Signs And Symptoms Of Alzheimer’s Disease
Alzheimer’s disease is a progressive condition, which means the symptoms develop gradually over many years and eventually become more severe. It affects multiple brain functions.
The first sign of Alzheimer’s disease is usually minor memory problems.
For example, this could be forgetting about recent conversations or events, and forgetting the names of places and objects.
As the condition develops, memory problems become more severe and further symptoms can develop, such as:
- confusion, disorientation and getting lost in familiar places
- difficulty planning or making decisions
- problems with speech and language
- problems moving around without assistance or performing self-care tasks
- personality changes, such as becoming aggressive, demanding and suspicious of others
- hallucinations; and delusions
- low mood;or anxiety
Read more about the symptoms of Alzheimer’s disease.
Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 6070% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Study Shows Link Between Alzheimers And Heart Disease
Recently, researchers discovered that Alzheimers is caused by amyloid beta proteins building up in the spaces between brain cells. While this causes noticeable symptoms in the brain first, this same protein plaque can build up around the heart.
This was discovered in a study that examined 22 patients with Alzheimers and 35 patients without, all of whom were 78 or 79 years old. The goal was to analyze the stiffness present in the hearts left ventricle; the thickest chamber of the heart responsible for transporting blood throughout the body.
During the study, published in the Journal of the American College of Cardiology, researchers discovered that those with Alzheimers had a thicker left ventricle than those without Alzheimers. This thickness was caused by the same plaque protein buildup that was building in the Alzheimers patients brains. The thickness can lead to various cardiovascular issues if and when the left ventricle becomes too thick to successfully pump blood through the body. As a result, this puts Alzheimers patients at a higher risk of heart attack and stroke.
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Cross Sectional Versus Longitudinal Studies
Studies with a longitudinal design are preferred over studies with a cross sectional design for several reasons. It is conceivable that information about risk factors may be systematically different between patients and controls. Patient data must come from a proxy, who might recall the medical history differently than a proxy of a control or the control himself. In addition, prevalence is determined by both the number of new cases over a given period of time, and by the duration of survival once patients have the disease. In analogy, findings of cross sectional studies can reflect the contribution a risk factor makes to developing dementia as well as to surviving after the dementia starts.
Another important issue in this respect is that risk factors may change over time. The impact of environmental factors, such as smoking, diet, physical activity, and vascular disease, may change over time both within an individual and across birth cohorts. Risk factors such as blood pressure change with ageing. Furthermore, the disease, once it has started, may in turn influence the risk factor. For example, the diet of a demented individual may change, when the person forgets to eat his or her meals on a regular basis. Therefore, the relationship between a risk factor and disease may differ depending on the age the risk factor is measured relative to the outcome.
Dementia In Older Adults
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- Dementia in Older Adults
As we get older, it takes us longer to learn new things and to recall information. Many of us worry that each time we struggle to remember a name, a word or an event, that this could be the first sign of Alzheimers disease or a related dementia. However, only about one per cent of people with age-related memory loss develop dementia. Dementia is a medical term for a set of symptoms. Whatever the cause of the dementia, symptoms may include:
- memory loss
- loss of understanding or judgment
- changes in how the person expresses their emotions
- changes in personality
- problems coping with daily living
- problems with speech and understanding language
- problems socializing.
Dementia is not a normal part of aging. It is an abnormal degeneration of the brain that leads to changes in a persons ability to think, speak, socialize and take part in normal daily activities. Detecting dementia early, and identifying the specific type, is crucial for providing proper care. An early diagnosis also gives you, your family and friends time to prepare and connect with the right resources in your community to help maintain your independence.
As a dementia progresses, different parts of the brain are affected leading to a range of changes and diminishing abilities. From what we know of dementia, abilities that are lost do not then return. Memory-enhancing drugs may, however, be able to maintain memory for a period of time.
What are the signs of dementia?
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Treatment Of Alzheimer’s Dementia
2.5.1 Pharmacologic treatment
None of the pharmacologic treatments available today for Alzheimer’s dementia slow or stop the damage and destruction of neurons that cause Alzheimer’s symptoms and make the disease fatal. The U.S. Food and Drug Administration has approved five drugs for the treatment of Alzheimer’s â rivastigmine, galantamine, donepezil, memantine, and memantine combined with donepezil. With the exception of memantine, these drugs temporarily improve cognitive symptoms by increasing the amount of chemicals called neurotransmitters in the brain. Memantine blocks certain receptors in the brain from excess stimulation that can damage nerve cells. The effectiveness of these drugs varies from person to person and is limited in duration.
Many factors contribute to the difficulty of developing effective treatments for Alzheimer’s. These factors include the slow pace of recruiting sufficient numbers of participants and sufficiently diverse participants to clinical studies, gaps in knowledge about the precise molecular changes and biological processes in the brain that cause Alzheimer’s disease, and the relatively long time needed to observe whether an investigational treatment affects disease progression.
2.5.2 Non-pharmacologic therapy
Managing Alzheimer’s Disease Behavior
Common behavioral symptoms of Alzheimers include sleeplessness, wandering, agitation, anxiety, and aggression. Scientists are learning why these symptoms occur and are studying new treatments drug and nondrug to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimers more comfortable and makes things easier for caregivers.
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Diagnosis Of Dementia Due To Alzheimer’s Disease
- Obtaining a medical and family history from the individual, including psychiatric history and history of cognitive and behavioral changes.
- Asking a family member to provide input about changes in thinking skills and behavior.
- Conducting problem-solving, memory and other cognitive tests, as well as physical and neurologic examinations.
- Having the individual undergo blood tests and brain imaging to rule out other potential causes of dementia symptoms, such as a tumor or certain vitamin deficiencies.
- In some circumstances, using PET imaging of the brain to find out if the individual has high levels of beta-amyloid, a hallmark of Alzheimer’s; normal levels would suggest Alzheimer’s is not the cause of dementia.
- In some circumstances, using lumbar puncture to determine the levels of beta-amyloid and certain types of tau in CSF; normal levels would suggest Alzheimer’s is not the cause of dementia.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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Compensating For Memory Loss
The same practices that contribute to healthy aging and physical vitality also contribute to a healthy memory. So, by taking steps early to prevent cognitive decline, youll also be improving all other aspects of your life as well.
Stay social. People who arent socially engaged with family and friends are at higher risk for memory problems than people who have strong social ties. Quality face-to-face social interaction can greatly reduce stress and is powerful medicine for the brain, so schedule time with friends, join a book club, or visit the local senior center. And be sure to put your phone away and focus fully on the people youre with if you want the full brain benefit.
Stop smoking. Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain. When you quit smoking, the brain quickly benefits from improved circulation.
Manage stress. Cortisol, the stress hormone, damages the brain over time and can lead to memory problems. But even before that happens, stress or anxiety can cause memory difficulties in the moment. When youre stressed out or anxious, youre more likely to suffer memory lapses and have trouble learning or concentrating. But simple stress management techniques can minimize these harmful effects.
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Genetic Testing For Alzheimer’s Disease
A blood test can identify which APOE alleles a person has, but results cannot predict who will or will not develop Alzheimer’s disease. Currently, APOE testing is used primarily in research settings to identify study participants who may have an increased risk of developing Alzheimer’s. This knowledge helps scientists look for early brain changes in participants and compare the effectiveness of possible treatments for people with different APOE profiles.
Genetic testing is also used by physicians to help diagnose early-onset Alzheimers disease and to test people with a strong family history of Alzheimers or a related brain disease.
Genetic testing for APOE or other genetic variants cannot determine an individuals likelihood of developing Alzheimers diseasejust which risk factor genes a person has. It is unlikely that genetic testing will ever be able to predict the disease with 100 percent accuracy, researchers believe, because too many other factors may influence its development and progression.
Some people learn their APOE status through consumer genetic testing or think about getting this kind of test. They may wish to consult a doctor or genetic counselor to better understand this type of test and their test results. General information about genetic testing can be found at:
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Pooled Estimates Of Prevalence
In 2000, prevalence data from 11 European population based studies were pooled to obtain stable estimates of prevalence of dementia in the elderly . Age standardised prevalence was 6.4% for dementia , 4.4% for AD, and 1.6% for VaD. Prevalence of dementia was higher in women than in men and nearly doubled with every five year increase in age: 0.8% in the group age 6569 years and 28.5% at age 90 years and older . Of all dementia cases, 54% suffered AD. Prevalence of AD showed the steepest increase with age, from 0.6% in the group age 6569 years to 22.2% in the group aged 90 years and older. VaD accounted for 16% of cases, and prevalence increased with age from 0.3% to 5.2% . More recently, prevalence rates for dementia were compared among 12 population based European studies. Crude prevalence rates varied between 5.9% and 9.4% . Again, an almost exponential increase with age and a female excessmostly after age 75was described.
Pooled prevalence of dementia by sex. Based on Lobo et al.
Frequently Misplacing Items And Not Being Able To Retrace Steps
Most people will lose items at some time, but they are usually able to locate them again by searching in logical locations and retracing their steps.
However, someone with Alzheimers disease may forget where they placed an item, especially if they put it in an unusual place. They may also be unable to retrace their steps to find the missing item. This can be distressing and may cause the person to believe that someone is stealing from them.
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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
Mortality Due To Any Cause
All-cause mortality rates increase with age. In 20132014, for Canadians with dementia, the rate was 75.5 deaths per 1,000 population in the 6569;years age group, and it reached 207.2 deaths per 1,000 population in the 85;years and older age group. However, as the overall mortality among Canadians with and without dementia increases later in life, mortality rates between the two groups tend to converge. In other words, the all-cause mortality rate ratios decrease with age. In 20132014, the rate ratio was 7.6 in the 6569;years age group, and it decreased to 2.9 in the 85;years and older age group.
Since 20032004, all-cause mortality rates have decreased among all Canadians. Among Canadians with dementia however, rates decreased at a slower pace. This is illustrated by the increasing rate ratios between 20032004 and 20132014. In 20132014, the age-standardized all-cause mortality rate was about four times higher among seniors with dementia compared to those without .
Figure;2: Age-standardized all-cause mortality rates and rate ratios among Canadians aged 65;years and older with and without diagnosed dementia, including Alzheimer’s disease, Canada, 20032004 to 20132014
Text description: Figure;2Figure;2: Age-standardized all-cause mortality rates and rate ratios among Canadians aged 65;years and older with and without diagnosed dementia, including Alzheimer’s disease, Canada, 20032004 to 20132014
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.
What Are The Risk Factors For Dementia
If you, or someone you know, has developed dementia, it is natural to ask why. It is not usually possible to say for certain, although a doctor may be able to say which factor might have contributed. In most cases a mixture of risk factors potentially avoidable and not will be responsible.;
Find out more about risk factors for dementia
Use our interactive tool to understand risk factors, and read more about the research evidence behind the newspaper headlines.
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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: