What Causes Alzheimers Disease
In recent years, scientists have made tremendous progress in better understanding Alzheimers and the momentum continues to grow. Still, scientists dont yet fully understand what causes Alzheimers disease in most people. In people with early-onset Alzheimers, a genetic mutation may be the cause. Late-onset Alzheimers arises from a complex series of brain changes that may occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimers may differ from person to person.
Brain Changes Detected 20 Years Before Alzheimers Symptoms
Scientists increasingly recognize Alzheimers as a disease process that begins years before symptoms of dementia become evident. Now, new research has found changes in the brain and body up to 20 years before Alzheimers symptoms arise.
The research, published in the journal Lancet Neurology, looked at a large extended South American family in Colombia that carried a gene for the early-onset form of Alzheimers, which typically arises before age 60. About 30 percent of the 5,000 family members carry the defective gene. Inheriting the gene, called presenelin 1, guarantees that youll get Alzheimers at a relative young age.
Among the relatives, members who had the gene typically began to develop serious memory problems in their mid-40s, with full-flown Alzheimers by their early 50s. The scientists discovered that many young people in the family, some as young as 18, had changes in their brain, blood and nervous system that presaged the onset of Alzheimers decades later.
The changes are the earliest signs yet detected of Alzheimers disease. Although it was a study of early-onset disease, scientists have noted related changes in those with the far more common late-onset form of Alzheimers.
Using brain scans and tests of the spinal fluid and blood, the researchers examined dozens of young people, ages 18 to 26, in the family. Only some carried the Alzheimers gene, and none had any memory problems or other symptoms.
Why Knowing Life Expectancy Is Useful
Knowing what to expect, including life expectancy helps with planning. Someone predicted to survive for five or six years, as opposed to two years, will want to make more extensive plans, including getting an estate in order, activity planning, and budget. Knowing how quickly the disease is expected to progress symptomatically can impact care decisions. If the disease is predicted to come on very quickly, for example, then skipping traditional assisted living and looking into memory care or a nursing home might be the best option.
Knowing when full-time care becomes a requirement, either at-home or in a memory care residence, is especially useful given the high cost of care. It is estimated that 50% of nursing home residents have some level of dementia and over 60% of nursing home residents care is paid for by Medicaid. Medicaid eligibility is complicated, and families can spend up to 5 years waiting for a loved one with dementia to become Medicaid-eligible. Therefore, knowing how soon care is required can make a huge financial difference.
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Stage : Moderately Severe Decline
Your loved one might start to lose track of where they are and what time it is. They might have trouble remembering their address, phone number, or where they went to school. They could get confused about what kind of clothes to wear for the day or season.
You can help by laying out their clothing in the morning. It can help them dress by themselves and keep a sense of independence.
If they repeat the same question, answer with an even, reassuring voice. They might be asking the question less to get an answer and more to just know you’re there.
Even if your loved one can’t remember facts and details, they might still be able to tell a story. Invite them to use their imagination at those times.
The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
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Understanding Early Onset Dementia
Some chapters of the Alzheimer’s Association are beginning to use the name younger-onset dementia instead of early-onset dementia. Members of the association state there can be confusion for families hearing the diagnosis of early-onset dementia. âEarly onset” does not refer to the stage of the disease it refers to the age at which a person is diagnosed with dementia.
What Are The Differences Between Early
In addition to age, there are other differences between early-onset and late-onset Alzheimer’s disease, including the following:
- Most cases of early-onset Alzheimer’s disease appears to be linked with a genetic defect on chromosome 1 or 14 late-onset Alzheimer’s is not linked to this genetic defect. Also Down syndrome patients develop early onset Alzheimers dementia after the age of 40 because they have an inherent defect on chromosome 21. Some patients who have early onset Alzheimers disease have the ApoE 4/4 gene, which is a very strong genetic risk factor for disease development.
- A condition called myoclonus muscle twitching and spasm is more commonly seen in early-onset Alzheimer’s disease than in late-onset Alzheimer’s disease.
- Some research suggests that people with early-onset Alzheimer’s disease decline at a faster rate than do those with late-onset Alzheimer’s disease.
Younger people who are diagnosed with Alzheimer’s disease tend to be more physically fit and active, and many still have family and career responsibilities. As a result, they tend to react differently to the disease, and may be more likely to feel powerless, frustrated and depressed.
Tips for living with early-onset Alzheimer’s disease
Here are some tips for living with Alzheimer’s disease:
Yourself
Family and friends
Career
Financial and legal matters
Last reviewed by a Cleveland Clinic medical professional on 03/26/2019.
References
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Be Open With Family And Friends
- Talk to your spouse and/or other close family members about your thoughts, fears, and wishes. Your family can help you plan for the future, including decisions about health care and legal and financial issues.
- Talk openly with children about your disease. Understand that they may be feeling concerned, confused, upset, or afraid. If appropriate, involve your children in discussions and decisions that affect the whole family.
- Your friends or neighbors might not know how to react to your diagnosis. They may feel like they dont know what to say or how to help, and may be waiting for you to make the first move. Invite friends to spend time with you. And dont be afraid to ask for help when you need it.
What Are The Signs Of Alzheimer’s Disease
Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimers disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimers disease, people seem to be symptom-free, but toxic changes are taking place in the brain.
Damage occurring in the brain of someone with Alzheimers disease begins to show itself in very early clinical signs and symptoms. For most people with Alzheimersthose who have the late-onset varietysymptoms first appear in their mid-60s. Signs of early-onset Alzheimers begin between a persons 30s and mid-60s.
The first symptoms of Alzheimers vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers disease. Decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. And some people may be diagnosed with mild cognitive impairment. As the disease progresses, people experience greater memory loss and other cognitive difficulties.
Alzheimers disease progresses in several stages: preclinical, mild , moderate, and severe .
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Stage : Severe Decline
As Alzheimer’s progresses, your loved one might recognize faces but forget names. They might also mistake a person for someone else, for instance, think their wife is their mother. Delusions might set in, such as thinking they need to go to work even though they no longer have a job.
You might need to help them go to the bathroom.
It might be hard to talk, but you can still connect with them through the senses. Many people with Alzheimer’s love hearing music, being read to, or looking over old photos.
At this stage, your loved one might struggle to:
- Feed themselves
- Changes in their sleeping patterns
Memory Loss That Impedes Daily Activities
The most noticeable symptom of Alzheimers disease is often memory loss. A person may start forgetting messages or recent events in a way that is unusual for them. They may repeat questions, having forgotten either the answer or the fact that they already asked.
It is not uncommon for people to forget things as they get older, but with early onset Alzheimers disease, this happens earlier in life, occurs more often, and seems out of character.
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Problem Solving Or Planning Difficulties
The person may find that they have difficulty following directions, solving problems, and focusing. For example, they may find it difficult to:
- follow a recipe
- follow directions on a product
- keeping track of monthly bills or expenses
Some people often have problems like these, but if they start to happen when they did not happen before, it could indicate early onset Alzheimers disease.
How Alzheimer’s Disease Is Treated
There’s currently no cure for Alzheimer’s disease, but medicines are available that can help relieve some of the symptoms.
Various other types of support are also available to help people with Alzheimer’s live as independently as possible, such as making changes to your home environment so it’s easier to move around and remember daily tasks.
Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
Read more about treating Alzheimer’s disease.
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The Short Answer To A Big Question
On this page we will discuss the development of an Alzheimers / dementia Life Expectancy Calculator, but lets first address the question most people ask after receiving the diagnosis of an incurable disease: How long do I have left to live? With dementia, the answer differs depending on the type. By far the most common form of dementia is Alzheimers disease, and the average life expectancy after diagnosis is 10 years. Other dementias have different life expectancies. Someone with vascular dementia lives for about five years after diagnosis. Someone who has dementia with Lewy bodies will typically live for six to twelve more years.
Average life expectancies for the most common types of dementia are as follows:
| Dementia type |
Stage : Moderately Severe Cognitive Declinemoderate Dementia
In this stage, deficits are of sufficient magnitude as to prevent catastrophe-free, independent community survival. The characteristic functional change in this stage is early deficits in basic activities of daily life. This is manifest in a decrement in the ability to choose the proper clothing to wear for the weather conditions or for everyday circumstances. Some persons with Alzheimers disease begin to wear the same clothing day after day unless reminded to change. The mean duration of this stage is 1.5 years.
The person with Alzheimers disease can no longer manage on their own. There is generally someone who is assisting in providing adequate and proper food, as well as assuring that the rent and utilities are paid and the finances are taken care of. For those who are not properly supervised, predatory strangers may become a problem. Very common reactions for persons at this stage who are not given adequate support are behavioral problems such as anger and suspiciousness.
Cognitively, persons at this stage frequently cannot recall major events and aspects of their current life such as the name of the current head of state, the weather conditions of the day, or their correct current address. Characteristically, some of these important aspects of current life are recalled, but not others. Also, the information is loosely held, so, for example, the person with moderate Alzheimers disease may recall their correct address on certain occasions, but not others.
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Evidence That Life Expectancy Calculators For Dementia Actually Work
It turns out that the length of time a person has before needing full-time care, before moving into a care community, and before dying can all be predicted somewhat accurately. This information, though not definitive, can help families get a general understanding of how to plan for the future and what to expect as the disease progresses.
In a study conducted at the department of neurology in Columbia University, groups of people with mild Alzheimers were followed for 10 years and assessed semiannually. Data from these assessments were plugged into a complicated algorithm. The people studied were tested for the following:
Mental status score Cognition and function Motor skills Psychology and behavior Basic demographic information
Other experiments have yielded similar results. A University of Kentucky study analyzed the records of more than 1,200 people with dementia and found that it was possible to accurately predict their life expectancy. Researchers looked at many variables including family history and medical problems like high blood pressure and heart disease, and ultimately realized it came down to three things:
age when the first symptoms appeared gender how impaired someone was when diagnosis was first made
How Does Alzheimers Impact Life Expectancy
According to a study, the key factors that determine how long someone lives after being diagnosed with Alzheimer’s disease and other forms of dementia are gender, age, and level of disability:
- While men lived approximately 4.1 years following diagnosis, women lived approximately 4.6 years.
- When someone who is over the age of 90 is diagnosed with Alzheimer’s disease, they live 3.8 years. In contrast, someone under the age of 70 lived 10.7 years.
- If a patient was frail when they were diagnosed, they didn’t live as long even after the adjustment for age has been made.
In the end, the average survival time for those diagnosed with Alzheimer’s disease and other forms of dementia was 4.5 years.
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Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Australian Government Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
How Do I Treat Early
An important part of managing your condition is to stay as positive as you can. Keep up with the activities you still enjoy. Try different ways to relax, like yoga or deep breathing.
Keep your body in good shape, too. Make sure you eat healthy food and get regular exercise.
Medications can help with some symptoms of early-onset Alzheimer’s. Your doctor may prescribe drugs to help with memory loss, such as:
These medicines can delay or improve your symptoms for a few months to a few years. They may give you more time to live independently.
The doctor also may also suggest sleeping pills, antidepressants, or tranquilizers to manage other problems related to Alzheimer’s, like insomnia, night terrors, and anxiety.
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Stage : Very Severe Decline
Many basic abilities in a person with Alzheimer’s, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping them use a spoon, and making sure they drink. This is important, as many people at this stage can no longer tell when they’re thirsty.
In this stage, people with Alzheimer’s disease need a lot of help from caregivers. Many families find that, as much as they may want to, they can no longer take care of their loved one at home. If thatâs you, look into facilities such as nursing homes that provide professional care day and night.
When someone nears the end of their life, hospice may be a good option. That doesn’t necessarily mean moving them to another location. Hospice care can happen anywhere. Itâs a team approach that focuses on comfort, pain management and other medical needs, emotional concerns, and spiritual support for the person and their family.
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Attention And Language Impairment
While memory challenges can be involved in early onset Alzheimers, signs that something could be wrong can be much broader. In fact, experts note that memory loss, which is closely associated with Alzheimers, may actually be less prominent in people with early onset Alzheimers.
Instead, people with early onset Alzheimers often complain about difficulties finding words in conversation. They can experience problems with attention and orientation, as well as with simple math.
In the aggregate, patients with early-onset Alzheimers Disease, compared to similarly impaired patients with late-onset Alzheimers Disease, have better memory recognition scores and semantic memory but worse attention, language, executive functions, ideomotor praxis, and visuospatial skills, a research paper by Dr. Mario Mendez noted.
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