Alzheimer disease is a disorder of the brain. It leads to a loss of the ability to think, reason, and remember. It worsens over time and will lead to severe impairment. Alzheimer dementia is when the disorder has made it impossible for people to care for themselves.
|Areas of the Brain Affected by Alzheimer Disease|
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For reasons that are not yet clear, brain cells stop working well and begin to die. It may be due to a complex mix of genes, environment, and overall health. Two known factors that play a role include:
- Plaques—protein called beta amyloid builds up between nerve cells
- Neurofibrillary tangles—twisted fibers of a protein called tau fibers inside nerve cells
These changes often begin in areas of the brain that store memory. This damage may start several years before the first symptoms appear.
There are a number of factors that my increase your risk for Alzheimer . Some factors cannot be changed such as:
- Age—more common in people over 65 years of age
- Family history
- Genetics—especially presence of APOE-e4 protein
Medical or health conditions that can increase your risk include:
- Previous serious head injury
- Elevated levels of homocysteine
Conditions of heart and blood vessels including:
- Coronary artery disease
- High blood pressure
- High cholesterol
- Down syndrome (or down syndrome in parent, sibling, or offspring)
Lifestyle factors that may increase risk include:
- Lower level of education
General symptoms include a gradual decline in :
- Ability to find right words
- Visual and spatial skills
- Reasoning or judgement
There are no signs in the earliest stages. At this point there are changes in the brain but not enough to cause signs or symptoms. The speed of progression will vary from person to person but can happen over several years.
Mild Disease (also called early-stage) signs include:
- Repeating yourself or losing things
- Trouble with more complex tasks like finances
- Personality changes, mood swings, increased anxiety
- Basic care tasks start to become more challenging, take longer to do
- Getting lost even when going to familiar areas
Moderate disease signs include:
- Difficulty with logic and organization
- Trouble doing care steps like getting dressed
- May not recognize family and friends
- Inappropriate behavior, outbursts, agitation, and anxiety
- Difficulty walking, moving with shuffle
- Need for regular supervision and care
Severe disease (late-stage) signs may include:
- Increased loss of physical abilities
- Difficulty swallowing
- No longer able to communicate
- Loss of bowel and bladder control
There are no tests to confirm Alzheimer. Instead, your doctor will ask about your symptoms and medical history. Tests will help to rule out other issues that can cause dementia. These may include:
- Physical exam
- Tests of cognitive process—can be done with verbal tests in office
- Examination of nervous system
- Blood tests
- Urine tests
- Lumbar puncture to test the cerebrospinal fluid that surrounds the brain and spinal cord
The doctor may need images of the brain. It will show how much damage has occurred. This can be done with:
- MRI scan
- CT scan
- PET/CT scan
There is no cure for Alzheimer disease. The goal of most care is support and safety. Options include:
Manage Symptom and Disease Progression
Medicine may help to slow the disease progress in some. Options that may reduce the symptoms of Alzheimer disease include:
- Cholinesterase inhibitors—for mild-to-moderate Alzheimer disease
- N-methyl-D-aspartate (NMDA) receptor antagonist—for moderate-to-severe Alzheimer disease
Certain steps and changes may help to improve the quality of life. Options will depend on individual needs but may include:
- Memory aids like notes or tools like pillboxes (may be helpful in early stages)
- Developing support system for home tasks such as cooking, cleaning, or transportation
- Finding reliable people to manage financial and legal matters
- Creating a calm, quiet, predictable environment
- Technical devices like door alarms or emergency assistance tools
- Learning techniques to help reduce frustration
- Encouraging family and close friends to visit frequently
Mental health issues are common. They can have a large impact on quality of life. Medicine may help to manage mental health problems such as:
People with Alzheimer will need care all day and night. It can be a very difficult task for the caregiver. They will need support, rest, and regular breaks. Some steps that may help include:
- Develop a network of family and friends for help. Even basic steps like groceries.
- Ask medical team for local support options.
- Seek out medical services for extra support. This can include overnight care.
- Look for support groups online or in person. They may provide more options.
There are no known ways to prevent Alzheimer disease. However, the following factors may reduce your risk of Alzheimer disease:
- Healthful diet that includes fish (examples DASH or Mediterranean diet)
- Regular physical activity
- Continued learning or mental stimulation through life
- Strong social connections
Decrease risk of head trauma:
- Use seat belt
- Wear helmet
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (Alzheimer Dementia)
Alzheimer's Association http://www.alz.org
National Institute on Aging http://www.nia.nih.gov
Alzheimer Society Canada http://www.alzheimer.ca
Health Canada https://www.canada.ca
Albanese E, Dangour AD, Uauy R, et al. Dietary fish and meat intake and dementia in Latin America, China, and India: A 10/66 Dementia Research Group population-based study. Am J Clin Nutr. 2009;90(2):392-400.
Alzheimer dementia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia . Updated August 21, 2017. Accessed October 2, 2017.
Treatment of Alzheimer's disease. National Institute on Aging website. Available at: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet. Accessed October 2, 2017.
Anstey KJ, Mack HA, Cherbuin N. Alcohol consumption as a risk factor for dementia and cognitive decline: Meta-analysis of prospective studies. Am J Geriatr Psychiatry. 2009;17(7):542-555.
Carillo MC, Blackwell A, Hampel H, et al. Early risk assessment for Alzheimer's disease. Alzheimers Dement. 2009;5(2):182-196.
Deweerdt S. Prevention: Activity is the best medicine. Nature. 2011;475(7355):S16-S17.
Gidoni R, Benussi L, Paterlini A, Albertini V, Binetti G, Emanuele E. Cerebrospinal fluid biomarkers in Alzheimer’s disease: The present and the future. Neurodegen Dis. 2011;8(6):413-420.
Green RC, Cupples LA, Go R, et al. Risk of dementia among white and African-American relatives of patients with Alzheimer disease. JAMA. 2002;287(3):329-336.
Hampel H, Frank R, Broich K, et al. Biomarkers for Alzheimer’s disease: Academic, industry, and regulatory perspectives. Nat Rev Drug Discov. 2010;9(7):560-574.
Hayden KM, Welsh-Bohmer KA. Epidemiology of cognitive aging and Alzheimer’s disease: Contributions of the Cache County Utah study of memory, health, and aging. Curr Top Behav Neurosci. 2012;10:3-31.
Neugroschl J, Sano M. An update on treatment and prevention strategies for Alzheimer’s disease. Curr Neurol Neurosci Rep. 2009;9(5):368-376.
Ruitenberg A, van Swieten JC, Wittemen JC, et al. Alcohol consumption and risk of dementia: The Rotterdam Study. Lancet. 2002;359(9303):281-286.
1/8/2010 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia : Snitz BE, O'Meara ES, et al. Ginkgo biloba for preventing cognitive decline in older adults: A randomized trial. JAMA. 2009;302(24):2663-2670.
5/4/2012 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia : Buchman AS, Boyle PA, et al. Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology. 2012;78(17):1323-1329.
9/3/2014 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia : Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed September 3, 2014.
10/17/2016 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia : Arvanitakis Z, Capuano AW, et al. Relation of cerebral vessel disease to Alzheimer's disease dementia and cognitive function in elderly people: a cross-sectional study. Lancet Neurol. 2016 Aug;15(9):934-943.