Alzheimer's is a type of dementia that affects memory, thought processes and behavior in older adults. It is the most common neurodegenerative disease of old age. Alzheimer's usually first starts with short-term memory loss and gradually gets worse until the victim has a hard time even doing everyday tasks like shopping or cooking dinner.
Understanding Alzheimer's disease and dementia:
Alzheimer’s disease:
A progressive, irreversible and fatal brain disorder.
The main reason for Alzheimer's is the loss of neurons that control memory and thinking. As the disease advances, these neurons start dying out. The main symptoms of Alzheimer's include forgetfulness, confusion, anxiety and depression.
Dementia:
A mental deterioration in which a person has lost cognitive ability to the point where they can no longer function at a normal level of their everyday life. There are many different reasons why people develop dementia; however, in most cases it is caused by Alzheimer's disease.
The symptoms typically include memory loss, a decline in language skills and impaired judgment. People with dementia eventually lose all cognitive functions.
What is the difference between Alzheimer's disease and other forms of dementia?
While the symptoms of Alzheimer's are very similar to those found in other forms of dementia, the way that Alzheimer's is diagnosed and treated greatly differs from other forms.
Alzheimer’s disease has several stages:
Early or pre-Alzheimer's:
The symptoms are mental in nature, such as mood changes, reduced motivation, and difficulty making decisions.
Middle or mild Alzheimer’s:
Symptoms include memory loss , forgetfulness, confusion , and feelings of depression. Eventually a person will have to take time off for constant care.
Late or moderate Alzheimer’s:
Treatment is more focused on nursing the patient through their last days or weeks of life.
Late or severe Alzheimer’s:
The person eventually needs 24-hour care and may be put in a long-term care facility. They are unable to recognize loved ones, and typically do not recognize themselves when taken out of their room. They also lose bladder and bowel control, and become incontinent.
What causes Alzheimer's disease?
The human brain consists of billions of nerve cells known as neurons that are responsible for thought processes. Many of these neurons are interconnected with branches called dendrites and are protected by a fatty myelin sheath that insulates the neuron.
When the brain develops, these neurons start growing branches at their ends (dendrites) which reach out to connect with other neurons. This is when the myelin sheath covering them is formed. Myelin provides a special coating or ‘insulation’ that allows groups of neurons to send messages quickly without interruption from other cells in your body.
Neurons communicate using a chemical named “nerve transmitter,” which can be likened to a cellular Morse code. When neuron A sends a nerve transmitter to neuron B, it attaches to the dendrite of neuron B.
How do nerve transmitters work?
A chemical connection between two neurons (A and B) is established when an electrical impulse from cell A causes the release of the transmitter into the space between these two cells. The chemical then crosses over to cell B, binds with a receptor on this cell, and triggers an electrical impulse that travels down this second neuron to another one (cell C).
The brain operates on the basis of a series of signals traveling through neural pathways. These pathways are created as neurons connect with each other and then pass information along their dendrites.
In Alzheimer’s disease, this process is disrupted when the neurons and their nerve transmitter are destroyed by a protein called beta-amyloid.
The protein, which normally provides support for the neuron, clumps together around the nerve cell and starts interfering with its ability to communicate with other brain cells. This disrupts neural transmission and leads to memory loss or dementia.
What are some of the symptoms?
While everyone may experience mild memory lapses from time to time, Alzheimer's disease can cause long-term damage over a period of years that is irreversible and eventually fatal.
The disease may start with problems in thinking, memory and behavior and eventually lead to language difficulties and personality changes.
Memory:
The most common early symptom of Alzheimer's disease is difficulty in recalling events or experiences that happened recently. People with mild dementia may find it difficult to remember things they learned in the past, such as a name, a date, an event or the location of an object. In severe Alzheimer's disease, they may even lose their sense of identity.
In middle stages, other symptoms include:
Extreme forgetfulness :
The person will often be unable to remember what he had just said or done moments earlier. This can lead to embarrassing mistakes and awkward social situations. For example, he may be unable to recall driving home from work when arriving at his driveway after a long day at work. A person with severe Alzheimer's may not recognize family members or become very anxious in social situations.
Memory lapses are still present, but short term memory usually remains better than long term memory.
Disorientation :
A person experiencing cognitive or memory problems may not be able to find his house, get dressed and remember where things need to be done around the house. For example, a person may forget how to eat without spilling or burning himself, or what is needed for a task at hand.
Misplacing items:
A person with Alzheimer's disease will often mix up items that look alike and can't recall where he put them the last time he saw them.
Confusion :
The symptoms can include confusion and disorientation such as:
Being unable to find his way home from work or school.
Not remembering appointments and events.
Inability to perform common household chores like taking out the garbage, emptying the dishwasher, getting dressed or driving a car. Many will not recognize family members or friends.
Behavioral changes :
A person with early mild cognitive impairment may feel lonely and frustrated, especially when planning social activities. They will often forget names and conversations they had only moments before. As the disease progresses, their behavior becomes more erratic and unpredictable - but they may not realize they are acting differently than usual.
Language skills:
A loss of language skills can include a change in vocabulary or how people say things to them. For example, if someone has Alzheimer's disease, he may not recognize a familiar word but can be understood when two words are put together. A person with severe dementia may have trouble reading or understanding written material.
Personality changes :
A person with dementia will often lose interest in hobbies and pastimes that were once enjoyable, like participating in an activity such as card games, sports or music. They can also lose their sense of humor and have trouble maintaining relationships with family members and friends. In the middle stages, people with Alzheimer's can experience changes in mood and behavior that can range from agitation to apathy, depression or anxiety. To loved ones, this can feel like the person is "snapping" for no clear reason.
Personality changes may include:
Insomnia and anxiety :
People with Alzheimer's disease sometimes have trouble sleeping or staying asleep due to anxiety at night. They may also become anxious because of their confusion and memory loss during the day.
Scattered thinking :
In extreme cases, a person with dementia may not be able to finish his sentences or thoughts out loud. They may talk to themselves, repeat statements and words over and over, or lose their train of thought in the middle of speaking. They may complain that people aren't listening to them, even when they are.
Aggression and agitation :
A person with Alzheimer's disease may show frustration and impatience when they can't communicate what they want. They may become easily agitated or aggressive when frustrated or confused by a change in plans.
To others, their behavior may seem like temper tantrums or mood swings. They can also develop paranoia, fear for their safety, hallucinations or delusions. Sometimes those with severe dementia will yell at family members without cause – this is known as "sundowning. "
When does it develop?
Alzheimer's disease usually develops slowly and worsens over time. It can start with memory problems in the early stages of the disease, but other symptoms may not appear until the late stages.
The length of time between when Alzheimer's begins and when symptoms become noticeable varies greatly – even for a single individual. In some cases, it takes years for the symptoms to emerge. In others, people start noticing changes within months or weeks of diagnosis. There is no way to predict how long someone with Alzheimer's will live after diagnosis. Some people with early onset start showing symptoms as young adults, while others don't realize they have Alzheimer's until they're in their 70s or later in life.
When to see a doctor?
Some people may not notice any symptoms until they have Alzheimer's disease. In this case, it's normal to feel concerned about your loved one's memory, thinking and behavior. Pay attention to changes in mood and behavior.
Because it rarely becomes clear that a person has Alzheimer's disease until the late stage, doctors can only diagnose it by doing a series of tests (imaging and laboratory studies) that look for signs of the disease process over time.
Alzheimer's disease is a progressive disease, meaning the symptoms get worse over time. When symptoms do start to appear, they are often very mild. If you notice any of these signs of Alzheimer's in your loved one, see a doctor for an evaluation.
When to seek professional help?
Early diagnosis means that this illness can be managed and treated at an earlier stage and can reduce severity of the dementia and shorten the time that it lasts. The sooner treatment is started, the more likely recovery is successful.
There are no tests that can detect Alzheimer's disease in its early phase. If you are concerned about your loved one's memory, mood or behavior, see a doctor.
What are the risk factors?
Although most people develop Alzheimer's disease as they age, it can still happen in young people. The following factors increase the risk of developing Alzheimer's disease:
Genetic : About 30% of those who have Alzheimer's disease have a genetic family history of it. In some families, two or more generations may develop it.
Other diseases : Other diseases linked to Alzheimer's include: syphilis, Creutzfeldt-Jakob disease, Parkinson's disease and Lewy body dementia . People with these conditions are more likely to experience more symptoms such as changes in mood and behavior. Some medications may also contribute to developing the disease.
Memory and thinking problems that happen in older people are often mistaken for having normal aging. A person may think he's just getting forgetful as he gets older, rather than recognizing the symptoms as a sign of dementia or another brain disorder.
People with any of these conditions should mention early symptoms to their doctor .His or her care team can rule out other causes.
This may include:
Family history of Alzheimer's disease:
This is when a family member has the disease or has experienced one of its stages.
Symptoms that begin before age 65 :
Signs of memory loss or changes in thinking are often subtle and aren't noticed until later in life. A person can have mild impairments and not know how much he struggles with everyday tasks, such as planning a route home from work.
Symptoms that occur around the same time every day :
People who have these symptoms are also more likely to have dementia and other brain disorders.
Symptoms that are persistent or worsening (rather than progressing gradually):
Fortunately, there's a way to test for Alzheimer's sooner rather than later. A special type of brain scan called an MRI can show areas of the brain that have been damaged. If a person has an MRI and shows other signs of Alzheimer's disease, he can get treated much more quickly before it's too late.
How else do people develop Alzheimer's?
Exposure to toxins may cause early stages of the disease in babies and young children. Even if they don't develop symptoms, their brains still change due to the damage.
How is Alzheimer's diagnosed?
A doctor can diagnose Alzheimer's disease through a medical history. An MRI scan or cognitive testing can also help experts detect early symptoms.
Diagnostic criteria:
If a person has six or more of the following, he or she has probable Alzheimer's disease : memory loss and changes in thinking, command of language, judgment and spatial skills, orientation to place and time and an inability to solve problems.
Memory symptoms :
Changes in short-term memory are early signs of Alzheimer's disease. When faced with something new for the first time (such as an email message), people with dementia may not recognize it for days or even months later. They may forget the name of a person or the name of their home.
Decline in short-term memory :
As memory loss continues and it affects a person's ability to learn, his ability to apply what he has learned to new situations may also decline. This can have consequences that range from social isolation to job loss.
Changes in short-term memory :
People with dementia may have problems remembering and organizing events, as well as storing information for later use (such as financial savings). This also applies to finding where and how information is located on paper or computer screens.
Changes in ability to learn:
People with Alzheimer's disease may have difficulty learning a new skill. A person may not understand that he needs to study for a test. He may also find it hard to remember where important items are kept. These changes can make his job more difficult or even impossible.
Naming :
With Alzheimer's, many people forget the names of family members and friends, as well as their own names. They also have trouble with complex word problems and asking for directions . They can even have trouble recognizing faces of people they know, even when the image is shown on TV or in a photograph book or scrapbook.
Language and communication:
People with Alzheimer's may not remember telephone numbers or address information, or can forget a particular word used many times before. They may also have trouble describing their routines (such as how they get to work).
Judgment problems :
Difficulties in people with Alzheimer's disease can affect a person's ability to make decisions. This includes everyday choices, such as where to go for the day. People may even have a hard time judging the right time to leave for an appointment.
Spatial skills :
Forgetfulness and confusion over place, time and direction are common features of Alzheimer's disease. A person may have trouble finding the right words to describe what he sees, as well as understanding and following instructions.
Personality and behavior changes:
Changes in mood, language or behavior can be caused by depression and other mental illnesses. A person with Alzheimer's can be withdrawn or appear angry for no reason at all. He may also talk about his childhood, his pets from long ago or things that made him happy in the past.
Elder abuse is a serious issue that requires immediate attention . Statistics show that one out of three older people experience physical abuse at some point in their life. The abuser is often someone they know and trust—like a friend, family member, caregiver or neighbor. Whether the abuse is verbal or physical depends on the situation. Physical abuse is when a caregiver uses his or her body to physically hurt a person, or does anything that could seriously damage the person's body. Verbal abuse is when a caregiver uses harsh words to attack, ridicule or embarrass their loved one. It also includes making threats or intimidating them. According to the Department of Justice , about 1 million older adults are abused every year by a close family member, friend or caretaker . There is no way to predict when someone will become an abuser, but abuse can happen at any age. How to avoid becoming an abuser: If you are currently experiencing verbal or physical abuse, contact the local police at 202-307-2424 . Also, if you witness someone else being abused, call 911 immediately. You may be in danger and need help.
The National Center on Elder Abuse (NCEA) provides assistance for older adults who have been victimized by family members and others who care for them. NCEA offers a 24-hour hotline at 1-800-677-1116 .
Prevention
NCEA has a list of 10 things to avoid when it comes to elder abuse. These include:
1. Never speak or act in a way that embarrasses or humiliates him.
2. Never physically hurt the person.
3. Never threaten, intimidate or otherwise control the person's money, assets and other property .
4. Never deny the person access to food or clothing
5. Never lie to the person.
6. Never take advantage of the person's age, mental deficiency, illness or other problems.
7 . Make arrangements for care services for the elderly.
8 . Get consent before making medical decisions for them.
9 . Learn about their financial situation and make sure everything is in order.
10 . Always protect the person.
