By Esther Heerema, MSW | Reviewed by a board-certified physician
Updated February 21, 2018
Alzheimer's disease is a progressive neurological disease that, over time, results in the brain's inability to function correctly. Alzheimer's disease causes changes in memory, communication, judgment, personality, and overall cognitive functioning.
Alzheimer's was first identified by Alois Alzheimer in 1906 in Germany and is the most common type of dementia, a general term for impaired brain functioning.
Although many people think of Alzheimer's disease as something that only affects older adults, there are actually two types of Alzheimer's disease: late onset (also called typical) Alzheimer's which affects people over the age of 60 and early onset Alzheimer's, which is defined by symptoms that begin before age 60.
Alzheimer's Disease can cause the shrinking of brain tissue.
Who Gets Alzheimer's Disease?
It's estimated that more than five million people in the United States are living with Alzheimer's or a related dementia, although not all are diagnosed.
Additionally, researchers believe that as many as 500,000 of those people in the United States have early onset Alzheimer's, or another type of dementia that affects persons who are under the age of 60.
Alzheimer's is not part of normal aging; however, as you age, the likelihood of developing Alzheimer's increases.Thirteen percent of individuals over age 65 have Alzheimer's or another form of dementia, while almost 50 percent of individuals over age 85 have Alzheimer's or another kind of dementia.
The demographic group with the highest percentage of Alzheimer's is Caucasian females, possibly since their life expectancy is the greatest.
However, women in general are particularly at risk for developing Alzheimer's disease. Approximately two-thirds of Americans with Alzheimer's disease or a related dementia are female.
There is an increased chance of developing Alzheimer's if you have relatives with the disease, but there are many things you can do to actively decrease this risk.
Symptoms and Effects of Alzheimer's
Symptoms of Alzheimer's include problems with memory, communication, comprehension, and judgment. Changes in personality may begin to develop as well. As the disease progresses, the ability to function mentally, socially, and physically continues to decline.
While the progression of Alzheimer's disease can vary based on the person, it typically follows a similar pattern which can be categorized into three different stages: early stage, middle stage, and late stage.
Early Stage Alzheimer's Disease
In the early stages of Alzheimer's, it can be more difficult to learn new information, find the right word to describe something, remember what just happened (short-term memory impairment) or plan and organize an activity- a task that requires executive functioning.
Middle Stage Alzheimer's Disease
In the middle stages of Alzheimer's, the ability to think clearly becomes more difficult. Long-term memories often fade, and there can be a decline in visual and spatial abilities (which can result in people wandering or getting lost). Emotional and behavioral changes, such as anxiety and agitation, are common in the middle stage, and these can be challenging for both those living with dementia, and their loved ones, to handle.
Late Stage Alzheimer's Disease
In the late stages of Alzheimer's disease, physical functioning declines significantly, making tasks like walking, getting dressed, and eating difficult. Eventually, the person with late stage Alzheimer's becomes completely dependent upon caregivers to help with their basic needs.
3 Things to Know About Alzheimer's Disease
1. Alzheimer's Disease Is One of Many Conditions That Cause Dementia.
You may hear the word dementia used in association with Alzheimer's disease. Dementia and Alzheimer's are not the same thing, although the terms are often used interchangeably.
Dementia is a general term for cognitive problems, such as memory loss and communication difficulties.
Alzheimer's disease is the most common cause of dementia, but there are many other kinds and causes of dementia. In other words, dementia is a broad category that houses many conditions, one of which is Alzheimer's disease.
Other types of dementia include vascular dementia, Lewy body dementia, Parkinson's disease dementia, frontotemporal dementia, Huntington's disease, and Creutzfeldt-Jakob disease.
Dementia is a general term for cognitive problems, such as memory loss and communication difficulties.
Alzheimer's disease is the most common cause of dementia, but there are many other kinds and causes of dementia. In other words, dementia is a broad category that houses many conditions, one of which is Alzheimer's disease.
Other types of dementia include vascular dementia, Lewy body dementia, Parkinson's disease dementia, frontotemporal dementia, Huntington's disease, and Creutzfeldt-Jakob disease.
2. Not All Memory Loss Is Caused by Alzheimer's Disease or Dementia
Sometimes, cognitive declines are caused by other conditions, some of which are potentially reversible conditions, such as normal pressure hydrocephalus or vitamin B12 deficiency. Identifying and treating these conditions as soon as possible is important to increase the chance of improved cognition.
Memory loss can also be caused by everyday issuesincluding stress, fatigue, distractions, depression, and too much multi-tasking.
Sometimes, cognitive declines are caused by other conditions, some of which are potentially reversible conditions, such as normal pressure hydrocephalus or vitamin B12 deficiency. Identifying and treating these conditions as soon as possible is important to increase the chance of improved cognition.
Memory loss can also be caused by everyday issuesincluding stress, fatigue, distractions, depression, and too much multi-tasking.
3. Quality of Life Is Possible in Alzheimer's Disease
Diagnosing Alzheimer’s
Diagnosing Alzheimer's disease is done by ruling out other diseases or causes, reviewing family history and conducting a mental exam to see how well the brain is working. Some physicians also conduct imaging tests, such as an MRI, which can show changes in the brain's size and structure that may lead to the conclusion of Alzheimer's.
While general practice physicians often diagnose Alzheimer's, you can also seek an evaluation from a psychologist, geriatrician, or neurologist. Alzheimer's cannot conclusively be diagnosed until after death when an autopsy is conducted and specific brain changes can be identified; however, diagnosis through the above tools is the industry standard at this time and has proven fairly accurate.
Alzheimer's has no cure at this time, but determining more effective treatment and prevention methods, as well as finding a cure for the disease, is a high priority for researchers. Current treatment for Alzheimer's focuses on alleviating the symptoms of Alzheimer's, including cognitive, behavioral, and emotional concerns, by using drug therapy and non-drug approaches.
Drug Therapy
Non-Drug Approaches
Non-drug approaches focus on treating the behavioral and emotional symptoms of Alzheimer's by changing the way we understand and interact with the person with Alzheimer's. These approaches recognize that behavior is often a way of communicating for those with Alzheimer's, so the goal is to understand the meaning of the behavior and why it is present.
Non-drug approaches include efforts to determine the underlying cause of a behavior or emotion. For example, understanding that restlessness could be triggered by a need to go for a walk or use the bathroom—and then addressing those needs—will result in a far more effective response than asking the person with dementia simply to sit back down.
Non-drug approaches should generally be attempted before using psychotropic medications since they do not have the potential for side effects or medication interactions.
The goal of these approaches is to develop more effective interventions by adjusting the caregiver's approach or the environment to minimize the challenging behaviors or distressing feelings.
Some research has found that non-drug approaches can also help maintain, or even improve, cognitive functioning for a limited time. For example, physical activity and mental exercisehave repeatedly been shown in multiple studies to benefit cognition in people living with Alzheimer's.
Can You Prevent Alzheimer’s?
There's a difference between preventing Alzheimer's disease and reducing the risk of developing it. Currently, there is no proven way to fully prevent Alzheimer's disease. However, you can significantly reduce your risk, and this idea is reinforced by hundreds of research studies.
A heart-healthy diet, an active lifestyle with plenty of physical exercise, social interaction, and regular mental exercise are strategies that have consistently been shown in research to be effective in reducing the risk of Alzheimer's disease.
It's normal to experience grief, sadness, and worry after a diagnosis of Alzheimer's, although there are occasionally some people who feel relieved at having a reason for the symptoms they (or a loved one) are experiencing. Learning about Alzheimer's disease can be overwhelming. However, what's important to know and remember is that it's still possible to have a full and meaningful life, even while living with Alzheimer's disease.
How? People with Alzheimer's and other kinds of dementia were asked this question and their answers provided us with encouragement and great insights about what contributes to their quality of life.
Their suggestions included the following ideas:
• Provide meaningful activities—not just bingo
• Help us have social interactions
• Keep (and use) a sense of humor
• Give a hug
• Offer spiritual care if desired
Diagnosing Alzheimer's disease is done by ruling out other diseases or causes, reviewing family history and conducting a mental exam to see how well the brain is working. Some physicians also conduct imaging tests, such as an MRI, which can show changes in the brain's size and structure that may lead to the conclusion of Alzheimer's.
While general practice physicians often diagnose Alzheimer's, you can also seek an evaluation from a psychologist, geriatrician, or neurologist. Alzheimer's cannot conclusively be diagnosed until after death when an autopsy is conducted and specific brain changes can be identified; however, diagnosis through the above tools is the industry standard at this time and has proven fairly accurate.
Treatment of Alzheimer’s
Alzheimer's has no cure at this time, but determining more effective treatment and prevention methods, as well as finding a cure for the disease, is a high priority for researchers. Current treatment for Alzheimer's focuses on alleviating the symptoms of Alzheimer's, including cognitive, behavioral, and emotional concerns, by using drug therapy and non-drug approaches.
Drug Therapy
• Two types of drugs have been approved by the Food and Drug Administration (FDA) to treat Alzheimer's disease: cholinesterase inhibitors, including Aricept (donepezil), Exelon (revastigmine), and Razadyne (galantamine), and N-Methyl D-Aspartate (NMDA) antagonists, including Namenda (memantine). While these medications do appear to improve thought processes for some people, the effectiveness overall varies greatly. These medications need to be monitored regularly for side effects and interaction with other medications.
• Psychotropic medications can be prescribed to target the behavior and emotional symptoms of Alzheimer's. Psychotropics are medications that address the psychological and emotional aspects of brain functioning. For example, if a person is experiencing distressing hallucinations, a psychotropic medication, such as an antipsychotic medication, can be prescribed and is often helpful in relieving the hallucinations. As with other drugs, psychotropics have the potential for significant side effects and interaction with other medications, so they should be used carefully and be coupled with non-drug approaches.
Non-drug approaches focus on treating the behavioral and emotional symptoms of Alzheimer's by changing the way we understand and interact with the person with Alzheimer's. These approaches recognize that behavior is often a way of communicating for those with Alzheimer's, so the goal is to understand the meaning of the behavior and why it is present.
Non-drug approaches include efforts to determine the underlying cause of a behavior or emotion. For example, understanding that restlessness could be triggered by a need to go for a walk or use the bathroom—and then addressing those needs—will result in a far more effective response than asking the person with dementia simply to sit back down.
Non-drug approaches should generally be attempted before using psychotropic medications since they do not have the potential for side effects or medication interactions.
The goal of these approaches is to develop more effective interventions by adjusting the caregiver's approach or the environment to minimize the challenging behaviors or distressing feelings.
Some research has found that non-drug approaches can also help maintain, or even improve, cognitive functioning for a limited time. For example, physical activity and mental exercisehave repeatedly been shown in multiple studies to benefit cognition in people living with Alzheimer's.
There's a difference between preventing Alzheimer's disease and reducing the risk of developing it. Currently, there is no proven way to fully prevent Alzheimer's disease. However, you can significantly reduce your risk, and this idea is reinforced by hundreds of research studies.
A heart-healthy diet, an active lifestyle with plenty of physical exercise, social interaction, and regular mental exercise are strategies that have consistently been shown in research to be effective in reducing the risk of Alzheimer's disease.