Alzheimer’s Disease: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Outlook

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A man who have symptoms of Alzheimer's disease

1Overview

Becoming forgetful once in a while is just normal, particularly in the elderly.
However, a disease, which leads to unusual forgetfulness is taking a toll on the older adults worldwide.

Alzheimer’s disease is a type of dementia characterized by the progressive loss of memory and the destruction of other important mental functions. It is the most common form of dementia.

This condition is considered serious because it affects the cognitive abilities and memory that can interfere with daily life. About 60 to 80 percent of all dementia cases are Alzheimer’s.

Despite the fact that dementia mainly affects older adults, it is not a normal part of aging. In fact, dementia it affects approximately 47 million people worldwide, with 10 million cases each year.

In Alzheimer’s disease, the neurons or brain cells degenerate and eventually die.
As a result, there is a steady decline in mental and cognitive function, including memory.

In the United States, about 5.3 million people of all ages have Alzheimer’s disease and this number could rise to 16 million by 2050. Every 67 seconds, a person develops the disease and it’s the only cause of death in the country that can’t be prevented, slowed or cured. In the United States, Alzheimer’s disease is the sixth leading cause of death.

Alzheimer’s disease worsens overtime because it’s a progressive disease.
The symptoms of this condition gradually worsen over the years. For instance, the memory problems are just mild during the early stages but it can worsen when the disease is in the advanced stages already.

2Symptoms

Dementia, specifically Alzheimer’s disease affects each in various ways, depending on the disease’s impact on the person.

Stages of Alzheimer’s disease

Early stage – In this stage of the disease, the progression and onset are gradual, making this stage overlooked most of the time.

  • Forgetfulness
  • Becoming lost in familiar locations such as going home from work
  • Losing track of time

Middle stage – The middle stage is when others will start to notice the signs and symptoms such as:

  • Becoming lost at home
  • Forgetting people’s names and recent events
  • Having a hard time communicating
  • Needing assistance with personal care
  • Behavior changes such as repeated questioning and wandering

Late stage – This stage is characterized by near or total inactivity or dependence on others. The memory problems become noticeable too. The signs and symptoms include:

  • Having a hard time recognizing loved ones and places
  • Needs assistance in self-care
  • Becoming unaware of place and time
  • Behavior changes including aggression
  • Hard time walking
  • Needing assistance with personal care
  • Behavior changes such as repeated questioning and wandering

People with Alzheimer’s disease will have increasing forgetfulness and mild confusion, but in time, the disease may affect more abilities. The changes in the brain linked to Alzheimer’s disease will affect:

Memory – Many people with the condition will have frequent memory lapses. The memory changes in people with Alzheimer’s worsen over time affecting the ability to work and function effectively in school or work. The signs and symptoms of memory loss include:

  • Forgetting conversations, events, and appointments
  • Getting lost in familiar places
  • Misplacing objects and in some cases, putting them in illogical places
  • Repeated statements and questions over and over again
  • Forgetting the names of people, friends, relatives and everyday items
  • Can’t find the right words to identify objects

Reasoning and thinking – Dementia affects thinking, reasoning and concentration. People with the condition may find multitasking hard, and it can be difficult to manage finances.

Making decisions – People with Alzheimer’s disease may find it hard to make judgments and decisions, even with the simple everyday problems.

Making plans and doing even familiar tasks – People with Alzheimer’s will find it hard to plan things or even perform routine tasks such as cooking a meal. In time, the patients may find it hard to perform even simple everyday tasks like bathing and changing clothes.

Personality changes – Alzheimer’s disease patients may have changes in their personality and behaviors which include experiencing depression, apathy, distrust, mood swings, social withdrawal, loss of inhibitions, sleep problems, delusions, and aggressiveness.

3Causes

Many experts do not fully understand the exact cause of Alzheimer’s disease but they believe that in most people, the condition is caused by a combination of lifestyle, genetic and environmental factors that lead to brain changes.

Scientists believe that in the brain of people with Alzheimer’s disease, there are amyloid plaques, which are abnormal protein deposits, chemical imbalances of acetylcholine and neurofibrillary tangles that lead to the brain changes.

These factors lead to the reduction of the effectiveness of healthy neurons, leading to gradual cell death. The first areas of the brain affected are those responsible for memory.

Genetics may play a part in the development of Alzheimer’s disease. Most individuals with the disease have late-onset forms, wherein the patient may experience the symptoms starting mid-60s.

Scientists revealed that a certain gene contributes to the development of late-onset Alzheimer’s disease. The gene, called APOE ε4, is linked to the earlier age onset of the disease. However, not everyone with the gene will develop Alzheimer’s disease. On the other hand, some people without the gene can develop the disease, too.

4Risk Factors

Despite the fact that the exact cause of Alzheimer’s disease is still unknown, many factors may increase the risk of developing the neurodegenerative disease, including:

Age – Age is the single most significant factor in the development of dementia, particularly Alzheimer’s disease. Increasing age can contribute to the development of the disease but the risk increases markedly after the age of 65 years old. However, about one in 20 people with Alzheimer’s disease may develop the symptoms before the age of 65.

Sex – Alzheimer’s disease is more common in women than in men.

Down’s syndrome – People with Down’s syndrome are at a greater risk of having Alzheimer’s disease. This is because those with Down’s syndrome have an extra chromosome that increases the risk of amyloid plaques build-up.

Family history – People that inherit the genes of parents with Alzheimer’s disease may have the disease, too.

Head trauma – Some studies have shown that people who suffered from severe head injury have an increased risk of developing Alzheimer’s disease.

Mild cognitive impairment – People with mild cognitive impairment (MCI) have memory problems that may worsen with age. In some cases, people with MCI are at a higher risk of developing dementia, specifically Alzheimer’s disease.

Cardiovascular disease – Studies have shown that lifestyle factors and conditions linked to cardiovascular disease may increase the risk of Alzheimer’s disease including high cholesterol, hypertension, obesity, diabetes, and smoking.

5Complications

Alzheimer’s disease can’t be prevented or slowed down. Eventually, disease progression may lead to various complications. The following are the possible complications of the condition, including:

Restlessness and agitation – People with Alzheimer’s disease may feel agitated at times and in some cases, they may develop anxiety.

Falls – People with Alzheimer’s disease may experience problems with balance and coordination. People with the condition may experience falls and slip inside the house. Making sure every fall hazard in the house is managed or renovated is important.

Bladder and bowel problems – People with Alzheimer’s disease may suffer from bladder and bowel problems. The patient may no longer recognize the sensation of needing to use a toilet

Infections – Patients with Alzheimer’s disease may lose control of normal body functions like the proper way of chewing and swallowing food. In some cases, they may have an increased risk of aspirating food particles. This may also lead to aspiration pneumonia.

Depression – Because of the many changes in the body and abrupt development of the disease, some people may have depression. The symptoms of depression include social withdrawal, problems with concentration, mood swings, and sleeping problems.

Wandering- Wandering can be another complication of Alzheimer’s disease. Some patients may wander away from home and may have a problem remembering where he lives. To prevent getting lost, AD patients should have a medical bracelet with their name, address, phone number and who to contact.

6Diagnosis

At present, no specific test can confirm Alzheimer’s disease. The doctor will usually make a diagnosis based on the information the patient and the loved ones will provide as well as the results of the several tests he will request.

Physical and neurological exam – The doctor may conduct a complete physical and medical examination. He will assess the presence of memory problems because these problems can’t always be caused by dementia. The other causes of memory loss include the use of alcohol or drugs, medications, stress, depression, anxiety, and other health problems.

Aside from that, the doctor will check or test the reflexes, balance, coordination, sense of sight and strength, muscle strength and the ability to get up from a chair and walk across the room.

Lab tests – Some tests may be requested to rule out the other causes of memory loss.

Imaging tests – Imaging tests such as magnetic resonance imaging (MRI) of the brain will show the visible abnormalities related to Alzheimer’s disease. The other tests include CT scans and positron emission tomography or PET scan.

7Treatment

At present, there is no current cure for Alzheimer’s disease. The doctors may prescribe medications that will help slow down the progression of the disease and reduce the symptoms.

Drugs – There are available Alzheimer’s disease medicines that can help reduce the loss of memory and other cognitive problems. The two medicines used are cholinesterase inhibitors, which boosts the cell-to-cell communication by producing acetylcholine, and memantine (Namenda) which slows the progression of the symptoms of Alzheimer’s disease.

Creating a supportive environment – People with Alzheimer’s disease need a supportive environment so they could still move on their own and have some degree of independence. Life will be easier for the patients if you promote the use of routine habits and reducing memory-demanding tasks.

You can renovate the house or rearrange things to fit the needs of the patient. For instance, put important things in the same place at home. Declutter and remove rags to prevent falls and make the room bigger for the patient to move around. Always lock the doors at night to prevent wandering and make sure all medicines are taken on time.

8Outlook

There is no cure for Alzheimer’s disease but the treatment can improve cognitive function and slow down the loss of memory. The goal of the treatment is to slow down the progression of the disease and prevent fast memory loss. With the proper treatment, education, and support, both the patient and the loved ones with cope with the Alzheimer’s disease diagnosis.