain damage. Some scientists think it plays a role in building the plaques in the brains of people with Alzheimer’s.
Whether or not ApoE partly causes Alzheimer’s, genes almost certainly play a role in the disease. Someone with a parent who had the disease is more likely to have it, too.
There is some evidence that people with high blood pressure and high cholesterol have a greater chance of getting Alzheimer’s. More rarely, head injuries may be a reason, too — the more severe they are, the greater the risk of Alzheimer’s later in life.
Scientists are still studying many of these theories, but it’s clear that the biggest risks linked to Alzheimer’s disease are being older and having Alzheimer’s in your family.
Alzheimer’s disease isn’t part of normal aging. If you think you or a loved one might be showing symptoms of the disease, it’s important to see a doctor to get a diagnosis. Some warning signs to get checked are memory loss, behavior changes, or trouble with speech and decision-making.
But Alzheimer’s has many of the same symptoms as other common conditions, too. Those include depression, poor nutrition, and taking medications that don’t work well together. A doctor can find out if the symptoms are happening because of Alzheimer’s or due to something else that’s easier to treat.
An early and accurate diagnosis can also give you or your loved one time to plan for the future. You can start using some medicines that help people in the earlier stages of Alzheimer’s control some of their symptoms for a while as well. On average, these drugs keep symptoms from getting worse for about 6 to 12 months in about half of the people who take them.
Getting a Diagnosis
Doctors can’t definitely diagnose Alzheimer’s disease until after death, when they can closely examine the brain under a microscope. But they can use tests to rule out other conditions that might cause the same symptoms.
Here’s what you can expect when you or your loved one is diagnosed with Alzheimer’s.
Health History
Your doctor will do a physical exam and ask questions about your past and current health. He’ll want to know:
- Your symptoms, including any trouble you have with everyday tasks
- Other medical conditions you have now or had before
- Medications you take
- Your personal history, like your marital status, living conditions, employment, sexual history, and important life events
- Your mental state. The doctor will ask you a series of questions that help him figure out if you’re having a mental health problem, like depression.
- Family history, including any illnesses that seem to run in the family
- Problem-solving skills
- Attention span
- Counting skills
- Memory
These tests will help your doctor know whether there are problems with the areas of your brain involved in learning, memory, thinking, or planning skills.
CT Scan
In CT (computed tomography) a machine takes X-rays of your body from many different angles in a very short period of time. A computer turns the scans into a series of images that look like “slices” through the body. CT scans can show brain changes that are common in the later stages of Alzheimer’s.
Magnetic Resonance Imaging (MRI)
MRI makes very clear pictures of your body using a large magnet, radio waves, and a computer. It can help doctors see if a tumor or a stroke has caused symptoms that look like Alzheimer’s. It also may help to show the brain changes that are linked to the disease.
Neuropsychological Testing
This studies the relationship between the brain and behavior. It helps in the diagnosis and treatment of conditions that affect thinking, emotion, and behavior, including Alzheimer’s.
Doctors give you these tests along with a thorough interview. They may also give you other tests to check memory, language, the ability to plan and reason, and the ability to change behavior.
Neuropsychological testing also can help the doctor and your family better understand the effect of a disorder on your everyday life.
Today, there is no cure for Alzheimer’s. Researchers are still trying to fully understand how the disease leads to memory loss and other problems with thinking and behavior. They hope to one day reverse those changes to prevent or stop the disease.
But if you or a loved one has Alzheimer’s, there are treatments that can make a difference. Some therapies ease the symptoms and help people do better for longer. Because the disease’s effects change over time, people often need to have their treatments adjusted by the doctor, or they need to start new ones as different problems emerge.
Medications
Different types of drugs can treat memory loss, behavior changes, sleepproblems, and other Alzheimer’s symptoms. They don’t stop the disease, but they can keep the problems from getting a lot worse for a few months or even years. All of them can have side effects, which can be more of a problem for older people.
Doctors may recommend one or more types of medicines depending on a person’s symptoms:
Some drugs treat problems with mood, depression, and irritability. Those include citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
For people who have anxiety or restlessness, medicines that can help include alprazolam (Niravam, Xanax), buspirone (BuSpar), lorazepam(Ativan) and oxazepam (Serax).
Doctors might prescribe medications to ease confusion, aggression, agitation or hallucinations (seeing, hearing, or feeling things that aren’t there). Options include aripiprazole (Abilify), haloperidol (Haldol), and olanzapine (Zyprexa). It’s important to note that studies have linked some of these “antipsychotic drugs” to a higher risk of death for people with dementia. The FDA has placed a “black box” warning on these drugs describing these problems. They can be helpful for many people, though.
Other Therapies
Many people have explored other ways outside of medication to treat Alzheimer’s disease or handle its symptoms. The science on whether or not they work has been mixed.
Vitamin E . Scientists once thought this antioxidant might protect nerve cells from damage. But many doctors no longer recommend it for people with Alzheimer’s, because there’s little evidence that it works.
Hormone replacement therapy(HRT). At one time, studies suggested that women who took hormone replacement therapyafter menopause had a lower risk for Alzheimer’s. The female hormone, estrogen, was thought to help nerve cells connect with each other, and keep the brain from making plaques that build up between brain cells. But more recent research found that HRT doesn’t help, and one study even showed that estrogen use might actually raise the risk of Alzheimer’s rather than protect against it. HRT also may increase a person’s chances for heart attack, stroke, and breast cancer.
Art and music therapies. Some science shows that these treatments, which stimulate the senses, can improve mood, behavior, and day-to-day function for people with Alzheimer’s. Art and music may help trigger memories and help people reconnect with the world around them.
Supplements . Some people have tried alternative remedies, including coenzyme Q10, coral calcium, huperzine A, and omega-3 fatty acids to prevent or treat Alzheimer’s disease. There’s not yet enough research to show if they do or don’t work.
The FDA doesn’t regulate supplements as it does medications, and the companies that make them don’t have to show if their products are safe or work before they can sell them. Some supplements also can cause dangerous side effects or keep other medications you take from working. Always talk to your doctor before you start using one.