Alzheimer's disease is a brain disease that affects memory, thinking, language, and behaviour. People with Alzheimer's disease lose mental abilities, and the disease gets worse over time. Alzheimer's disease is a form of dementia.
What Are The Causes of Alzheimer's Disease?
This condition develops when a protein called beta-amyloid forms deposits in the brain. It is not known what causes these deposits to form.
Alzheimer's disease may also be caused by a gene mutation that is inherited from one parent or both parents. A gene mutation is a harmful change in a gene. Not everyone who inherits the genetic mutation will get the disease.
What Increases The Risk of Alzheimer's Disease?
You are more likely to develop this condition if you:
- are older than age 65.
- have a family history of dementia.
- have had a brain injury.
- have heart or blood vessel disease.
- have had a stroke.
- have high blood pressure or high cholesterol.
- have diabetes.
What Are The Signs Or Symptoms of Alzheimer's Disease?
Symptoms of this condition may happen in three stages, which often overlap.
Early stage
In this stage, you may continue to be independent. You may still be able to drive, work, and socialize with others. Symptoms in this stage include:
- minor memory problems, such as forgetting a name or what you read.
- difficulty with:
- paying attention.
- communicating.
- doing familiar tasks.
- problem solving or doing calculations.
- following instructions.
- learning new things.
- anxiety.
- social withdrawal.
- loss of motivation.
Moderate stage
In this stage, you will start to need care. Symptoms in this stage include:
- difficulty with expressing thoughts.
- memory loss that affects daily life. This can include forgetting:
- your address or phone number.
- recent events that have happened.
- parts of your personal history, such as where you went to school.
- confusion about where you are or what time it is.
- difficulty in judging distance.
- changes in personality, mood, and behaviour. You may be moody, irritable, angry, frustrated, fearful, anxious, or suspicious.
- poor reasoning and judgment.
- delusions or hallucinations.
- changes in sleep patterns.
- wandering and getting lost, even in familiar places.
Severe stage
In the final stage, you will need help with your personal care and daily activities. Symptoms in this stage include:
- worsening memory loss.
- personality changes.
- loss of awareness of your surroundings.
- changes in physical abilities, including the ability to walk, sit, and swallow.
- difficulty in communicating.
- inability to control your bladder and bowels.
- increasing confusion.
- increasing behaviour changes.
How Is This Diagnosed?
This condition is diagnosed by a health care provider who specialises in diseases of the nervous system (neurologist). Other causes of dementia may also be ruled out. Your healthcare provider will discuss with you and your family, friends, or caregivers about your history and symptoms.
A thorough medical history will be taken, and you will have a physical exam and tests. Tests may include:
- lab tests, such as blood or urine tests.
- imaging tests, such as a CT scan, a PET scan, or an MRI.
- a lumbar puncture. This test involves removing and testing a small amount of the fluid that surrounds the brain and spinal cord.
- an electroencephalogram (EEG). In this test, small metal discs are used to measure electrical activity in the brain.
- memory tests, cognitive tests, and neuropsychological tests. These tests evaluate brain function.
- genetic testing may be done if you have early onset of the disease (before age 60) or if other family members have the disease.
How Is This Treated?
Currently, there is no treatment to cure Alzheimer's disease or stop it from getting worse. The goals of treatment are:
- to slow down symptoms of the disease, if possible.
- to manage behavioural changes.
- to provide you with a safe environment.
- to help manage daily life for you and your caregivers.
The following treatment options are available:
- Medicines may help to slow down memory loss and manage behavioral symptoms.
- Cognitive therapy. Cognitive therapy provides you with education, support, and memory aids. It is most helpful in the early stages of the condition.
- Counselling or spiritual guidance. It is normal to have a lot of feelings, including anger, relief, fear, and isolation. Counselling and guidance can help you deal with these feelings.
- Having caregivers help you with your daily activities.
- Support groups. These provide education, emotional support, and information about community resources to family members who are taking care of you.
Follow These Instructions At Home:
Medicines:
- Take over-the-counter and prescription medicines only as instructed by your health care provider.
- Use a pill organiser or pill reminder to help you manage your medicines.
- Avoid taking medicines that can affect thinking, such as pain medicines or sleeping medicines.
Lifestyle:
- Make healthy lifestyle choices:
- Be physically active as instructed by your healthcare provider. Regular exercise may help improve symptoms.
- Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
- Do not drink alcohol.
- Eat a healthy diet.
- Practice stress-management techniques when you get stressed.
- Stay social.
- Drink enough fluid to keep your urine pale yellow.
- Make sure to get quality sleep.
- Avoid taking long naps during the day. Take short naps of 30 minutes or less if needed.
- Keep your sleeping area dark and cool.
- Avoid exercising during the few hours before you go to bed.
- Avoid caffeine products in the afternoon and evening.
General instructions:
- Work with your healthcare provider to determine what you need help with and what your safety needs are.
- If you were given a bracelet that identifies you as a person with memory loss or tracks your location, make sure to wear it at all times.
- Talk with your healthcare provider about whether it is safe for you to drive.
- Work with your family to make important decisions, such as advance directives, medical power of attorney, or a living will.
- Keep all follow-up visits as instructed by your healthcare provider. This is important.
Contact A Healthcare Provider If:
- you have nausea, vomiting, or trouble with eating.
- you have dizziness or weakness.
- you or your family members become concerned for your safety.
Get Help Right Away If:
- you feel depressed or sad, or feel that you want to harm yourself.
- you develop chest pain or difficulty with breathing.
- you pass out.
If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call SOS (Samaritans of Singapore) at 1800 221 4444.
Summary
- Alzheimer's disease is a brain disease that affects memory, thinking, language, and behaviour. Alzheimer's disease is a form of dementia.
- This condition is diagnosed by a specialist who specialises in diseases of the nervous system (neurologist).
- At this time, there is no treatment to cure Alzheimer's disease or stop it from getting worse. The goals of treatment are to slow memory loss and help you manage any symptoms.
- Work with your family to make important decisions, such as advance directives, medical power of attorney, or a living will.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your healthcare provider.
References:
Alford S., Patel D., Perakakis N., Mantzoros C.S.: Obesity as a risk factor for Alzheimer’s disease: weighing the evidence. Obes. Rev. 2018; 19: pp. 269-280.
Benedictus M.R., Leeuwis A.E., Binnewijzend M.A.A., Kuijer J.P.A., Scheltens P., Barkhof F., van der Flier W.M., Prins N.D.: Lower cerebral blood flow is associated with faster cognitive decline in Alzheimer’s disease. Eur. Radiol. 2017; 27: pp. 1169-1175.
Castrillo J., Oliver S.: Alzheimer’s as a systems-level disease involving the interplay of multiple cellular networks. Methods Mol. Biol. 2016; 1303: pp. 3-48.
Fu H., Hardy J., Duff K.E.: Selective vulnerability in neurodegenerative diseases. Nat. Neurosci. 2018; 21: pp. 1350-1358.
Grieder M., Wang D.J.J., Dierks T., Wahlund L.O., Jann K.: Default mode network complexity and cognitive decline in mild alzheimer’s disease. Front. Neurosci. 2018; 12: pp. 770.
Kisler K., Nelson A.R., Montagne A., Zlokovic B.V.: Cerebral blood flow regulation and neurovascular dysfunction in Alzheimer disease. Nat. Rev. Neurosci. 2017; 18: pp. 419-434.
Wang Z.T., Tan C.C., Tan L., Yu J.T.: Systems biology and gene networks in Alzheimer’s disease. Neurosci. Biobehav. Rev. 2019; 96: pp. 31-44.
For more information on Alzheimer’s Disease, visit:
Alzheimer’s Disease Association
MSF Helplines for Elderly Issues
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