Alzheimer’s Disease is the most common form of dementia. It is a progressive neurodegenerative disease that develops gradually and is characterized by the destruction of nerve cells, especially in the areas of the brain vital to memory and learning. The pathological changes in the Alzheimer’s brain include deterioration and loss of neurons (nerve cells) leading to brain atrophy (shrinkage), and the abnormal accumulation of proteins forming amyloid plaques and neurofibrillary tangles. In addition, neurotransmitters such as acetylcholine, dopamine, norepinephrine, glutamate, and serotonin are affected in Alzheimer’s Disease. While it is now clear that AD develops as a result of a complex cascade of events that take place over many years inside the brain, the cause (or causes) remains unknown.
The symptoms of AD become more evident as the client ages however, they may occur as early as age 40 (in rare cases, even younger). The risk of AD doubles every five years beyond age 65. The course of the disease varies from person to person. In some people the disease progresses quickly, reaching the end stage in only five years, while others may have it for as long as 20 years. The most common cause of death for people who survive to the end stage of AD is pneumonia.
The type, severity, sequence, and progression of mental changes vary widely. The early symptoms of AD are often dismissed as natural signs of aging. AD typically begins with forgetfulness, loss of concentration and a decline in problem-solving ability. Confusion and restlessness may also occur. As the illness progresses, AD destroys cognition and ability to function and changes personality.
In contrast to the milder signs of memory loss associated with normal aging and mild cognitive impairment, changes in memory associated with AD and the other primary dementias are more pervasive, affecting orientation, mood, behavior, language, speech, movement and coordination. These changes differ from normal aging and mild cognitive impairment in quantity and quality.
Many people aren’t aware that AD does actually affect physical functioning. It is now known that AD begins to have subtle effects on motor function, muscle tone and balance even in the earliest stages of the illness. If people survive until the late stages of AD, the illness affects all areas of their brains and they ultimately become incapable of performing even the most basic physical functions. This makes AD perhaps the most devastating disease of the elderly.
A commonly believed myth that prevents people from seeking a diagnostic evaluation even for severe memory problems is that there is no point going to a doctor because nothing can be done. In fact, there are many ways to relieve the suffering of people with AD and their families. Drug treatments are now available to manage some of the symptoms of AD. While no currently available drugs can prevent or halt the underlying disease process, advances in understanding Alzheimer’s Disease may lead to such treatment in the future. In the meantime, researchers and clinicians are working to enhance the quality of life for both patients and caregivers by developing ways to improve behavioral management and caregiver skills.
Psychosocial interventions can reduce the impact of AD on the patient and the family. For people in the early or moderate stages of the disease, medication has become available that may alleviate some cognitive symptoms. In addition, some medications may help control behavioral symptoms such as sleeplessness, agitation, wandering, anxiety, and depression that are frequently seen in the middle stages of AD. This makes it even more important to have a thorough diagnostic evaluation by well-trained medical specialists when someone seems to have significant changes in cognitive ability.
A common fear is that AD is inherited, and family members of patients are frequently concerned about their risk of getting AD themselves. Although geneticists are beginning to find chromosomal mutations in some families in which there are many cases of AD, these families are very rare–genetic factors are the sole determinant in fewer than 2% of the cases of AD. A variant of the ApoE protein called ApoE-4, located on chromosome 19, appears to increase the risk and lower the age of onset of AD. Nevertheless, while about two thirds of the cases of AD have at least one copy of this form of ApoE, almost one quarter of the normal elderly population do also.
Researchers today are actively searching for ways not only to increase longevity and disease-free aging but also to improve the quality of life of the aging population. Owing to the increase in life expectancy in modern societies and the fact that the risk of AD increases with age, many people currently face the prospect of suffering from dementia. A major focus of ongoing studies is to postpone, ameliorate, or prevent the onset of debilitating illnesses such as AD and to develop improved ways of helping the families of those who are afflicted.
For information about the diagnosis of Alzheimer’s Disease and other topics pertaining to the disease, please call the Alzheimer’s Disease Association of Kern County, Inc. at (661) 665-8871.
What causes Alzheimer's Disease?
Scientists still are not certain. Age and family history have been identified as potential risk factors. Researchers are exploring the role of genetics in the development of Alzheimer’s, but most agree the disease is likely caused by a variety of factors. Each year, scientists are uncovering important new clues about potential causes of the disease, which is helping to generate more accurate diagnostic tests and better treatment options for affected individuals.
How many people are affected by Alzheimer's Disease?
One in 10 persons over 65 and nearly half of those over 85 have Alzheimer’s Disease. Today, four million Americans have Alzheimer’s Disease. Unless a cure or prevention is found, that number will jump to 14 million by the year 2050. Worldwide, it is estimated that 22 million individuals will develop Alzheimer’s Disesae by the year 2025. Caregivers are affected by this disease, too. In a national survey, 19 million Americans said they have a family member with Alzheimer’s Disease, and 37 million said they knew someone with the disease.
How is Alzheimer's Disease diagnosed?
There is no single, comprehensive diagnostic test for Alzheimer’s Disease. Instead, physicians or other specialists rule out other conditions through a process of elimination. They usually conduct physical, psychological, and neurological exams and take a thorough medical history. A diagnosis of probable Alzheimer’s Disease can be obtained through evaluation with approximately 90 percent accuracy. The only way to confirm a diagnosis of Alzheimer’s Disease is through autopsy.
How does Alzheimer's Disease progress?
Alzheimer’s Disease causes the formation of abnormal structures in the brain called plaques and tangles. As they accumulate in affected individuals, nerve cell connections are reduced. Areas of the brain that influence short-term memory tend to be affected first. Later, the disease works its way into sections of the brain that control other intellectual and physical functions.
Alzheimer’s Disease affects people in different ways, making it difficult for medical professionals to predict how an individual’s disease will progress. Some experts classify the disease by stage (early, middle, and late). But specific behaviors and how long they last vary greatly, even within each stage of the disease.
As more is learned about the progession of the disease, new assessment scales are being developed to help physicians track, predict, and treat symptoms of Alzheimer’s Disease.
Does Alzheimer's Disease run in families?
The evidence is not clear. Cases where several members of a single family have been diagnosed with Alzheimer’s are rare (except in families who have a history of early-onset Alzheimer’s, a form of the disease that typically strikes middle-aged members of the same family). Much more common is the situation where a single family member is diagnosed with Alzheimer’s Disease late in life.
Can Alzheimer's Disease occur in younger adults?
Yes, though less frequently. The disease can occur in people in their 30s, 40s, and 50s. However, most people diagnosed with Alzheimer’s are older than 65. The early onset form of the disease that strikes younger people accounts for less than 10 percent of all reported cases. Scientists believe this variation of the disease may be genetically transmitted across multiple generations of the same family.
What treatment is available?
There is no medical treatment currently available to cure or stop the progression of Alzheimer’s Disease. Four FDA-approved drugs –tacrine (Cognex), donepezil (Aricept), and rivastigmine (Exelon), and galantamine (Reminyl)–may temporarily relieve some symptoms of the disease.
Many other new promising drugs are now being developed–some which may be available within the next few years. Medication and nondrug therapies are also available to reduce some of the behavioral symptoms associated with Alzheimer’s, such as depression, sleeplessness, and agitation.
What is being done to find a cure or prevention?
Alzheimer research is being tackled from many sides. Pharmaceutical companies, the U.S. federal government, and the national Alzheimer’s Association are funding research to learn more about the disease process and to find compounds that will alleviate symptoms and prevent or cure the disease.
Can I continue to live independently?
Whether you can continue to live independently depends on the progression of the disease and your remaining abilities. You may be able to live alone or with some assistance for some time. However, as the disease progresses, your care needs will increase, and you will need to rely on others for more help.
How do I handle my anger?
Anger is normal. The hard part is eventually letting go of that anger so it does not consume you. The best way to deal with your anger is to face it and know that it is a normal part of the process. Tap into sources such as family, friends, or counselor; on-line chat rooms; or a support group.
Why should I participate in a support group?
A support group allows you to hear how others have coped or are coping with difficult challenges similar to your own. Support groups are safe places to talk openly about various issues and feelings.