Be Cautious About Alzheimer’s Cures
Because Alzheimer’s disease is so devastating, some people are tempted by untried or unproven “cures.” Check with your doctor before trying pills or any other treatment or supplement that promises to prevent Alzheimer’s. These “treatments” might be unsafe, a waste of money, or both. They might even interfere with other medical treatments that have been prescribed.
Geographic And Ethnic Comparisons
Alzheimer’s disease and vascular dementia may occur at different rates in different parts of the world and in different ethnic groups. But it is not easy to be certain what factors are responsible. There may be different patterns of mortality for dementia cases under different living conditions, different genetic vulnerabilities, or different environmental exposures. A finding of potential significance comes from a comparison of prevalence rates for dementia and specifically for Alzheimer’s disease in elderly Nigerian Africans and African Americans in Indianapolis by Hendrie et al. . The two groups have much of their heredity in common, but very different life-styles. The prevalence was only 2.3 percent and 1.4 percent for dementia and Alzheimer’s disease respectively in the Nigerians, but 8.2 percent and 6.2 percent in the combined community and nursing home sample of African Americans in Indianapolis. This demonstration of significant differences in rates in two different communities having similar ethnic origins again points to the possibility that some unknown environmental factors promote the neuropathological processes in Alzheimer’s disease. The Cree Indians in Canada have also been found to have a lower prevalence of Alzheimer’s disease than White Canadians .
Bethany R. Raiff, … Matthew J. Dwyer, in, 2020
Symptoms Of Alzheimer’s Disease
In the early stages the symptoms of Alzheimer’s disease can be very subtle. However, it often begins with lapses in memory and difficulty in finding the right words for everyday objects.
Other symptoms may include:
- Persistent and frequent memory difficulties, especially of recent events
- Vagueness in everyday conversation
- Apparent loss of enthusiasm for previously enjoyed activities
- Taking longer to do routine tasks
- Forgetting well-known people or places
- Inability to process questions and instructions
- Deterioration of social skills
- Emotional unpredictability
Symptoms vary and the disease progresses at a different pace according to the individual and the areas of the brain affected. A person’s abilities may fluctuate from day to day, or even within the one day, becoming worse in times of stress, fatigue or ill-health.
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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.
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.
The Brain And Alzheimer’s Disease
When a person has Alzheimerâs, their brain changes. It has fewer healthy cells, and it gets smaller over time. Most of the time, the brain cells also form two types of flaws:
- Neurofibrillary tangles. These are twisted fibers inside brain cells that keep nutrients and other important things from moving from one part of the cell to another
- Beta-amyloid plaques. These are sticky clumps of proteins that build up between nerve cells instead of breaking down like they do in healthy brains.
Plaques and tangles damage the healthy brain cells around them. The damaged cells die, and the brain shrinks. These changes cause the symptoms of Alzheimerâs, such as memory loss, speech problems, confusion, and mood swings.
Brain cells affected by the disease also make lower amounts of the chemicals called neurotransmitters that nerves use to send messages to each other.
Scientists don’t know if these brain cell changes cause Alzheimerâs or happen because of it.
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Health Environmental And Lifestyle Factors That May Contribute To Alzheimer’s Disease
Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimer’s disease. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic conditions such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimer’s.
A nutritious diet, physical activity, social engagement, sleep, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimer’s disease. Clinical trials are testing some of these possibilities.
Early-life factors may also play a role. For example, studies have linked higher levels of education with a decreased risk of dementia. There are also differences in dementia risk among racial groups and sexesall of which are being studied to better understand the causes of Alzheimers disease and to develop effective treatments and preventions for all people.
Evaluating The Latest Alzheimer’s Disease Prevention Research
A recent review of research looked carefully at the evidence on ways to prevent or delay Alzheimer’s dementia or age-related cognitive decline. Led by a committee of experts from the National Academies of Sciences, Engineering, and Medicine , the review found “encouraging but inconclusive” evidence for three types of interventions:
The evidence for other interventions, such as medications and diet, was not as strong. However, scientists are continuing to explore these and other possible preventions.
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How Is Alzheimer’s Different From Other Forms Of Dementia
Alzheimer’s disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy. Brains affected by Alzheimer’s disease often show presence of the following:
Fiber tangles within nerve cells
Clusters of degenerating nerve endings
Another characteristic of Alzheimer’s disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and somatostatin.
What Happens If A Doctor Thinks It’s Alzheimer’s Disease
If a primary care doctor suspects Alzheimers, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:
- Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem.
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
- Neuropsychologists, who can conduct tests of memory and thinking.
Memory clinics and centers, including Alzheimers Disease Research Centers, offer teams of specialists who work together to diagnose the problem. In addition, these specialty clinics or centers often have access to the equipment needed for brain scans and other advanced diagnostic tests.
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How Is Alzheimers Disease Diagnosed
These tests are used to diagnose Alzheimers disease or to rule out other medical conditions that cause symptoms similar to Alzheimers disease:
Difficulty Determining Time Or Place
Losing track of dates and misunderstanding the passage of time as it occurs are also two common symptoms. Planning for future events can become difficult since they arent immediately occurring.
As symptoms progress, people with AD can become increasingly forgetful about where they are, how they got there, or why theyre there.
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Early Onset Alzheimers Disease
Although age is the main risk factor for Alzheimers disease, this is not just a condition that affects older adults.
According to the Alzheimers Association, early onset Alzheimers disease affects around 200,000 U.S. adults under the age of 65 years. Many people with this condition are in their 40s or 50s.
In many cases, doctors do not know why younger people develop this condition. Several rare genes can cause the condition. When there is a genetic cause, it is known as familial Alzheimers disease.
What Is The Burden Of Alzheimers Disease In The United States
- Alzheimers disease is one of the top 10 leading causes of death in the United States.2
- The 6th leading cause of death among US adults.
- The 5th leading cause of death among adults aged 65 years or older.3
In 2020, an estimated 5.8 million Americans aged 65 years or older had Alzheimers disease.1 This number is projected to nearly triple to 14 million people by 2060.1
In 2010, the costs of treating Alzheimers disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4
Death rates for Alzheimers disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimers disease, has been shown to be under-reported in death certificates and therefore the proportion of older people who die from Alzheimers may be considerably higher.6
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What Newer Medications Are Under Study
All currently approved medications target Alzheimers disease after it develops. Scientists are currently researching ways to stop or slow the progress of Alzheimers disease before it starts.
Some of the drugs in late-stage investigation are called monoclonal antibodies. These drugs target the amyloid protein that builds up in brain cells. They work by attaching to the amyloid proteins as they float in the brain and remove them, before they form into the plaques and tangles that interfere with the brains ability to properly function.
These drugs are still in clinical trials and are several years away from Food and Drug Administration approval in the United States. Early results have been mixed, with some trials showing no improvement in brain function others showing a slight improvement . Despite the mixed results, researchers are excited about this new potential method to modify the disease process.
How Does Alzheimer’s Disease Progress
The rate of progression of the disease varies from person to person.
However, the disease does lead eventually to complete dependence and finally death, usually from another illness such as pneumonia. A person may live from three to twenty years with Alzheimer’s disease, with the average being seven to ten years.
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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.
Can Increasing Physical Activity Prevent Alzheimer’s Disease
Physical activity has many health benefits, such as reducing falls, maintaining mobility and independence, and reducing the risk of chronic conditions like depression, diabetes, and high blood pressure. Based on research to date, there’s not enough evidence to recommend exercise as a way to prevent Alzheimer’s dementia or mild cognitive impairment , a condition of mild memory problems that often leads to Alzheimer’s dementia.
Years of animal and human observational studies suggest the possible benefits of exercise for the brain. Some studies have shown that people who exercise have a lower risk of cognitive decline than those who don’t. Exercise has also been associated with fewer Alzheimer’s plaques and tangles in the brain and better performance on certain cognitive tests.
While clinical trials suggest that exercise may help delay or slow age-related cognitive decline, there is not enough evidence to conclude that it can prevent or slow MCI or Alzheimer’s dementia. One study compared high-intensity aerobic exercise, such as walking or running on a treadmill, to low-intensity stretching and balance exercises in 65 volunteers with MCI and prediabetes. After 6 months, researchers found that the aerobic group had better executive functionthe ability to plan and organizethan the stretching/balance group, but not better short-term memory.
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Is There Treatment Available
At present there is no cure for Alzheimer’s disease. However, one group of drugs called cholinergeric drugs appears to be providing some temporary improvement in cognitive functioning for some people with mild to moderate Alzheimer’s disease.
Drugs can also be prescribed for secondary symptoms such as restlessness or depression or to help the person with dementia sleep better.
Community support is available for the person with Alzheimer’s disease, their families and carers. This support can make a positive difference to managing dementia. Dementia Australia provides support, information and counselling for people affected by dementia. Dementia Australia also aims to provide up-to-date information about drug treatments.
For more information contact the National Dementia Helpline on 1800 100 500.
For a range of books and videos contact our Library.
For advice, common sense approaches and practical strategies on the issues most commonly raised about dementia, read our Help Sheets.
Medications For Cognitive Symptoms
No disease-modifying drugs are available for Alzheimers disease, but some options may reduce the symptoms and help improve quality of life.
Drugs called cholinesterase inhibitors can ease cognitive symptoms, including memory loss, confusion, altered thought processes, and judgment problems. They improve neural communication across the brain and slow the progress of these symptoms.
Three common drugs with Food and Drug Administration approval to treat these symptoms of Alzheimers disease are:
- donepezil , to treat all stages
- galantamine , to treat mild-to-moderate stages
- rivastigmine , to treat mild-to-moderate stages
Another drug, called memantine , has approval to treat moderate-to-severe Alzheimers disease. A combination of memantine and donepezil is also available.
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.
What Can Lead To Alzheimer’s Disease
There are a few things that may make people more likely to get Alzheimerâs. So far, research has linked the disease with:
- Age. Your risk for Alzheimer’s goes up as you get older. For most people, it starts going up after age 65.
- Gender. Women get the disease more often than men.
- Family history. People who have a parent or sibling with Alzheimerâs are more likely to get it themselves.
- Down syndrome. Itâs not clear why, but people with this disorder often get Alzheimer’s disease in their 30s and 40s.
- Head injury. Some studies have shown a link between Alzheimer’s disease and a major head injury.
- Other factors. High cholesterol levels and high blood pressure may also raise your risk.
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Can Eating Certain Foods Or Diets Prevent Alzheimer’s Disease
People often wonder if a certain diet or specific foods can help prevent Alzheimer’s disease. The recent NASEM review of research did not find enough evidence to recommend a certain diet to prevent cognitive decline or Alzheimer’s. However, certain diets and healthy eating patterns have been associated with cognitive benefits. Studies of diets, such as the Mediterranean diet and the MIND dieta combination of the Mediterranean and DASH dietsare underway. Learn more about what we know about diet and the prevention of Alzheimer’s disease.
For more information, read What Do We Know About Diet and Alzheimer’s Prevention?
Causes Of Alzheimer’s Disease
The brain is made up of billions of nerve cells that connect to each other. In Alzheimers disease, connections between these cells are lost. This is because proteins build up and form abnormal structures called plaques and tangles. Eventually nerve cells die and brain tissue is lost.
The brain also contains important chemicals that help to send signals between cells. People with Alzheimers have less of some of these chemical messengers in their brain, so the signals are not passed on as well. There are some drug treatments for Alzheimers disease that can help boost the levels of some chemical messengers in the brain. This can help with some of the symptoms.
Alzheimers is a progressive disease. This means that gradually, over time, more parts of the brain are damaged. As this happens, more symptoms develop, and they also get worse.More than 520,000 people in the UK have dementia caused by Alzheimers disease and this figure is set to rise.
Dementia and the brain