With an aging population and no available cure on the horizon, Alzheimer’s disease is becoming a growing concern. Apart from commonly causing severe disability for the patient, it often becomes a huge burden for family and relatives as well. It is the sixth most common cause of death in the United States. Finding a cure for Alzheimer’s disease is a major challenge for the medical community.
Sometimes people speak of dementia and Alzheimer’s as if they were the same thing, which is not true. Dementia is not a specific disease. It is a general term for a decline in mental ability severe enough to interfere with daily life.
Dementia describes a wide range of symptoms. Memory and other thinking skills are usually affected. Alzheimer’s disease is the most common cause of dementia accounting for 60 to 80 per cent of cases. Vascular dementia is the second most common cause of dementia. It is caused by impaired blood flow to parts of the brain and is a consequence of cardiovascular disease.
The science of Alzheimer’s disease has come a long way since 1906 when a German neurologist and psychiatrist named Dr. Alois Alzheimer first described the key features of the disease now named after him. He noticed abnormal deposits in the brain of a 51-year old woman who had dementia. Researchers now know that Alzheimer’s disease is characterized by brain abnormalities called plaques and tangles.
The exact cause of Alzheimer’s disease isn’t known, although some risk factors have been described.
The risk of developing the disease increases with age. Family history also plays a role, there’s a higher risk of Alzheimer’s if a family member has the disease. However, inherited factors are responsible in only a small number of families. When the disease is inherited, it tends to lead to early onset of Alzheimer’s, usually between the ages of 35 and 60.
Examples of genes that may be at fault are the presenilin-1 gene on chromosome 14 and the amyloid precursor protein gene on chromosome 21. Most cases of Alzheimer’s develop later in life and most patients with the disease are 65 or older. The genetic link is usually weaker when the disease develops late in life. The genes at fault here are those for apolipoprotein E. Having the ApoE4 genetic variant is one of the biggest risk factors for developing the disease.
The risk of developing Alzheimer’s or vascular dementia appears to be increased by many factors that affect the heart and blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. So, although there’s no definitive way to prevent the disease, not smoking, keeping blood pressure and cholesterol at healthy levels, taking regular exercise, maintaining a healthy weight and eating a healthy diet rich in the antioxidant vitamins C and E and oily fish are all sensible.
Alzheimer’s disease usually affects memory and the ability to think clearly. There may also be a change in personality. For example, someone who used to be a calm person may become easily agitated or upset. Behavior problems and communication difficulties may occur. People with severe Alzheimer’s may find it difficult to perform everyday tasks, such as dressing, washing, and eating. They may not recognize people or their surroundings and it’s common for them to go for a walk and get lost. Depression may also develop.
Alzheimer’s is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer’s, individuals lose the ability to carry on a conversation and respond to their environment.
There is no cure available for Alzheimer’s.
Although current Alzheimer’s treatments cannot stop Alzheimer’s from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer’s and their caregivers.
Acetylcholinesterase inhibitors (i.g. donepezil, galantine and rivastigmin) are drugs that may slow the loss of mental function in some cases. These drugs improve brain cell communication. Memantine is a glutamate blocker which protects brain cells against damage.
Other drugs such as aspirin and statins (cholesterol lowering drugs) may be of use in slowing the vascular damage that may play a role in many types of dementia including Alzheimer’s.
Anti-psychotic drugs are sometimes used to try to control behavior in more severe dementia but their use has been criticized by many as a poor substitute for more expensive and time-consuming management plans including counseling, psychotherapy, and nursing care.
Treatment can be given for symptoms such as depression.
Techniques to aid memory, such as writing lists or reminders, can be helpful in the early stages.
Support and help can be provided by social services for those with Alzheimer’s disease and their careers, but full-time residential care may be necessary for the later stages of the disease.