What do you really know about Alzheimer’s Disease?

What pops into your mind when you hear the term Alzheimer’s Disease? Elderly people who are completely incapable of doing anything and are unable to care for themselves? Who cannot remember anything and are easily confused, to the extent that they cannot function independently? Do you think that it is just a natural part of aging that is unavoidable? Unfortunately, this is part of the stigma associated with Alzheimer’s Disease, often causing individuals to put off talking to doctors about their symptoms or to hide their diagnosis from others. Alzheimer’s Disease can affect individuals as young as in their 40s, or even 30s in rare cases. There are also several stages in the progression of Alzheimer’s Disease, and the impairment/abilities of individuals within the same stage can vary greatly. And although cognitive decline can occur with aging to a certain extent, it does not mean that Alzheimer’s is inevitable. It also does not mean that life cannot still be fulfilling if a diagnosis does occur.

What is Alzheimer’s Disease?

Dementia is a general term used to describe a group of disorders with symptoms such as memory loss and reduced cognitive abilities, to the extent that they interfere with everyday life. Alzheimer’s Disease is the most common cause of dementia, as 60-80% of individuals with dementia have Alzheimer’s Disease. Its symptoms include difficulty remembering newly learned information, confusion, disorientation, suspicion of others, and behavioral changes. It is a progressive disease which affects an individual’s memory, thinking, language, problem solving, personality, and movement. Scientists have found that the brains of individuals with Alzheimer’s Disease have more plaques and tangles than normal, and they develop in a very specific pattern. It is believed that these plaques and tangles cause damage the brain, and for individuals with Alzheimer’s it begins in areas used for memory. Also, the neurons in their brains slowly stop working properly and die, which causes a further decrease in functioning.

There are two main types of Alzheimer’s Disease, early-onset and late-onset. Early-onset is the rarer form, occurring in individuals who are younger than 65, typically in their 40s or 50s but possibly as young as in their 30s, when they are diagnosed. Most individuals with early-onset Alzheimer’s Disease have Familial Alzheimer’s Disease, which is cause by a genetic mutation passed along through generations of a family. Conversely, less is known about the cause of late-onset Alzheimer’s Diseasel, although it is the more common form of the disease. Scientists have theorized that it may be caused by genetics, lifestyle, and/or the environment. Its symptoms appear in individuals who are 65 and older, and it is associated with a relatively slower decline.

The progression of Alzheimer’s Disease is generally divided into 3 stages, although it can be broken down to as many as seven stages. In the early, mild stage, individuals can usually still live independently but begin to have difficulty with remembering things like names or past events, and may have trouble staying organized. The middle, moderate stage usually lasts the longest. The weakened skills from the first stage further deteriorate, with more difficulty remembering past events, planning future events, learning new things, and possibly even with reading, writing, and using numbers. As this stage progresses, individuals have increased severity in remembering names, even of loved ones. They may need assistance with basic daily activities like getting dressed. And they may exhibit changes in their behavior or even personality. In the late, severe stage, individuals will require constant care as they lose some physical abilities and can communicate with some words but not enough to participate in a conversation. Individuals with Alzheimer’s Disease live on average 8 years after their symptoms emerge. Alzheimer’s disease is the sixth leading cause of death in the United States.

Who has Alzheimer’s Disease?

Alzheimer’s Disease is often thought of as an ailment of just the elderly. It is perceived this way because diagnosis usually does not occur until later in the course of the disease and late-onset Alzheimer’s Disease is more common. Alzheimer’s Disease starts changing the brain years before any outward changes are evident. And as mentioned earlier, most individuals with Alzheimer’s Disease are not afflicted until after the age of 65. Many of the early symptoms of the disease are considered to be a natural part of aging, such as having minor difficulty with recalling information or names. This leads to a delay in diagnosis, as many people are not evaluated until their symptoms are more severe and the disease has worsened.

Women account for 2/3 of the Alzheimer’s population in the United States. As the cause of Alzheimer’s Disease is unknown, there are several theories about why this gender gap exists. Researchers are looking at variables such as age, environmental factors, and genetics.

How is Alzheimer’s Disease Diagnosed?

Medical testing is an important first stage of diagnosing Alzheimer’s Disease because by looking at an individual’s overall health, it helps to rule out other health issues, such as depression, thyroid problems, or side effects of medications. This can be done by a primary care doctor, a neurologist, or a geriatrician. General cognitive screenings, while insufficient to fully identify the many possible aspects of Alzheimer’s Disease, can be used to help determine if an individual’s impairment is significant enough to require more in-depth neuropsychological testing. Neuropsychologists are able to give a more complete picture of the extent of the deterioration of functioning ability caused by Alzheimer’s Disease.

It is important to know the specific impairments that Alzheimer’s Disease causes for an individual, as well as the severity of these impairments, in order to formulate the most effective treatment plan for that individual. Neuropsychological evaluations look at memory, attention and processing speed, language, visuospatial abilities, executive functioning, mood, and behavior. In addition to providing a diagnosis, these tests can help determine areas of weakness in which an individual may require additional support or an intervention strategy.

Brain imaging tests, such as MRI, CT, and PET scans, are sometimes used to evaluate the physical degeneration of brain cells causing Alzheimer’s Disease, but cannot independently be used for a diagnosis. They can look for other conditions that are causing Alzheimer’s-like symptoms, such as a brain tumor or stroke. These tests can also differentiate between different types of degenerative brain diseases and give a baseline of the level of degeneration to track its progress.

Genetic testing may be used to look for Alzheimer’s Disease, although this is very uncommon. Familial Alzheimer’s Disease, which primarily affects those with early-onset, is believed to be caused by a genetic mutation. But this testing is not a routine part of diagnosing Alzheimer’s Disease because it only occurs in 2-3% of those with the disorder.

What treatment options are available Alzheimer’s Disease?

There is currently no cure for Alzheimer’s Disease. But this does not mean that there are not ways to help individuals with Alzheimer’s Disease and improve their quality of life. There are medications that may be able to slow the progression of the disease in some cases by treating the symptoms. The earlier the diagnosis, the more effective the medications are. Beginning medication early on may allow individuals to maintain their current skills and quality of life for a longer period of time. Non-medication treatments include addressing environmental factors that may be triggering behavioral symptoms of Alzheimer’s Disease, as well as teaching coping methods to afflicted individuals as well as their caregivers.

What does Alzheimer’s Disease have to do with me?

The rate of incidence of Alzheimer’s Disease is greatly increasing. When National Alzheimer’s Disease Awareness Month was first recognized in 1983, less than 2 million people in the United States were believed to have Alzheimer’s Disease. In 2019, it is estimated that 5.8 million people in the country are now suffering from it. It is expected that this figure will go up to 13.8 million people by 2050 if researchers are unable to find a cure or method of prevention. This means that there is a very good chance that you will be directly or indirectly affected by Alzheimer’s Disease in the future, if you are not already. Knowing what signs to look for and getting an early diagnosis and treatment can slow the course of the disease and help to maintain an individual’s quality of life for a longer period of time. Getting yearly cognitive evaluations is as important as getting yearly physical evaluations. It will help recognize any changes sooner and help professionals to monitor the impact of Alzheimer’s Disease on an individual.

Although the cause of Alzheimer’s Disease is unknown, researchers have found that making changes in lifestyle habits can reduce the risk of cognitive decline. This includes simple things such as exercising frequently, eating healthy foods, getting enough sleep, and continuing to use your brain to read or to participate in activities that are mentally challenging. And any time you have a change in your physical or mental abilities, make sure you get evaluated by a professional.

Where can I go for help?

There are many resources available to provide information as well as support for individuals with Alzheimer’s Disease and their families. Organizations like the Alzheimer’s Association provide a wide variety of resources. There are professionals, such as neuropsychologists, who offer a wide range of services, including evaluations, education, and even classes to help strengthen cognitive abilities to help retain cognitive functioning. Being proactive and utilizing these types of resources can have a significant positive impact on maintaining quality of life.

We are pleased to announce that Mindful Assessments and Psychological Services will soon be starting a geriatric care center REEACH: Respectful Evaluations and Education for Adult Cognitive Health
Click here for more information!

Resources

https://www.nia.nih.gov/health/what-alzheimers-disease
https://www.alzheimers.net/
https://www.dementia.org/
https://www.alz.org/
https://www.dfamerica.org/

References

https://www.webmd.com/alzheimers/guide/alzheimers-types
https://www.alz.org/alzheimers-dementia/what-is-alzheimers
https://blog.caregiverhomes.com/the-7-stages-of-alzheimers
https://www.alzheimers.net/2-19-15-familial-alzheimers-disease/
https://practicalneurology.com/articles/2016-july-aug/a-primer-in-neuropsychological-assessment-for-dementia
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075
https://www.dementia.org.au/files/helpsheets/Helpsheet-AboutDementia13-AlzheimersDisease_english.pdf
https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease
https://www.alz.org/help-support/brain_health/10_ways_to_love_your_brain
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/alzheimers-prevention/faq-20058140