Alzheimers Disease: What You Need To Know As You Age
An estimated 5.2 million Americans are living withAlzheimers disease, the most common form ofdementiain the world and the sixth leading cause of death in the United States.Todays statistics are just the tip of the iceberg, however. By 2025, thenumber of people afflicted will top 7 milliona 40 percent jumpas babyboomers continue to age and people live longer overall.
Although the risk of AD increases with age, it is not a usual partof aging or something that should be expected in older people, saysConstantine Lyketsos, M.D., director of the Memory and Alzheimers Treatment Center at Johns Hopkins.In fact, early onset Alzheimers can occur in people younger than 65,although it accounts for a small number of all cases. The rest areclassified as late onset.
Alzheimers and many other dementias occur as a result of damage toneuronsin the brain that affects their ability to communicate with each other.Over time, those neurons death and malfunction affects memory, learning,mood, behavior, and eventually physical functions, such as walking, andswallowing.
Alzheimers Disease Vs Other Types Of Dementia
Dementia is an umbrella term for a range of conditions that involve a loss of cognitive functioning.
Alzheimers disease is the most common type of dementia. It involves plaques and tangles forming in the brain. Symptoms start gradually and are most likely to include a decline in cognitive function and language ability.
To receive a diagnosis of Alzheimers, a person will be experiencing memory loss, cognitive decline, or behavioral changes that are affecting their ability to function in their daily life.
Friends and family may notice the symptoms of dementia before the person themselves.
There is no single test for Alzheimers disease. If a doctor suspects the presence of the condition, they will ask the person and sometimes their family or caregivers about their symptoms, experiences, and medical history.
The doctor may also carry out the following tests:
- cognitive and memory tests, to assess the persons ability to think and remember
- neurological function tests, to test their balance, senses, and reflexes
- blood or urine tests
- a CT scan or MRI scan of the brain
- genetic testing
A number of assessment tools are available to assess cognitive function.
In some cases, genetic testing may be appropriate, as the symptoms of dementia can be related to an inherited condition such as Huntingtons disease.
Some forms of the APOE e4 gene are associated with a higher chance of developing Alzheimers disease.
How Common Is Alzheimer’s Disease
About 5.5 million Americans are living with Alzheimer’s disease. The disease is rapidly growing. By 2050, this number could potentially rise to 16 million. Every 66 seconds, someone in the United States is diagnosed. Soon, that number could increase to a diagnosis every 33 seconds. Let’s dive into these figures and how Alzheimer’s is impacting families across the world.
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Incidence Of Alzheimer’s Disease
The pooled incidence rate of AD among people 65+ years of age in Europe was 19.4 per 1000 person-years. The pooled data from two large-scale community-based studies of people aged 65+ years in the US Seattle and Baltimore, areas yielded an incidence rate for AD of 15.0 per 1000 person-years., The incidence rate of AD increases almost exponentially with increasing age until 85 years of age .,-
Age-specific incidence of Alzheimer’s disease across continents and countries. *, incidence of all types of dementia
There appears to have been some geographic variations in the incidence of AD. The pooled data of eight European studies suggested a geographical dissociation across Europe, with higher incidence rates being found among the oldest-old people of north-western countries than among southern countries. The incidence rates of AD were reported to be slightly lower in North America than in Europe. Differences in methodology , rather than real different regional distributions of the disease, may be partly responsible for the geographic variations. The study using identical methods in UK found no evidence of variation in dementia incidence among five areas in England and Wales. Studies have confirmed that AD incidence in developing countries is generally lower than in North America and Europe. For example, the incidence rate of AD among people aged 65+ years was 7.7 per 1 000 person-years in Brazil and 3.2 per 1 000 person-years in India.,
A Costly And Growing National Crisis
- In 2021, the total national cost of caring for people living with Alzheimers and other dementias is projected to reach $355 billion. This number does not include the estimated $257 billion price of unpaid caregiving.
- Medicare and Medicaid are expected to cover $239 billion, or 67%, of the total health care and long-term care payments for people with Alzheimers or other dementias. Out-of-pocket spending is expected to be $76 billion, or 22% of total payments.
Source: Alzheimers Associations 2021 Facts & Figures Report
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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.
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.
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Determinants Of Alzheimer’s Disease
Alzheimer’s dementia is a multifactorial disease, in which older age is the strongest risk factor, suggesting that the aging-related biological processes may be implicated in the pathogenesis of the disease. Furthermore, the strong association of AD with increasing age may partially reflect the cumulative effect of different risk and protective factors over the lifespan, including the effect of complex interactions of genetic susceptibility, psychosocial factors, biological factors, and environmental exposures experienced over the lifespan. Following various etiologic hypotheses, Table I summarizes the major risk and protective factors for AD. Moderate to strong evidence, most from epidemiologic, neuroimaging, and neuropathological research, supports the role of genetic, vascular, and psychosocial factors in the development of AD, whereas evidence for the etiologic role of other factors is mixed or insufficient.
Diagnosis Of Alzheimers Disease
There is not a simple test to tell us if someone has Alzheimerâs. Diagnosis requires a comprehensive medical evaluation, which may include:
Is there an Alzheimerâs test?There is no simple way to detect Alzheimerâs. Diagnosis requires a complete medical exam. Blood tests, mental status tests and brain imaging may be used to determine the cause of symptoms.
- Your familyâs medical history
- A neurological exam
- Cognitive tests to evaluate memory and thinking
- Blood tests (to rule out other possible causes of symptoms
- Brain imaging
While doctors can usually determine if someone has dementia, it may be more difficult to distinguish what type of dementia. Misdiagnosis is more common with younger-onset Alzheimerâs.
Less than half of the people with dementia in England, Wales and Northern Ireland receive a diagnosis. Receiving an accurate diagnosis earlier in the disease process is important because it allows:
- A higher likelihood of benefiting from available treatments, which can improve quality of life
- The opportunity to receive support services
- A chance to participate in clinical trials and studies
- An opportunity to express wishes regarding future care and living arrangements
- Time to put financial and legal plans in place
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Use And Costs Of Health Care Services
6.2.1 Use of health care services
People with Alzheimer’s or other dementias have twice as many hospital stays per year as other older people. Moreover, the use of health care services by people with other serious medical conditions is strongly affected by the presence or absence of dementia. In particular, people with coronary artery disease, diabetes, chronic kidney disease, chronic obstructive pulmonary disease , stroke or cancer who also have Alzheimer’s or other dementias have higher use and costs of health care services than people with these medical conditions but no coexisting dementia.
- * This table does not include payments for all kinds of Medicare services, and as a result the average per-person payments for specific Medicare services do not sum to the total per-person Medicare payments.
- Created from unpublished data from the National 5% Sample Medicare Fee-for-Service Beneficiaries for 2014.
Numbers Of People With Dementia
Someone in the world develops dementia every 3 seconds. There are over 55 million people worldwide living with dementia in 2020. This number will almost double every 20 years, reaching 78 million in 2030 and 139 million in 2050. Much of the increase will be in developing countries. Already 60% of people with dementia live in low and middle income countries, but by 2050 this will rise to 71%. The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours.
Demographic ageing is a worldwide process that shows the successes of improved health care over the last century. Many are now living longer and healthier lives and so the world population has a greater proportion of older people. Dementia mainly affects older people, although there is a growing awareness of cases that start before the age of 65.
There are over 10 million new cases of dementia each year worldwide, implying one new case every 3.2 seconds.
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Alzheimers Is The Only Top
- 1 in 3 seniors dies with Alzheimers or another dementia, killing more than breast and prostate cancer combined.
- Alzheimers disease is listed as the sixth leading cause of death in the U.S. States, but it may cause more deaths than is recognized by official sources.
- The COVID-19 pandemic caused Alzheimers deaths to increase by approximately 16% more than expected.
- Deaths due to Alzheimers between 2000 and 2019 have more than doubled, increasing 145%. During the same time period, deaths from heart disease increased 7.3%.
More Caregivers Will Be Needed
As the number of older Americans increases, so will the number of caregivers needed to provide care. The number of people 65 years old and older is expected to double between 2000 and 2030. It is expected that there will be 71 million people aged 65 years old and older when all baby boomers are at least 65 years old in 2030.
Currently, there are 7 potential family caregivers per adult. By 2030, there will be only 4 potential family caregivers per adult.
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Memory Loss & Other Symptoms Of Alzheimers
Trouble with memoryâspecifically difficulty recalling information that has recently been learnedâis often the first symptom of Alzheimerâs disease.
As we grow older, our brains change, and we may have occasional problems remembering certain details. However, Alzheimerâs disease and other dementias cause memory loss and other symptoms serious enough to interfere with life on day-to-day basis. These symptoms are not a natural part of getting older.
Alzheimer’s is not the only cause of memory loss. Many people have trouble with memory â this does NOT mean they have Alzheimer’s. There are many different causes of memory loss. If you or a loved one is experiencing symptoms of dementia, it is best to visit a doctor so the cause can be determined.
In addition to memory loss, symptoms of Alzheimerâs include:
- Trouble completing tasks that were once easy.
- Difficulty solving problems.
- Changes in mood or personality withdrawing from friends and family.
- Problems with communication, either written or spoken.
- Confusion about places, people and events.
- Visual changes, such trouble understanding images.
Family and friends may notice the symptoms of Alzheimerâs and other progressive dementias before the person experiencing these changes. If you or someone you know is experiencing possible symptoms of dementia, it is important to seek a medical evaluation to find the cause.
Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people. To learn more about clinical trials, watch this video from NIH’s National Library of Medicine.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
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Who Has Alzheimers Disease
- In 2020, as many as 5.8 million Americans were living with Alzheimers disease.1
- Younger people may get Alzheimers disease, but it is less common.
- The number of people living with the disease doubles every 5 years beyond age 65.
- This number is projected to nearly triple to 14 million people by 2060.1
- Symptoms of the disease can first appear after age 60, and the risk increases with age.
Down Syndromeand Other Intellectual Disabilities
Adults with Down syndrome are much more likely than the general population to develop dementia: after age 60, more than half will have dementia.6 People with other intellectual disabilities have rates of dementia similar to the general population however, like people with Down syndrome, they face additional challenges to getting care. The first challenge is assessing dementia when there is great variation in baseline functioning. People in this population are often cared for by their family members, who themselves are aging and perhaps facing declining health. Some stakeholders believe that it may be difficult to find supportive services to enable the person to live in the community.7
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Racial And Ethnic Minorities
Racial and ethnic minority populations comprise approximately 37% of the United States population,3 and the proportion of older adults who belong to minority groups is rising sharply.4 Many older adults from minority groups have limited proficiency in English. Some racial and ethnic minorities are differentially affected by Alzheimer’s disease. African-American and Hispanics are more likely than Whites to have Alzheimer’s disease and other dementias with African-Americans 2-3 times more likely to suffer from cognitive impairment, a difference that is more pronounced at younger ages.5 In addition, these populations suffer disproportionately from diabetes mellitus, stroke and other chronic illnesses complicating treatment. Thus understanding the role of co-morbidities is essential to early intervention, diagnosis and treatment. Rapid population increases, coupled with unmitigated health disparities’ are cause for special attention, particularly because racial and ethnic minority populations are significantly underrepresented among health and behavioral health professionals and related research. This lack of attention to diversity has contributed to health care disparities in the availability of, access to, and the provision of quality cultural and linguistic appropriate care.
How Does Alzheimer’s Disease Affect The Brain
Scientists continue to unravel the complex brain changes involved in Alzheimers disease. Changes in the brain may begin a decade or more before symptoms appear. During this very early stage of Alzheimers, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimers as well.
The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimers, damage is widespread and brain tissue has shrunk significantly.
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