Alzheimer's Disease
- Liz F
- Dec 28, 2022
- 5 min read
What is Alzheimer's disease?
By definition, Alzheimer’s disease is a form of dementia that affects one’s memory, thinking, and behavior. Severe cases of the disease cause interference with daily tasks. Alzheimer’s is the most common form of dementia, which is a group of conditions that impair at least two brain functions. Despite what one might think, Alzheimer’s is not a common part of growing old. The majority of people with Alzheimer's are over 65, but about 200,000 people under the age of 65 are diagnosed with early-onset Alzheimer’s. Alzheimer's is a progressive disease meaning that as time goes on, the symptoms worsen. The average number of years survived after being diagnosed with Alzheimer’s is 4-8 years but can go up to 20 years. In terms of the brain, Alzheimer's is believed to restrain parts of cell factories from doing their jobs. When the disease progresses, the cells can no longer do their jobs and will die, which as one would guess leads to significant damage to the brain. On a happier note, Alzheimer’s disease serves as the leading position in biomedical research and remarkable understandings continue to be made.
What are the causes of Alzheimer’s disease? It is not completely certain what causes Alzheimer’s, but some likely causes are a combination of the effects aging has on the brain alongside genetic, environmental, and lifestyle influences. Changes in the brain that might cause Alzheimer’s consists of shrinking of areas of the brain, inflammation, vascular damage, production of unstable molecules, and breakdown of cell’s energy production. Although, aging is a risk factor, not a cause. Regarding genetics, having a family history of Alzheimer’s only gives a chance of developing it. If a parent has Alzheimer’s, those genes are inherited by their children and affect the likeness of them developing the disease. Some health factors that contribute to Alzheimer’s are high blood pressure, heart disease, obesity, and diabetes. Some environmental and lifestyle factors that could help reduce the risk of developing Alzheimer’s are sleep, a nutritious diet, physical activity, social participation, and mentally stimulating activities. Lastly, early-life factors such as higher levels of education have been linked to a decreased risk of Alzheimer’s disease. All in all, while there isn’t a list of 100% confirmed causes for Alzheimer’s disease, brain changes due to aging combined with genetic, health, environmental, and lifestyle factors contribute to the disease.
Diagnosis: Alzheimer’s can typically be diagnosed with an explanation of symptoms, a perspective of someone who sees one’s daily life, and several tests administered by doctors. Some tests that would be given to diagnose Alzheimer’s are a physical and neurological test, which tests reflexes, balance, coordination, muscle strength, sense of sight, sense of hearing, and the ability to get up from a chair and walk. Also, lab tests such as blood tests and brain imaging such as an MRI, CT, or a type of PET scan. Additionally, future diagnostic tests and neuropsychological testing. Despite these tests, the diagnosis of Alzheimer’s can only be completely certain after death through microscopic examination of the brain that reveals plaques and tangles.
How does this affect people/symptoms? Alzheimer's is most known for affecting people’s memories, thinking skills, and ability to perform tasks. That said, the most significant symptoms of Alzheimer's disease are memory loss and behavior changes. The most common symptom of Alzheimer’s is having trouble remembering newly learned information due to the changes occurring in the brain. The symptoms of mild Alzheimer’s disease are the usual memory loss and mood changes, poor judgment, loss of sense of initiative, repeating questions, trouble handling money, wandering and getting lost, losing things, and increased anxiety/progression. The symptoms of moderate Alzheimer’s disease are increased memory loss, difficulty with language, difficulty thinking logically, shortened attention span, issues with new situations, inability to multitask, trouble recognizing friends/family, hallucinations, impulsive behavior, outbursts of anger, agitation, and repetitive statements/movement. Lastly, the symptoms of severe Alzheimer’s are weight loss, seizures, skin infections, inability to communicate, loss of bowel and bladder control, increased sleeping, difficulty swallowing, and groaning. Some other general symptoms that arise due to the changes in the brain occurring from Alzheimer’s are disorientation, deepening confusion, unfounded suspicions, and difficulty speaking, reading, and walking.
Treatment: Alzheimer’s is an irreversible disease and therefore has no cure, but there are forms of treatment that lessen symptoms. In exciting news, Aducanumab, a new drug by Biogen is being reviewed by the FDA and could be a new and more effective drug to treat Alzheimer’s. One form of treatment consists of medications for memory. The FDA has approved cholinesterase inhibitors and memantine as the types of drugs to treat memory loss, confusion, and difficulty with thinking/reasoning. Some treatments for behavior are both medications and non-drug treatments. Some non-drug treatments are physical and emotional comfort which can be determined by recognizing that someone is experiencing symptoms, identifying the relation to their disease, and changing the environment. Medications that treat behavior are antidepressants, anxiolytics, antipsychotic medications, or a mood stabilizer. Although it is important to only take antipsychotic medications if the behavior is due to mania, the symptoms are dangerous, and if there is constant distress. In addition, there are treatments for sleep changes. Non-drug treatments for sleep changes include regular timely routines, morning sunlight, daily exercise (no later than four hours before bed), avoiding alcohol and caffeine, avoiding medicine before bed, having a comfortable bedroom temperature, and others. Some medication treatments for sleep changes are tricyclic antidepressants, benzodiazepines, sleeping pills, and antipsychotics. There are alternative treatments that act as memory strengtheners and delayers/preventers for the disease. However, keep in mind that the safety and success of the treatments have been determined by testimonials, traditions, and a small amount of scientific research. The alternative treatments are Coenzyme Q10, Ginkgo Biloba, Huperzine A, Omega-3 fatty acids, Phosphatidylserine, Tramiprosate, and more. When considering these treatments for Alzheimer’s disease it is critical to ask questions to one’s doctor to find out what treatment is best based on one’s age, health, goals, symptom intensity, and availability of caretakers.
Prevention: There is no definitive prevention of Alzheimer’s disease, however, there are ways to decrease the risk of developing Alzheimer's disease. There are ongoing clinical trials through the Dominantly Inherited Alzheimer Network and the Alzheimer’s Disease Cooperative Study. The clinical trial by the DIAN is testing if antibodies to beta-amyloid can decrease the buildup of beta-amyloid plaque in the brain which could act as prevention for symptoms of the disease. The other trial is testing if antibodies to beta-amyloid can decrease the possibility of people ages 65-85 obtaining Alzheimer's. There are ways to prevent Alzheimer’s that are backed up by strong evidence such as physical activity and diet. Regular exercise is beneficial to the brain cells, therefore, lowering the chance of Alzheimer’s. Heart-healthy diets including the DASH diet and a Mediterranean diet are also useful to the brain. Strong social connections act to strengthen nerve cell connections and could contribute towards preventing Alzheimer’s as well. Lastly, it is essential to protect oneself from head trauma by wearing a seat belt, wearing a helmet during sports, and fall-proofing one’s home in order to reduce the risk of Alzheimer’s disease. Overall, lifestyle changes and taking care of one’s health helps to strengthen the brain and therefore suppressing Alzheimer’s disease, in addition to other diseases.
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