Latest Advances In Alzheimers Disease Fluid Biomarkers
The past several years have witnessed dramatic advances in the analysis of p-tau species in the CSF and plasma as potential AD biomarkers . Measurements of plasma tau phosphorylated at residues 181 and 217 in particular have shown that these tau species have remarkable accuracy as candidate biomarkers of AD diagnosis and progression, both in CSF and plasma . However, much work remains to be done in determining the validity of these biomarkers in diverse populations that have thus far been underrepresented in these studies.
What Is Alzheimer’s Disease
Alzheimers disease is the most common form of dementia, affecting up to 70% of all people with dementia. It was first recorded in 1907 by Dr Alois Alzheimer. Dr Alzheimer reported the case of Auguste Deter, a middle-aged woman with dementia and specific changes in her brain. For the next 60 years Alzheimers disease was considered a rare condition that affected people under the age of 65. It was not until the 1970s that Dr Robert Katzman declared that “senile dementia” and Alzheimers disease were the same condition and that neither were a normal part of aging.
Alzheimers disease can be either sporadic or familial.
Sporadic Alzheimer’s disease can affect adults at any age, but usually occurs after age 65 and is the most common form of Alzheimer’s disease.
Familial Alzheimers disease is a very rare genetic condition, caused by a mutation in one of several genes. The presence of mutated genes means that the person will eventually develop Alzheimer’s disease, usually in their 40’s or 50’s.
The Healthy Human Brain
Behind the ears and temples are the temporal lobes of the brain. These regions process speech and working memory, and also higher emotions such as empathy, morality and regret. Beneath the forebrain are the more primitive brain regions such as the limbic system. The limbic system is a structure that is common to all mammals and processes our desires and many emotions. Also in the limbic system is the hippocampus a region that is vital for forming new memories.
Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
You May Like: Can You Die From Alzheimer’s
Changes In Mood Or Emotion
The person may be more anxious, frightened or sad, and so at risk of depression. It is also common to become more irritable perhaps in frustration at lost abilities or easily upset. A person can often be more withdrawn, lack self-confidence and lose interest in hobbies or people.
Changes in behaviour are not common in early-stage dementia, other than in FTD. A person with behavioural variant FTD may lose their inhibitions and behave in socially inappropriate ways. They may also act impulsively and lose empathy for others.
Significant physical changes at this stage tend to be limited to DLB, where problems with movement are similar to Parkinsons disease. If someone with vascular or mixed dementia has a stroke, this can lead to weak limbs on one side.
Need help finding dementia information?
Everybody forgets things from time to time. But if you or other people are noticing that memory problems are getting worse, or affecting everyday life, it could be a sign of dementia.
Mapt Variation In Clinical Early
A subset of variants in MAPTencoding the microtubule-associated protein tau and the causative gene for chromosome 17-linked familial FTD with parkinsonism have been found in cases of early-onset dementia resembling clinical AD. In particular, the p.R406W variant is often associated with a clinical phenotype resembling EOAD . This phenotype may be connected to the observations that p.R406W tau can form the paired helical filaments that make up NFTs in AD and that individuals harboring the p.R406W variant have abnormal levels of p-tau217a marker that is otherwise very specific for ADin the absence of amyloid pathology . Independent of causative alleles, the rare p.A152T variant of MAPT has been identified in several individuals with sporadic EOAD after having previously been found to increase risk for both AD and FTD .
Fig. 3: Alzheimers disease tau pathology can be induced by distinct amyloids and specific MAPT variants.
You May Like: What Is Vascular Dementia And What Causes It
What You Can Do
If you think you notice the signs of Alzheimerâs in yourself or a loved one, the best thing to do is to talk to a doctor. They can let you know what the symptoms mean and what your options are for treating them. There are new advances available which can help with early detection and treatment. One is as simple as a blood test to determine the presence or absence of proteins that may indicate there are Alzheimer’s associated plaques in the brain.
Wandering Or Getting Lost
Wandering also features prominently as one of the warning signs of early-onset Alzheimers. Studies show that 6 in 10 people who have the disease will wander.
Persons with the illness may become disoriented because they cannot remember where they are coming from or their destination. This can make them get lost or wander even on familiar grounds.
A couple of factors may contribute to wandering. These include fear, following past routines like going to their favorite store, boredom, or wanting to satisfy basic needs like eating or using the toilet.
Wandering can pose safety issues if a person is not doing it in a controlled, safe environment. Caregivers should, therefore, come up with adequate preventive measures to deal with wandering.
Don’t Miss: Can Dementia Get Worse Suddenly
What Happens In The Early Stage Of Dementia
Dementia affects everyone differently and early symptoms are often relatively mild and not always easy to notice.
Many people at the early stage of dementia stay largely independent and only need a bit of assistance with daily living. It is important to focus on what the person can do and not to take over and do things for them. Instead, try doing things with them, for example helping the person develop a routine, reminder lists and prompts, and use technology.
For more information for people living with dementia, see the ‘Keeping active and involved‘ page.
The early stage of dementia is when many people choose to make plans for the future, while they still have the ability to do so. This includes making a Lasting power of attorney , and advance decisions and advance statements to ensure their wishes and preferences are made clear.
Putting Things In Strange Places
Everyone forgets where they put their keys every once in a while, and sometimes you’re so tired that you might accidentally put the milk in the cupboard. That’s totally normal! For those with Alzheimer’s, though, misplacing possessions and putting them in places that don’t make sense happens with startling frequency, according to the Mayo Clinic. And for more age-related health issues to be aware of, check out these 40 Things Doctors Say Affect Your Health After 40.
You May Like: How To Stop Dementia Patients From Spitting
Signs Of Mild Alzheimers Disease
In mild Alzheimers disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family. Problems can include:
- Memory loss
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Increased sleeping
- Loss of bowel and bladder control
A common cause of death for people with Alzheimers disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.
There is currently no cure for Alzheimers, though there are medicines that can treat the symptoms of the disease.
Difficulty Completing Familiar Tasks
Some people may experience a greater problem with concentration. Routine day-to-day tasks requiring critical thought may take longer as the disease progresses.
The ability to drive safely may also be called into question. If you or a loved one gets lost while driving a commonly traveled route, this may be a symptom of AD.
You May Like: How Do Anti Dementia Drugs Work
Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
What Can You Do About It
Unfortunately, there is no cure for Alzheimer’s or other forms of dementia. According to the Alzheimer’s Association, 1 in 10 seniors over the age of 65 has dementia. Though the disease affects each patient differently, most people with Alzheimer’s live only 4 to 8 years after diagnosis.
While you cannot reverse dementia or the damage it causes, there are ways to improve quality of life. Here are some simple tips for management that you can discuss with your doctor:
- Take prescription medications to counteract cognitive and behavioral symptoms such as anxiety, depression, and mood swings.
- Find support in the form of therapy, support groups, friends, or family to help develop coping mechanisms for cognitive and behavioral changes.
- Address safety issues in the home by installing safety bars in the bathroom and shower, automatic shut-off switches on appliances, and reminders to lock the door.
- Stay on top of co-existing conditions, working with your doctor to manage medical problems with the proper form of treatment.
- Follow a healthy diet that supports brain health and function. Focus on antioxidant-rich fruits and vegetables, natural sources of omega fatty acids, and foods high in fiber and protein.
- Talk to your doctor about taking supplements to support memory and cognitive function. Options you might consider include caprylic acid, coenzyme Q10, ginkgo biloba, phosphatidylserine, and omega-3 fatty acids.
Don’t Miss: Family Education For Dementia Patients
Early Warning Signs Of Alzheimers Disease Include:
- Difficulty recalling newly learned information
- Forgetting appointments
- Easily distracted
- Trouble with word recall or language comprehension
For most of us, forgetting things is just a normal part of aging, Garrett said. You dont need to worry about Alzheimers disease just because you forgot where you parked your car unless it happens all the time. But if youre consistently forgetting things, Id recommend that you contact your doctor.
There are many potential causes of Alzheimers-like symptoms, including brain injuries, stroke, heart disease, severe infections, sleep apnea, vitamin B12 deficiencies, and diabetes. So while Alzheimers disease has no known cure, many of the other dementia-causing conditions can be treated. Plus there are some medications and treatments that have had some success in slowing the progression of Alzheimers if theyre administered early. Thats why its important to see a doctor soon if youve noticed signs of memory disorders.
Early Symptoms Of Dementia
Misplaced your keys again? Forgot the title of that movie you saw last night? How can you tell whether you’re just having a âsenior moment,” or if there’s a more serious health problem to consider? Current treatments available for dementia are more effective when the condition is caught in its early stages, so it’s important to know when a âsenior moment” might really be a sign that it’s time to see your doctor.
You May Like: How To Take Coconut Oil For Alzheimer’s
Identification Of The Major Mendelian Early
A crucial genetic discovery in EOADwhich has been massively influential for the course of research into all forms of ADoccurred 30 years ago with the mapping of a missense variant in APP that segregated with disease in an autosomal-dominant EOAD family . Subsequent studies identified pathogenic variants in PSEN1 and PSEN2 in additional autosomal-dominant AD families . Analysis of LOAD families has more recently resulted in the identification of rare, risk-conferring variants and established pathogenic variants in APP, PSEN1, and PSEN2, thus suggesting that these genes may also be relevant for the more common, late-onset variety of AD . Additional studies using data from the AD Sequencing Project also provide suggestive evidence that rare variation in PSEN1 increases risk for LOAD . Given the potent influence that the amyloid cascade hypothesis has had on the field and on AD drug development, the finding that variants in these genes may also confer risk for LOAD provides important support for the generalizability of this hypothesis to all forms of AD.
Frequently Asked Questions About Dementia
Don’t Miss: What Is The Icd 10 Code For Dementia
Struggling To Adapt To Change
For someone in the early stages of dementia, the experience can cause fear. Suddenly, they cant remember people they know or follow what others are saying. They cant remember why they went to the store, and they get lost on the way home.
Because of this, they might crave routine and be afraid to try new experiences. Difficulty adapting to change is also a typical symptom of early dementia.
Limitations And Interpretation Of Genetic Studies Of Early
In the sections that follow, we highlight associations of several genes with clinical EOAD that are better known for their role in other neurodegenerative diseases. When interpreting the results of genetic studies of EOAD, it is important to ask several questions. First, is the phenotype in question clinically diagnosed EOAD or pathologically confirmed EOAD? If the former, is there good reason to believe the underlying neuropathology is AD? If such evidence is not presented, interpretation of the results should be shaped by the possibility that any identified variants may actually contribute to clinical EOAD via non-AD pathology. The importance of these questions is further highlighted by the broad spectrum of clinical EOADand particularly the atypical syndromeswhich may overlap with that of etiologically distinct neurodegenerative disorders. Finally, it is important to remain cognizant of the fact that many genetic studies have focused, for reasons of cost and practicality, on genes already known to be implicated in AD and other forms of dementia or neurodegeneration. The above factors and biases have cumulatively played an important role in shaping our current knowledge regarding the genetics of EOAD.
Recommended Reading: Can A Person Diagnosed With Dementia Change Their Will
Warning Signs Of Alzheimer’s
Memory often changes as people grow older. Some people notice changes in themselves before anyone else does. For other people, friends and family are the first to see changes in memory, behavior, or abilities. Memory loss that disrupts daily life is not a typical part of aging. People with one or more of these 10 warning signs should see a doctor to find the cause. Early diagnosis gives them a chance to seek treatment and plan for the future.
1. Memory loss that disrupts daily life: forgetting events, repeating yourself or relying on more aids to help you remember .
2.Challenges in planning or solving problems: having trouble paying bills or cooking recipes you have used for years.
3.Difficulty completing familiar tasks at home, at work, or at leisure: having problems with cooking, driving places, using a cell phone, or shopping.
4.Confusion with time or place: having trouble understanding an event that is happening later, or losing track of dates.
5.Trouble understanding visual images and spatial relations: having more difficulty with balance or judging distance, tripping over things at home, or spilling or dropping things more often.
The Centers for Disease Control and Prevention and the Alzheimers Association have created the Healthy Brain Initiatives State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map.
8. being a victim of a scam, not managing money well, paying less attention to hygiene, or having trouble taking care of a pet.
Signs Of Dementia Where To Find Help
When your loved one is displaying troubling symptoms, a trip to a primary care physician is often the first step. But to get a definitive diagnosis, youll need to see a specialist such as a neurologist, geriatrician or geriatric psychiatrist.
If you cant find one, the National Institute on Aging recommends contacting the neurology department of a nearby medical school. Some hospitals also have clinics that focus on dementia.
Ailments can mimic dementia
Specialists will want to know about the patients personal and family medical history. A close relative or relatives having had Alzheimers is a major risk factor.
Recent research suggests that a prevalence among even members of your extended family can increase your dementia risk. Doctors also will conduct physical and neurological exams to rule out other treatable causes for dementia symptoms.
Some of the methods that doctors use to diagnose dementia:
Cognitive and neuropsychological tests assess language and math skills, memory, problem-solving and other types of mental functioning.
Lab tests of blood and other fluids, including checking levels of various chemicals, hormones and vitamins, can help rule out nondementia causes for the symptoms.
Brain scans such as CT, MRI or PET imaging can spot changes in brain structure and function. These tests also can identify strokes, tumors and other problems that can cause dementia.
More on Dementia
Don’t Miss: How Is Alzheimer’s Spread Among Humans