What Happens To The Brain In Alzheimer’s Disease
The healthy human brain contains tens of billions of neuronsspecialized cells that process and transmit information via electrical and chemical signals. They send messages between different parts of the brain, and from the brain to the muscles and organs of the body. Alzheimers disease disrupts this communication among neurons, resulting in loss of function and cell death.
What To Do If You Suspect Alzheimers Disease
Getting checked by your healthcare provider can help determine if the symptoms you are experiencing are related to Alzheimers disease, or a more treatable conditions such as a vitamin deficiency or a side effect from medication. Early and accurate diagnosis also provides opportunities for you and your family to consider financial planning, develop advance directives, enroll in clinical trials, and anticipate care needs.
Differences Between Women And Men In The Prevalence And Risk Of Alzheimer’s And Other Dementias
More women than men have Alzheimer’s or other dementias. Almost two-thirds of Americans with Alzheimer’s are women., Of the 5.8 million people age 65 and older with Alzheimer’s in the United States, 3.6 million are women and 2.2 million are men., Based on estimates from ADAMS, among people age 71 and older, 16% of women have Alzheimer’s or other dementias compared with 11% of men.
The prevailing reason that has been stated for the higher prevalence of Alzheimer’s and other dementias in women is that women live longer than men on average, and older age is the greatest risk factor for Alzheimer’s.- But when it comes to differences in the actual risk of developing Alzheimer’s or other dementias for men and women of the same age, findings have been mixed. Most studies of incidence in the United States have found no significant difference between men and women in the proportion who develop Alzheimer’s or other dementias at any given age., , – However, some European studies have reported a higher incidence among women at older ages,, and one study from the United Kingdom reported higher incidence for men. Differences in the risk of dementia between men and women may therefore depend on age and/or geographic region.,
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Can Alzheimer’s Disease Be Prevented
As the exact cause of Alzheimer’s disease is not clear, there’s no known way to prevent the condition.
But there are things you can do that may reduce your risk or delay the onset of dementia, such as:
- staying physically fit and mentally active
These measures have other health benefits, such as lowering your risk of cardiovascular disease and improving your overall mental health.
Read more about preventing Alzheimer’s disease.
Key Biological Processes In The Brain
Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.
- The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cells activities.
- Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
- The axon is a cable-like structure at the end of the cell body opposite the dendrites and transmits messages to other neurons.
The function and survival of neurons depend on several key biological processes:
Neurons are a major player in the central nervous system, but other cell types are also key to healthy brain function. In fact, glial cells are by far the most numerous cells in the brain, outnumbering neurons by about 10 to 1. These cells, which come in various formssuch as microglia, astrocytes, and oligodendrocytessurround and support the function and healthy of neurons. For example, microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. To carry out these functions, glial cells often collaborate with blood vessels in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best.
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What Is Dementia And What Is Alzheimer’s Disease
Dementia refers to a set of symptoms and signs associated with a progressive deterioration of cognitive functions that affects daily activities. It is caused by various brain diseases and injuries. Alzheimer’s disease is the most common cause of dementia. Vascular dementia, frontotemporal dementia, and Lewy body dementia constitute other common types. Symptoms of dementia can include memory loss, judgement and reasoning problems, and changes in behaviour, mood and communication abilities.Footnote 4
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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Burden Of Alzheimer’s Disease
The long duration of illness before death contributes significantly to the public health impact of Alzheimer’s disease because much of that time is spent in a state of disability and dependence. Scientists have developed methods to measure and compare the burden of different diseases on a population in a way that takes into account not only the number of people with the condition, but also the number of years of life lost due to that disease and the number of healthy years of life lost by virtue of being in a state of disability. The primary measure of disease burden is called disability-adjusted life years , which is the sum of the number of years of life lost due to premature mortality and the number of years lived with disability , totaled across all those with the disease or injury. These measures indicate that Alzheimer’s is a very burdensome disease, not only to the individuals with the disease, but also to their families and informal caregivers, and that the burden of Alzheimer’s has increased more dramatically in the United States than the burden of other diseases in recent years. According to the most recent Global Burden of Disease classification system, Alzheimer’s disease rose from the 12th most burdensome disease or injury in the United States in 1990 to the sixth in 2016 in terms of DALYs. In 2016, Alzheimer’s disease was the fourth highest disease or injury in terms of YLLs and the 19th in terms of YLDs.
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.
7.5.2 Increasing diversity in dementia care
Economic Impact Of Dementia
The total estimated worldwide cost of dementia was US$;818 billion in 2015, which represents 1.09% of global GDP. The annual global cost of dementia is now above US$;1 trillion.
This figure includes costs attributed to informal care , direct costs of social care and the direct costs of medical care .
Direct medical care costs account for roughly 20% of global dementia costs, while direct social sector costs and informal care costs each account for roughly 40%. The relative contribution of informal care is greatest in the African regions and lowest in North America, Western Europe and some South American regions, while the reverse is true for social sector costs.
This means that if global dementia care were a country, it would be the 18th largest economy in the world. More information is available in our World Alzheimer Report 2015.
Social And Economic Impact
Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be US$ 818 billion, equivalent to 1.1% of global gross domestic product . The total cost as a proportion of GDP varied from 0.2% in low- and middle-income countries to 1.4% in high-income countries.
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Disparities Still Impacting Health And Health Care
Reducing or eliminating disparity has been part of the national conversation as a key goal of the U.S. Department of Health and Human Services Healthy People initiative for more than 20 years., Yet disparity is still evident in health and health care.
While health disparities and health care disparities are often used interchangeably, there are important distinctions between the two terms. A health disparity exists when there is a higher burden of illness, injury, disability, or mortality in one group relative to another, whereas a health care disparity is used to describe differences between groups in health insurance coverage, access to and use of health care, and quality of health care. For both these disparities, the differences are not explained by variations in health needs, patient preferences, or treatment recommendations and are closely linked with social, economic, and/or environmental disadvantage.
The existence and adverse effects of health disparities are well documented. For example, Blacks and Native Americans are more likely than Whites to report a range of health conditions, including asthma and diabetes. Native Americans also have higher rates of heart disease compared with Whites.
Health care system factors that contribute to disparity should also be acknowledged. These include implicit bias on the part of health care providers, as well as cultural and language barriers that impede patient-provider relationships.
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.
Alzheimer’s Is On The Rise Throughout The World
- Worldwide, at least 50 million people are believed to be living with Alzheimer’s disease or other dementias.4 According to the United Nations, that is more than the population of Columbia.5 If breakthroughs are not discovered, rates could exceed 152 million by 2050.4
- In the time it takes to read this sentence out loud, another person somewhere in the world has been diagnosed with dementia.6 Every 3 seconds, someone in the world develops dementia.4
What Is Alzheimers Disease
- Alzheimers disease is the most common type of dementia.
- It is a progressive disease beginning with mild memory loss and;possibly leading to loss of the ability to carry on a conversation and respond to the environment.
- Alzheimers disease involves parts of the brain that control thought, memory, and language.
- It can seriously affect a persons ability to carry out daily activities.
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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.
Estimates Of The Number Of People With Alzheimer’s Dementia By State
TableÂ; lists the estimated number of people age 65 and older with Alzheimer’s dementia by state for 2020, the projected number for 2025, and the projected percentage change in the number of people with Alzheimer’s between 2020 and 2025.,
|Projected Number with Alzheimer’s||Percentage Increase|
- Created from data provided to the Alzheimer’s Association by Weuve etÂ;al.,
As shown in FigureÂ;, between 2020 and 2025 every state across the country is expected to experience an increase of at least 6.7% in the number of people with Alzheimer’s. These projected increases in the number of people with Alzheimer’s are due solely to projected increases in the population age 65 and older in these states. Because risk factors for dementia such as midlife obesity and diabetes can vary dramatically by region and state, the regional patterns of future burden may be different than reported here. Based on these projections, the West and Southeast are expected to experience the largest percentage increases in people with Alzheimer’s dementia between 2020 and 2025. These increases will have a marked impact on statesâ health care systems, as well as the Medicaid program, which covers the costs of long-term care and support for many older residents with dementia, including more than a quarter of Medicare beneficiaries with Alzheimer’s or other dementias.
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Avoidable Use Of Health Care And Long
6.5.1 Preventable hospitalizations
Preventable hospitalizations are one common measure of health care quality. Preventable hospitalizations are hospitalizations for conditions that could have been avoided with better access to, or quality of, preventive and primary care. Unplanned hospital readmissions within 30 days are another type of hospitalization that potentially could have been avoided with appropriate post-discharge care. In 2013, 21% of hospitalizations for fee-for-service Medicare enrollees with Alzheimer’s or other dementias were either for unplanned readmissions within 30 days or for an ambulatory care sensitive condition . The total cost to Medicare of these potentially preventable hospitalizations was $4.7 billion . Of people with dementia who had at least one hospitalization, 18% were readmitted within 30 days. Of those who were readmitted within 30 days, 27% were readmitted two or more times. Ten percent of Medicare enrollees had at least one hospitalization for an ambulatory care-sensitive condition, and 14% of total hospitalizations for Medicare enrollees with Alzheimer’s or other dementias were for ambulatory care sensitive conditions.
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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Stage 3: Mild Dementia
The mild dementia stage is the point at which doctors typically diagnose Alzheimers disease. If people use a three-stage description of Alzheimers disease, this will be the early stage.
Problems with memory and thinking may become more noticeable to friends and family and also begin to affect daily life.
Symptoms of mild dementia due to Alzheimers disease include:
- having difficulty remembering newly learned information
- asking the same question repeatedly
- having trouble solving problems and completing tasks
- exhibiting reduced motivation to complete tasks
- experiencing a lapse in judgment
- becoming withdrawn or uncharacteristically irritable or angry
- having difficulty finding the correct words to describe an object or idea
- getting lost or misplacing items
The Truth About Aging And Dementia
As we age, our brains change, but Alzheimers disease and related dementias are not an inevitable part of aging. In fact, up to 40% of dementia cases may be prevented or delayed. It helps to understand whats normal and whats not when it comes to brain health.
Normal brain aging may mean slower processing speeds and more trouble multitasking, but routine memory, skills, and knowledge are stable and may even improve with age. Its normal to occasionally forget recent events such as where you put your keys or the name of the person you just met.
In the United States, 6.2 million people age 65 and older have Alzheimers disease, the most common type of dementia. People with dementia have symptoms of cognitive decline that interfere with daily lifeincluding disruptions in language, memory, attention, recognition, problem solving, and decision-making. Signs to watch for include:
Alzheimer’s disease or related dementias are not an inevitable part of aging. There are 7 ways to help maintain your brain health.
- Not being able to complete tasks without help.
- Trouble naming items or close family members.
- Forgetting the function of items.
- Repeating questions.
- Taking much longer to complete normal tasks.
- Misplacing items often.
- Being unable to retrace steps and getting lost.
If you have one or more of the 10 warning signs, please see your health care provider. Early diagnosis gives you the best chance to seek treatment and time to plan for the future.
Heres what you can do:
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