Dementia is a loss of brain function that occurs with certain diseases. Alzheimer’s disease is one form of dementia. It affects memory, thinking, and behavior.
The exact cause of Alzheimer’s disease is not known. You are more likely to develop Alzheimer’s disease if you:
- Are older. Developing Alzheimer’s disease is not a part of normal aging
- Have a close relative, such as a brother, sister, or parent with Alzheimer’s disease
- Have certain genes linked to Alzheimer’s disease
The following may also increase the risk:
- Being female
- Having heart and blood vessel problems due to high cholesterol
- History of head trauma
There are two types of Alzheimer’s disease:
- Early onset Alzheimer’s disease. Symptoms appear before age 60. This type is much less common than late onset. It tends to get worse quickly. Early onset disease can run in families. Several genes have been identified.
- Late onset Alzheimer’s disease. This is the most common type. It occurs in people age 60 and older. It may run in some families, but the role of genes is less clear.
Alzheimer’s Disease Symptoms
Symptoms include difficulty with many areas of mental function, including:
- Emotional behavior or personality
- Thinking and judgment (cognitive skills)
Alzheimer’s disease usually first appears as forgetfulness.
Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging, and the development of Alzheimer’s disease. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They are often aware of the forgetfulness. Not everyone with MCI develops Alzheimer’s disease.
Symptoms of MCI include:
- Difficulty performing more than one task at a time
- Difficulty solving problems
- Forgetting recent events or conversations
- Taking longer to perform more difficult activities
Early symptoms of Alzheimer’s disease can include:
- Difficulty performing tasks that take some thought, but used to come easily, such as balancing a checkbook, playing complex games (bridge), and learning new information or routines
- Getting lost on familiar routes
- Language problems, such as trouble remembering the names of familiar objects
- Losing interest in things previously enjoyed and being in a flat mood
- Misplacing items
- Personality changes and loss of social skills
As Alzheimer’s disease becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include:
- Change in sleep patterns, often waking up at night
- Delusions, depression, and agitation
- Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, and driving
- Difficulty reading or writing
- Forgetting details about current events
- Forgetting events in one's life history and losing self-awareness
- Hallucinations, arguments, striking out, and violent behavior
- Poor judgment and loss of ability to recognize danger
- Using the wrong word, mispronouncing words, or speaking in confusing sentences
- Withdrawing from social contact
People with severe Alzheimer’s disease can no longer:
- Recognize family members
- Perform basic activities of daily living, such as eating, dressing, and bathing
- Understand language
Other symptoms that may occur with Alzheimer’s disease:
- Problems controlling bowel movements or urine
- Swallowing problems
Alzheimer’s Disease Diagnosis
A skilled health care provider can often diagnose Alzheimer’s disease with the following steps:
- Performing a complete physical exam, including a nervous system exam
- Asking about the person's medical history and symptoms
- Mental function tests (mental status examination)
A diagnosis of Alzheimer’s disease is made when certain symptoms are present, and by making sure other causes of dementia are not present.
Tests may be done to rule out other possible causes of dementia, including:
- Brain tumor
- Chronic infection
- Intoxication from medicines
- Severe depression
- Increased fluid on the brain (normal pressure hydrocephalus)
- Thyroid disease
- Vitamin deficiency
CT or MRI of the brain may be done to look for other causes of dementia, such as a brain tumor or stroke. Sometimes, a PET scan can be used to rule out Alzheimer’s disease.
The only way to know for certain that someone has Alzheimer’s disease is to examine a sample of their brain tissue after death.
Alzheimer’s Disease Treatment
There is no cure for Alzheimer’s disease. The goals of treatment are:
- Slow the progression of the disease (although this is difficult to do)
- Manage symptoms, such as behavior problems, confusion, and sleep problems
- Change the home environment to make daily activities easier
- Support family members and other caregivers
Medicines are used to:
- Slow the rate at which symptoms worsen, though the benefit from using these drugs may be small
- Control problems with behavior, such as loss of judgment or confusion
Before using these medicines, ask the provider:
- What are the side effects? Is the medicine worth the risk?
- When is the best time, if any, to use these medicines?
- Do medicines for other health problems need to be changed or stopped?
Someone with Alzheimer’s disease will need support in the home as the disease gets worse. Family members or other caregivers can help by helping the person cope with memory lossand behavior and sleep problems. It is important to make sure the home of a person who has Alzheimer’s disease is safe for them.
Sticht Center for Healthy Aging and Alzheimer’s Prevention
One of the world’s first geriatrics-focused health care centers, the Sticht Center for Healthy Aging and Alzheimer’s Prevention conducts a wide array of leading-edge clinical, rehabilitation, wellness and research programs to help seniors and their families understand and address the unique physical, mental, social and emotional challenges that accompany aging.
Within the Sticht Center, we believe in the team approach to care. Our patients are often dealing with multiple, complex health problems at the same time, with many factors complicating the situation. Therefore, within our health-care system, patients are treated by an interdisciplinary team that has the expertise to evaluate and to treat medical, mental and functional problems at the same time.