What Are The Stages Of Alzheimers
Alzheimers disease slowly gets worse over time. People with this disease progress at different rates and in several stages. Symptoms may get worse and then improve, but until an effective treatment for the disease itself is found, the persons ability will continue to decline over the course of the disease.
Early-stage Alzheimers is when a person begins to experience memory loss and other cognitive difficulties, though the symptoms appear gradual to the person and their family. Alzheimers disease is often diagnosed at this stage.
During middle-stage Alzheimers, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. People at this stage may have more confusion and trouble recognizing family and friends.
In late-stage Alzheimers, a person cannot communicate, is completely dependent on others for care, and may be in bed most or all the time as the body shuts down.
How long a person can live with Alzheimers disease varies. A person may live as few as three or four years if he or she is older than 80 when diagnosed, to as long as 10 or more years if the person is younger. Older adults with Alzheimers disease need to know their end-of-life care options and express their wishes to caregivers as early as possible after a diagnosis, before their thinking and speaking abilities fail.
Active Management Of Alzheimer’s Dementia
- Appropriate use of available treatment options.
- Effective management of coexisting conditions.
- Providing family caregivers with effective training in managing the day-to-day life of the care recipient.
- Coordination of care among physicians, other health care professionals and lay caregivers.
- Participation in activities that are meaningful to the individual with dementia and bring purpose to his or her life.
- Having opportunities to connect with others living with dementia; support groups and supportive services are examples of such opportunities.
- Becoming educated about the disease.
- Planning for the future.
To learn more about Alzheimer’s disease, as well as practical information for living with Alzheimer’s and being a caregiver, visit alz.org.
Sexual Differences In Incidence
Some studies have reported a higher risk of AD in women than in men; other studies, however, including the Aging, Demographics, and Memory Study, found no difference in risk between men and women. Almost two thirds of Americans with AD are women. Among AD patients overall, any sexual disparity may simply reflect womens higher life expectancy. Among those who are heterozygous for the APOE E4 allele, however, Payami et al found a twofold increased risk in women.
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Isnt Dementia Part Of Normal Aging
No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:
- Occasionally misplacing car keys
- Struggling to find a word but remembering it later
- Forgetting the name of an acquaintance
- Forgetting the most recent events
Normally, knowledge and experiences built over years, old memories, and language would stay intact.
Amyloid Hypothesis Versus Tau Hypothesis
A central but controversial issue in the pathogenesis of AD is the relationship between amyloid deposition and NFT formation. Evidence shows that abnormal amyloid metabolism plays a key pathogenic role. At high concentrations, the fibrillar form of Ab has been shown to be neurotoxic to cultured neurons.
Cultured cortical and hippocampal neurons treated with Ab protein exhibit changes characteristic of apoptosis , including nuclear chromatin condensation, plasma membrane blebbing, and internucleosomal DNA fragmentation. The fibrillar form of Ab has also been shown to alter the phosphorylation state of tau protein.
The identification of several point mutations within the APP gene in some patients with early-onset familial AD and the development of transgenic mice exhibiting cognitive changes and SPs also incriminate Ab in AD. The apolipoprotein E E4 allele, which has been linked with significantly increased risk for developing AD, may promote inability to suppress production of amyloid, increased production of amyloid, or impaired clearance of amyloid with collection outside of the neuron.
Autopsies have shown that patients with 1 or 2 copies of the APOE E4 allele tend to have more amyloid. Additional evidence comes from recent experimental data supporting the role of presenilins in Ab metabolism, as well as findings of abnormal production of Ab protein in presenilin-mutation familial Alzheimer disease.
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What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one.;Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment.;Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting.;Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
Myth #4: Risk Factors For Alzheimers Are Beyond Our Control
There is a misconception that genetic or hereditary risks are the sole factors that predict Alzheimers. While a small percentage of Alzheimers cases are due to gene mutations, many of the risk factors for Alzheimers are related to lifestyle or environment. While age is a risk factor beyond control, others are not and modifying them could prevent as many as 40 percent of the worlds dementia cases.;
Diet and exercise
Lack of exercise and an unhealthy diet have been linked to a higher incidence of dementia. However, research has shown that people who eat healthy diets for example, those who follow a Mediterranean diet or have a physical exercise regimen; have a lower dementia risk.
Alcohol and smoking
Several large studies have shown that alcohol use can lead to a higher risk of dementia. Smoking can lead to the same.
Cardiovascular diseases and diabetes
Hypertension , high cholesterol as well as poorly controlled diabetes are significant risk factors for dementia. Getting these factors under control can reduce a persons chances of developing dementia or help delay the onset of symptoms.
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Public Health Impact Of Deaths From Alzheimer’s Disease
Although deaths from other major causes have significantly or remained approximately the same, official records indicate that deaths from Alzheimer’s disease have increased significantly. Between 2000 and 2019, the number of deaths from Alzheimer’s disease as recorded on death certificates more than doubled, increasing 145.2%, while deaths from the number one cause of death decreased 7.3% ., The increase in the number of death certificates listing Alzheimer’s as the underlying cause of death probably reflects both a real increase in the actual number of deaths from Alzheimer’s due in large part to Alzheimer’s becoming a more common cause of death as the population ages, as well as increased reporting of Alzheimer’s deaths on death certificates over time by physicians, coroners and others who assign causes of death.
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Pandemic Sparks New Discussions About Disparity
In 2020, the COVID-19 pandemic and social justice movements sparked new conversations about endemic and long-standing health and health care disparities faced by people of color, especially when it comes to access, discrimination and trust in the health care system., People of color were disproportionately affected by the environmental, societal and economic impact of the pandemic facing greater risk of losing a job or income, being more likely to be frontline workers with greater risk of exposure to the SARS-CoV-2 virus that causes COVID-19, and having a higher likelihood of housing uncertainty and food insecurity due to the pandemic.- The effects of these social, economic and environmental factors, known as social determinants of health, can put a population’s current and future health in jeopardy. For example, they have created stark contrasts in COVID-19 infection rates and outcomes. Black, Native American and Hispanic communities have seen COVID-19 cases, hospitalizations and deaths at rates greater than Whites, and these events far exceed their share of the U.S. population.-
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What Is Mild Cognitive Impairment
Mild cognitive impairment, or MCI, is a condition in which people have more memory problems than normal for their age but are still able to carry out their normal daily activities. A doctor can do thinking, memory, and language tests to see if a person has MCI. People with MCI are at a greater risk for developing Alzheimers disease, so its important to see a doctor or specialist regularly if you have this condition.
Age Distribution For Alzheimer Disease
The prevalence of AD increases with age. AD is most prevalent in individuals older than 60 years. Some forms of familial early-onset AD can appear as early as the third decade, but familial cases constitute less than 10% of AD overall.
More than 90% of cases of AD are sporadic and occur in individuals older than 60 years. Of interest, however, results of some studies of nonagenarians and centenarians suggest that the risk may decrease in individuals older than 90 years. If so, age is not an unqualified risk factor for the disease, but further study of this matter is needed.
Savva et al found that in the elderly population, the association between dementia and the pathological features of AD is stronger in persons 75 years of age than in persons 95 years of age. These results were achieved by assessing 456 brains donated to the population-based Medical Research Council Cognitive Function and Ageing Study from persons 69-103 years of age at death.
Studies have demonstrated that the relationship between cerebral atrophy and dementia persist into the oldest ages but that the strength of association between pathological features of AD and clinical dementia diminishes. It is important to take age into account when assessing the likely effect of interventions against dementia.
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What Are Some Risk Factors For Alzheimers Disease
Risk factors for the development of Alzheimers disease include:
- Age. Increasing age is the primary risk factor for developing Alzheimers disease.
- Genetics . There is a certain gene, apolipoprotein E that is associated with late-onset Alzheimers disease. Other genes have been associated with early-onset Alzheimers disease.
- Smoking
- Obesity
Researchers believe the presence of the last five risk factors mentioned above might reduce the clearance of amyloid protein from the brain, which then increases the risk of developing Alzheimers disease. In particular, the presence of a number of these risk factors at the same time and while the person is in his or her 50s is associated with a higher risk of Alzheimers disease.
There may be some ways to reduce the risk of mental decline. In general, living a healthy lifestyle protects the body from strokes and heart attacks and is believed to also protect the brain from cognitive decline. Scientists cant absolutely prove the cause and effect of the following factors, but studies have shown a positive association.
Bridging Racial And Ethnic Barriers In Alzheimer’s And Dementia Care: A Path Forward
Findings from the Alzheimer’s Association surveys indicate that despite ongoing efforts to address health and health care disparities in Alzheimer’s and dementia care, there is still much work to do.
Current efforts to reduce health disparities, address social determinants of health, build diversity in the health care profession, and train health care providers to meet the needs of a growing population of older adults from different racial and ethnic groups must be accelerated. Amid broader calls for social justice, greater strides must be made to eliminate discrimination and other forms of bias to ensure all Americans have access to high quality dementia care and support services, as well as opportunities to participate in and benefit from Alzheimer’s research.
- Preparing the workforce to care for a racially and ethnically diverse population of older adults.
- Increasing diversity in dementia care.
- Engaging, recruiting and retaining diverse populations in Alzheimer’s research and clinical trials.
7.5.1 Preparing the workforce to care for a racially and ethnically diverse population of older adults
Current and future health care providers need to be prepared to screen, diagnose and treat Alzheimer’s and dementia in this expanding racially and ethnically diverse population of older adults so that disparities are not perpetuated.
Cultural competence
Implicit bias
7.5.2 Increasing diversity in dementia care
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Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 6070% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
What Are The Warning Signs Of Alzheimers Disease
Watch this video;play circle solid iconMemory Loss is Not a Normal Part of Aging
Alzheimers disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimers disease and related dementias.
In addition to memory problems, someone with symptoms of Alzheimers disease may experience one or more of the following:
- Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
- Trouble handling money and paying bills.
- Difficulty completing familiar tasks at home, at work or at leisure.
- Misplacing things and being unable to retrace steps to find them.
- Changes in mood, personality, or behavior.
Even if you or someone you know has several or even most of these signs, it doesnt mean its Alzheimers disease. Know the 10 warning signs .
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How Many Americans Have Alzheimers Disease
Estimates vary, but experts suggest that more than 6;million Americans age 65 and older may have Alzheimers. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimers disease.
How Long Can A Person Live With Alzheimers Disease
The time from diagnosis to death varies as little as three;or four;years if the person is older than 80 when diagnosed, to as long as 10 or more years if the person is younger.
Alzheimers disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.
Currently, there is no cure for Alzheimers disease, though there has been significant progress in recent years in developing and testing new treatments. Several medicines have been approved by the U.S. Food and Drug Administration;to treat people with Alzheimers.
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Trends In Dementia Caregiving
There is some indication that families are now better at managing the care they provide to relatives with dementia than in the past. From 1999 to 2015, dementia caregivers were significantly less likely to report physical difficulties and financial difficulties related to care provision. In addition, use of respite care by dementia caregivers increased substantially . However, as noted earlier, more work is needed to ensure that interventions for dementia caregivers are available and accessible to those who need them. A 2016 study of the Older Americans Act’s National Family Caregiver Support Program found that over half of Area Agencies on Aging did not offer evidence-based family caregiver interventions.
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How Much Does It Cost
Two thirds of the cost of dementia is paid by people with dementia and their families.
Unpaid carers supporting someone with dementia save the UK economy £13.9 billion a year.
The total cost of care for people with dementia in the UK is £34.7billion. This is set to rise sharply over the next two decades, to £94.1billion by 2040.
The cost of social care for people with dementia is set to nearly treble by 2040, increasing from £15.7billion to £45.4billion.
Dementia is one of the main causes of disability later in life, ahead of cancer, cardiovascular disease and stroke. As a country we spend much less on dementia than on these other conditions.
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Ps1 And Ps2 Mutations
Approximately 50-70% of early-onset autosomal-dominant AD cases appear to be associated with a locus mapped by genetic linkage to the long arm of chromosome 14 . Numerous missense mutations have been identified on a strong candidate gene, called PS1.
At the same time, another autosomal dominant locus responsible for early-onset AD was localized to chromosome 1. Two mutations were identified on the candidate gene, designated PS2. The physiological role of presenilins and the pathogenic effects of their mutations are not yet well understood.
Duration Of Illness From Diagnosis To Death
Studies indicate that people age 65 and older survive an average of four to eight years after a diagnosis of Alzheimer’s dementia, yet some live as long as 20 years with Alzheimer’s dementia., – This reflects the slow, insidious and uncertain progression of Alzheimer’s. A person who lives from age 70 to age 80 with Alzheimer’s dementia will spend an average of 40% of this time in the severe stage. Much of this time will be spent in a nursing home. At age 80, approximately 75% of people with Alzheimer’s dementia live in a nursing home compared with only 4% of the general population age 80. In all, an estimated two-thirds of those who die of dementia do so in nursing homes, compared with 20% of people with cancer and 28% of people dying from all other conditions.
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Medications To Maintain Mental Function In Alzheimer’s Disease
Several medications are approved by the U.S. Food and Drug Administration to treat symptoms of Alzheimers. Donepezil, rivastigmine, and galantamine are used to treat the symptoms of mild to moderate Alzheimers. Donepezil, memantine, the rivastigmine patch, and a combination medication of memantine and donepezil are used to treat moderate to severe Alzheimers symptoms. All of these drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms and help with certain behavioral problems. However, these drugs dont change the underlying disease process. They are effective for some but not all people and may help only for a limited time.