Alzheimer’s disease (AD) is the most common form of dementia. A chronic neurodegenerative disease, it causes problems with memory, cognition, and behavior. Early signs of Alzheimer’s develop slowly but worsen over time. Alzheimer’s typically affects older adults, though it may appear earlier in rare cases.
In this post, we’ll bring you up to date with this condition, including its characteristics and risk factors, prevalence, costs, symptoms, and treatments. We will look at how it differs from other dementias and zoom in on its distinctive features. Keep reading to learn more about the disease which Robert Butler, the first director of the National Institute on Aging, once called the “polio of geriatrics.”
Alzheimer’s Disease Overview
Dementia is a broad term that refers to brain disorders that cause a decline in mental ability, memory problems, and personality changes. Alzheimer’s accounts for as many as 80% of cases of dementia. It’s a specific degenerative form of dementia that causes changes in the brain. These changes are not part of the natural process of aging. According to prevalent theories, during the course of the disease neurons in the brain become damaged or destroyed. Neurons connect at synapses, forming a communication system for brain cells. Neurotransmitters or tiny bursts of chemicals carry information between synapses. During its progression, Alzheimer’s interferes with this process, destroying synapses and neurons.
Neuronal damage begins with the parts of the brain that are responsible for memory, thinking, and learning. It progresses within areas that define a person’s identity and then areas that enable fundamental bodily actions such as walking or swallowing. While it typically affects adults over 65 years, Alzheimer’s can have an onset as early as the late 20s. The disease takes its name from German psychiatrist Alois Alzheimer, who identified what is today considered the first published case of presenile dementia. He was a colleague of Emil Kraepelin, alongside whom he is credited to have co-discovered the condition.
Alzheimer’s Vs. Other Forms of Dementia
Alzheimer’s disease is one of several forms of dementia. Other forms include vascular dementia, frontotemporal dementia, dementia with Lewy bodies, and the rare Creutzfeldt-Jakob disease. People with advanced Parkinson’s or Huntington’s disease furthermore have a higher risk of developing dementia. Brain damage, brain tumors, or strokes may also cause dementia.
Most forms of dementia tend to have an identifiable cause, whether it is vascular damage, the build-up of abnormal protein plaques, loss of nerve cells in specific areas of the brain, protein transformations, or inherited defects in one or more genes. Another typical feature of Alzheimer’s is progressive memory loss to the point of losing one’s identity. While memory loss may occur in other dementias, it is a characteristic early symptom of Alzheimer’s. The cause of Alzheimer’s remains unknown today and unlike other dementias which may be cured, it is irreversible.
Alzheimer’s Disease Causes and Risk Factors
We don’t yet fully understand what causes Alzheimer’s disease. A popular theory claims that high levels of the amyloid protein buildup in the brain, causing plaques which ultimately disrupt the functioning of neurons. These plaques can be observed under a microscope. However, the amyloid buildup theory has been challenged in recent years. What we do know so far is that during the course of the disease, proteins in the brain stop working properly and disrupt brain cells. This results in toxic events that damage neurons and sever the connections between them.
The complex changes in the brain that Alzheimer’s causes have been linked to several risk factors:
- Having high blood glucose levels
- Being overweight or obese at midlife
- High consumption of sugary beverages
According to one study, the buildup of amyloid plaques and other brain changes may appear as early as 20 years before the onset of the condition.
Prevalence of Alzheimer’s Disease
Over 47 million people live with Alzheimer’s worldwide, of which over 5.8 million live in the U.S. According to the Alzheimer’s Disease Facts and Figures report, 1 in 10 U.S. citizens age 65 or older have Alzheimer’s.
The prevalence of the disease increases with age, peaking in the 75-84 age group. People who develop the condition before the age of 65 represent only around 3% of all cases in the U.S. Women are more at risk of developing Alzheimer’s than men. According to the same report, the estimated lifetime risk by sex at age 65 is 11.6% for men and 21.1% for women. By 2030, it’s estimated that over 76 million people will develop the condition. In other words, Alzheimer’s could be considered a global epidemic.
Cost of Alzheimer’s Disease
With a global cost of Alzheimer’s is over $1 trillion annually, Alzheimer’s is one of the world’s most expensive diseases. Put another way, if Alzheimer’s were a corporation, it would have a bigger profit than the world’s top 10 most profitable companies combined. What is more, the costs of the disease transcend medical services. In the U.S. alone, caregivers provided in 2019 an estimated value of over $234 billion hours. Caring for a person with Alzheimer’s can be very challenging, especially during the later stages of the condition when the symptoms of the disease can dramatically change the personality and behavior of the sufferer.
One in three seniors in the U.S. dies with Alzheimer’s or another form of dementia. In the last few years, deaths from Alzheimer’s have increased and the disease has become one of the leading causes of death in Western countries. Yet despite growing awareness about the condition and over $2 billion federal spending on research projects, many people still think that dementia is a natural consequence of old age. And it’s not just uninformed people who think this. According to the World Alzheimer Report 2019, almost 62% of healthcare providers think that dementia is part of normal aging.
Alzheimer’s Disease Symptoms
Part of the reason for that is that the early manifestation of the disease can pass for what many of us would refer to not without a smile as “the fogginess of old age.” Symptoms can be divided into early, middle, and late stages.
- Early-stage symptoms present themselves as memory lapses. A person in the early stage of the disease may forget about a recent conversation, constantly misplace items, ask questions repetitively, or find it difficult to make decisions. Early symptoms may also include mood changes, anxiety, or confusion.
- Middle stage symptoms can include worsening memory problems, repetitive or impulsive behavior, speech problems or aphasia, delusions, difficulty judging distances, and hallucinations. At this stage, sufferers require support for everyday tasks like eating or getting dressed.
- Late-stage symptoms include dysphagia or difficulty eating and swallowing, movement limitations, weight loss, incontinence, significant speech loss, and memory problems. By this stage, patients may need full-time care.
During the course of the disease, people suffering from Alzheimer’s may become suspicious of those around them and even violent. This can mean further challenges for caregivers. According to the WAR 2019 report, over 50% of caregivers say their own health has suffered as a result of their responsibilities in providing support to a person with Alzheimer’s.
Alzheimer’s Disease Diagnostic and Treatment
Alzheimer’s disease is diagnosed through physical and neurological exams, blood tests, neuropsychological testing, and brain imaging. Self-reporting about symptoms such as memory loss plays an important role in the diagnosis, as does the information provided by the family. There is no single test that can diagnose Alzheimer’s. Doctors diagnose it by eliminating other forms of dementia and other conditions that may cause cognitive decline. While a cure for Alzheimer’s Disease has not yet been developed, medication can help treat some of the symptoms, especially in the earlier stages. Treatments such as Cholinesterase inhibitors and Memantine (Namenda) both treat cognitive symptoms and especially those related to memory.
Cholinesterase inhibitors can improve communication between cells in the brain and may also alleviate depression, agitation and other neuropsychiatric symptoms. Unfortunately, this type of medication has unpleasant side effects including nausea, loss of appetite, diarrhoea, and sleep disturbances. Commonly prescribed cholinesterase inhibitors include Donepezil, Galantamine, and Rivastigmine.
Memantine (Namenda) reduces the action of certain chemicals in the brain and slows the progression of some symptoms. It may improve memory and awareness as well as help with daily functions. In addition to these treatments for memory and cognitive function, doctors may also prescribe additional treatments for behavior and sleep changes.
A number of medical foods are marketed as alternative treatments for dementia, including coral calcium, Ginko Biloba, or omega-3 fatty acids. However, according to the Alzheimer’s Association, there is no conclusive evidence that these supplements help. Some have not received FDA approval to be marketed as Alzheimer’s alternative treatments. However, teas and other supplements may help deal with the side effects of Alzheimer’s medication or the problems the disease creates, such as sleep disturbances or behavior problems.
Studies suggest that lifestyle changes such as exercising, diet improvements, and blood pressure control may play a crucial in reducing the risk of dementia, and possibly checking its progress. With amyloid-targeting drugs as yet unable to cure dementia, studies funded by NIH and other organizations are now focusing on aerobic exercise and other potential non-drug treatments. A heart-healthy diet may also be important, as inflammation may prove to play a key role in the development of the disease. What’s more, regular cognitive assessments together with cognitive health programs could play an important role in developing brain-healthy habits that ward of Alzheimer’s and other dementias.
Alzheimer’s disease is one of the biggest challenges that humanity faces in the 21st century. With life expectancy in the U.S. and many Western countries exceeding 78 years, it’s a condition whose impact cannot be downplayed. Affecting more than tens of millions of people, it creates daily challenges for carers and costs countries billions of dollars. It is not merely a medical problem, but a social challenge.
Alzheimer’s may cause irremediable forgetfulness on a deeply personal level, but for every person who forgets, there are many others who remember. And they carry on the great task not only of finding a cure for Alzheimer’s but also of finding ways to prevent it. By informing yourself about this condition, you too are one of them.