What is Alzheimer’s Disease?
Alzheimer’s disease (AD), also referred to simply as Alzheimer’s, is a chronic neurodegenerative disease that usually starts slowly and worsens over time. It is the cause of 60% to 70% of cases of dementia. The most common early symptom is difficulty in remembering recent events (short-term memory loss).
As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self care, and behavioural issues. As a person’s condition declines, they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death. Although the speed of progression can vary, the average life expectancy following diagnosis is three to nine years.
In the year 2010, it was discovered that about 4.7 million people of 65 years of age and above were living with Alzheimer’s disease in the US. In the same 2010, dementia resulted in about 486,000 deaths. The 2013 statistical report from the Alzheimer’s Association gives a proportion of the population affected at just over a tenth of people in the over-65 age group have the disease in the US.
Among seniors of 85 years and above, the proportion goes up to about a third. In 2015, there were approximately 48 million people worldwide with AD. It most often begins in people over 65 years of age, although 4% to 5% of cases are early-onset Alzheimer’s which begin before this. It affects about 6% of people 65 years and older.
In developed countries, AD is one of the most financially costly diseases.
Symptoms of Alzheimer’s Disease
There are three stages Alzheimer’s patients pass through;
Early stage Alzheimer’s
- Not remembering episodes of forgetfulness
- Forgets names of family or friends
- Changes may only be noticed by close friends or relatives
- Some confusion in situations outside the familiar
Middle stage Alzheimer’s
- Greater difficulty remembering recently learned information
- Deepening confusion in many circumstances
- Problems with sleep
- Trouble knowing where they are
Late stage Alzheimer’s
- Poor ability to think
- Problems speaking
- Repeats same conversations
- More abusive, anxious, or paranoid
Causes of Alzheimer’s Disease
Just like all other cases of dementia, Alzheimer’s is caused by brain cell death. It is a neurodegenerative disease, which means some brain cells have been dying gradually over the years.
The total brain size shrinks with Alzheimer’s – the tissue has progressively fewer nerve cells and connections.
While they cannot be seen or tested in the living brain affected by Alzheimer’s disease, postmortem/autopsy will always show tiny inclusions in the nerve tissue, called plaques and tangles (though recent research by Professor Giovanna Mallucci’s team at the University of Leicester recently demonstrated that the plaque itself may not be a problem):
- Plaques are found between the dying cells in the brain – from the build-up of a protein called beta-amyloid (you may hear the term “amyloid plaques”).
- The tangles are within the brain neurons – from a disintegration of another protein, called tau.
The abnormal protein clumps, inclusions, in the brain tissue are always present with the disease, but there could be another underlying process that is actually causing the Alzheimer’s – scientists are not yet sure.
This sort of change in brain nerves is also witnessed in other disorders, and researchers want to find out more than just that there are protein abnormalities – they also want to know how these develop so that a cure or prevention might be discovered.
Researchers do not fully understand why the changes that lead to Alzheimer’s disease occur. Several different factors are believed to be involved. Risk factors for developing the condition include aging, a family history of Alzheimer’s, and carrying certain genes.
Treatment of Alzheimer’s Disease
As of today there is no known cure for Alzheimer’s disease because the death of brain cells in the dementia cannot be halted or reversed.
There is, however, much call for therapeutic interventions to help people live with Alzheimer’s disease more happily.
The Alzheimer’s Association includes the following as important elements of dementia care:
- Effective management of any conditions occurring alongside the Alzheimer’s
- Activities and/or programs of adult day care
- Support groups and services.
United States of America has generated a national plan to address Alzheimer’s disease, making it a medical priority for the country.
Along with an aim to improve research into prevention and treatment, the goals of the plan also include measures for present interventions:
- Enhance care quality and efficiency
- Expand supports for people with Alzheimer’s disease and their families, and
- Enhance public awareness and engagement.
There are no drugs to cure Alzheimer but research shows there are drugs that could reduce the pain and help improve quality of life. There are four drugs in a class called cholinesterase inhibitor approved for symptomatic relief in the US. Their names are:
- Donepezil (brand name Aricept)
- Alantamine (Reminyl)
- Rivastigmine (Exelon)
- Tacrine (Cognex).
A different kind of drug, memantine (Namenda), an NMDA receptor antagonist, may also be used, alone or in combination with a cholinesterase inhibitor.
As with other neurodegenerative disease, a major part of therapy for patients with Alzheimer’s comes from the care shown by healthcare workers to provide dementia quality care, which becomes more necessary as needs intensify with waning independence.
Prevention of Alzheimer’s Disease
According to research, the risk of suffering from Alzheimer can be greatly reduced if we
- Do not deprive our body and brain of sleep and rest.
- Take care of our heart, that is, do everything possible to prevent heart diseases like hypertension, high cholesterol, stroke, diabetes and the likes.
- Eat well.
- Exercise regularly.
- Keep the mind active.
- Avoid smoking.