Alzheimer's disease is the most common cause of dementia — the loss of intellectual and social abilities severe enough to interfere with daily functioning. In Alzheimer's disease, healthy brain tissue degenerates, causing a steady decline in memory and mental abilities.
Alzheimer's disease is not a part of normal aging, but the risk of the disorder increases with age. About 5 percent of people between the ages of 65 and 74 have Alzheimer's disease, while nearly half the people over the age of 85 have Alzheimer's.
Although there's no cure, treatments may improve the quality of life for people with Alzheimer's disease. Those with Alzheimer's — as well as those who care for them — need support and affection from friends and family to cope.
Symptoms and Facts
Alzheimer's disease may start with slight memory loss and confusion, but it eventually leads to irreversible mental impairment that destroys a person's ability to remember, reason, learn and imagine.
Memory loss
Everyone has occasional lapses in memory. It's normal to forget where you put your car keys or to blank on the names of people whom you rarely see. But the memory problems associated with Alzheimer's disease persist and worsen. People with Alzheimer's may:
- Repeat things
- Often forget conversations or appointments
- Routinely misplace things, often putting them in illogical locations
- Eventually forget the names of family members and everyday objects
Problems with abstract thinking
People with Alzheimer's may initially have trouble balancing their checkbook, a problem that progresses to trouble recognizing and dealing with numbers.
Difficulty finding the right word
It may be a challenge for those with Alzheimer's to find the right words to express thoughts or even follow conversations. Eventually, reading and writing also are affected.
Disorientation
People with Alzheimer's disease often lose their sense of time and dates, and may find themselves lost in familiar surroundings.
Loss of judgment
Solving everyday problems, such as knowing what to do if food on the stove is burning, becomes increasingly difficult, eventually impossible. Alzheimer's is characterized by greater difficulty in doing things that require planning, decision making and judgment.
Difficulty performing familiar tasks
Once-routine tasks that require sequential steps, such as cooking, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer's may forget how to do even the most basic things.
Personality changes
People with Alzheimer's may exhibit:
- Mood swings
- Distrust in others
- Increased stubbornness
- Social withdrawal
- Depression
- Anxiety
- Aggressiveness
Diagnosis
Doctors can accurately diagnose 90 percent of Alzheimer's cases. Alzheimer's disease can be diagnosed with complete accuracy only after death, when microscopic examination of the brain reveals plaques and tangles.
To help distinguish Alzheimer's disease from other causes of memory loss, doctors typically rely on the following types of tests.
Lab tests
Blood tests may be done to help doctors rule out other potential causes of the dementia, such as thyroid disorders or vitamin deficiencies.
Neuropsychological testing
Sometimes doctors undertake a more extensive assessment of thinking and memory skills. This type of testing, which can take several hours to complete, is especially helpful in trying to detect Alzheimer's and other dementias at an early stage.
Brain scans
By looking at images of the brain, doctors may be able to pinpoint any visible abnormalities — such as clots, bleeding or tumors — that may be causing signs and symptoms. Positron emission tomography (PET) can reveal areas of the brain that may be less active and the density of amyloid plaques.
Magnetic resonance imaging (MRI). An MRI machine uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into the tube-shaped MRI machine, which makes loud banging noises during scans. The entire procedure can take an hour or more. MRIs are painless, but some people feel claustrophobic in the machine.
Computerized tomography (CT). For a CT scan, you lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images, or slices, of your brain. The test is painless and takes about 20 minutes.
Positron emission tomography (PET). During a PET scan, you'll be injected with a low-level radioactive material, which binds to chemicals that travel to the brain. You lie on a table while an overhead scanner tracks the radioactive material. This helps show which parts of your brain aren't functioning properly. The test is painless and can be particularly useful in distinguishing between different types of dementia.
Treatment and Care
Often, as Alzheimer’s disease progresses, people experience depression, agitation and psychotic symptoms (paranoid thoughts, delusions or hallucinations).These behaviors may be manifested verbally (screaming, repetitive questions, etc.) or physically (hoarding, pacing, etc.), and they can sometimes lead to aggression, hyperactivity or combativeness. The symptoms may have an underlying medical origin such as a drug interaction or physical pain, and if this is a suspected cause a physician should be consulted. Agitation or psychotic behavior may also be triggered by something different in the person’s environment. Often, a change in routine, caregivers or surroundings can cause fear, anxiety or fatigue and lead to agitation.
The individual may be unable to communicate, be frustrated by his or her limitations, misunderstand what is happening or simply forget how to respond appropriately. In these cases, non-medical intervention is recommended to determine the source of the problem, modify the environment and change the behavior. If non-medical intervention does not work or the person becomes a danger to himself or others, a physician should be consulted to evaluate the need for medical treatments for depression, psychosis or anxiety.