The Process Of Remembering A Name
To learn a name, the first thing that we need to do is pay attention when we hear the name. Then the name typically goes into a short-term, temporary storage area, and finally into long-term storage.
When we want to recall the name, a cue or trigger, usually a face, is perceived by our eyes, processed, and then linked up with the long-term storage area and the name is retrieved. Sometimes retrieving the name occurs automatically, without effort, but at other times help is needed from an effortful search mechanism directed by our frontal lobes.
How Is Alzheimers Disease Treated
Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.
Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.
Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.
What Are The Warning Signs Of Alzheimers Disease
Watch this video play circle solid iconMemory Loss is Not a Normal Part of Aging
Alzheimers disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimers disease and related dementias.
In addition to memory problems, someone with symptoms of Alzheimers disease may experience one or more of the following:
- Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
- Trouble handling money and paying bills.
- Difficulty completing familiar tasks at home, at work or at leisure.
- Misplacing things and being unable to retrace steps to find them.
- Changes in mood, personality, or behavior.
Even if you or someone you know has several or even most of these signs, it doesnt mean its Alzheimers disease. Know the 10 warning signs .
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Causes And Risk Factors
Despite its prevalence and the amount of research into the disease, theres still much about Alzheimers that remains unclear. For a long time, scientists looking for the causes of Alzheimers focused mainly on the buildup of proteins in the brainamyloid that accumulates in plaques and tau that forms tangleswhich degenerate nerve connections and gradually destroy memory and thinking.
However, new evidence suggests that many other factors may also play a role in the development of the disease, such as inflammation, immunity impairment, exposure to toxins, and changes in the way the brain handles glucose. Since women experience Alzheimers at significantly higher rates than men, its possible hormonal changes could also contribute to the disease.
With the exception of early-onset Alzheimers, the disease is most likely triggered by a combination of advancing age and genetic, environmental, and lifestyle factors.
What Does Alzheimers Disease Look Like
Memory problems are typically one of the first signs of Alzheimers, though initial symptoms may vary from person to person. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. Mild cognitive impairment is a condition that can be an early sign of Alzheimers, but not everyone with MCI will develop the disease.
People with Alzheimers have trouble doing everyday things like driving a car, cooking a meal, or paying bills. They may ask the same questions over and over, get lost easily, lose things or put them in odd places, and find even simple things confusing. As the disease progresses, some people become worried, angry, or violent.
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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.
Slowing The Progression Of Symptoms
The same healthy lifestyle changes that are used to prevent Alzheimers disease can also be useful in slowing the advancement of symptoms.
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Impact On Families And Carers
In 2019, informal carers spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming . Physical, emotional and financial pressures can cause great stress to families and carers, and support is required from the health, social, financial and legal systems. Fifty percent of the global cost of dementia is attributed to informal care.
Alzheimer’s Disease And Name Recall
Alzheimers disease can damage the hippocampus, anterior temporal lobes, and frontal lobes. For this reason, in Alzheimers, there can be difficulty paying attention when we are learning the name, difficulty storing the name in both our short-term and long-term memory, as well as difficulty in retrieving the name. What’s different from normal aging is that the name is often never properly stored or it is completely lost. Thus, in Alzheimers disease, even when a hint or cue is given, the name may not be able to be retrieved.
Names are difficult for everyone to remember but are particularly hard for older adults and those with brain diseases such as Alzheimers. The good news is that there are many strategies and techniques to help everyone better remember names. I will discuss these strategies in future posts.
References
Budson AE, Solomon PR. Memory Loss, Alzheimers Disease, & Dementia: A Practical Guide for Clinicians, 2nd Edition, Philadelphia: Elsevier Inc., 2016.
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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.
What Is Known About Alzheimers Disease
Scientists do not yet fully understand what causes Alzheimers disease. There likely is not a single cause but rather several factors that can affect each person differently.
- Age is the best known risk factor for Alzheimers disease.
- Family historyresearchers believe that genetics may play a role in developing Alzheimers disease. However, genes do not equal destiny. A healthy lifestyle may help reduce your risk of developing Alzheimers disease. Two large, long term studies indicate that adequate physical activity, a nutritious diet, limited alcohol consumption, and not smoking may help people. To learn more about the study, you can listen to a short podcast.
- Changes in the brain can begin years before the first symptoms appear.
- Researchers are studying whether education, diet, and environment play a role in developing Alzheimers disease.
- There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. Heres 8 ways.
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Understanding The Different Stages Of Alzheimers Disease
Understanding the different stages of Alzheimers can help you to track the progression of symptoms and plan appropriate care. However, its important to remember that everyone with Alzheimers disease progresses differently and there are steps you can take to slow the onset of symptoms at each stage.
Also, cognitive, physical, and functional phases often overlap, the time in each stage varies from patient to patient, and not everyone experiences all symptoms.
Two commonly used models of Alzheimers progression are the 3-stage model and 7-stage model.
What Is Alzheimer Disease
Alzheimer disease, which affects some older people, is different from everyday forgetting. It is a condition that permanently affects the brain. Over time, the disease makes it harder to remember even basic stuff, like how to tie a shoe.
Eventually, the person may have trouble remembering the names and faces of family members or even who he or she is. This can be very sad for the person and his or her family.
It’s important to know that Alzheimer disease does not affect kids. It usually affects people over 65 years of age. Researchers have found medicines that seem to slow the disease down. And there’s hope that someday there will be a cure.
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Emotion And Behavior Treatments
The emotional and behavioral changes linked with Alzheimers disease can be challenging to manage. People may increasingly experience irritability, anxiety, depression, restlessness, sleep problems, and other difficulties.
Treating the underlying causes of these changes can be helpful. Some may be side effects of medications, discomfort from other medical conditions, or problems with hearing or vision.
Identifying what triggered these behaviors and avoiding or changing these things can help people deal with the changes. Triggers may include changing environments, new caregivers, or being asked to bathe or change clothes.
It is often possible to change the environment to resolve obstacles and boost the persons comfort, security, and peace of mind.
The Alzheimers Association offer a list of helpful coping tips for caregivers.
In some cases, a doctor may recommend medications for these symptoms, such as:
- antidepressants, for low mood
develops due to the death of brain cells. It is a neurodegenerative condition, which means that the brain cell death happens over time.
In a person with Alzheimers, the brain tissue has fewer and fewer nerve cells and connections, and tiny deposits, known as plaques and tangles, build up on the nerve tissue.
Plaques develop between the dying brain cells. They are made from a protein known as beta-amyloid. The tangles, meanwhile, occur within the nerve cells. They are made from another protein, called tau.
- aging
Dementia With Lewy Bodies
Initial symptoms: Dementia with Lewy bodies is a type of Lewy body dementia. Dementia with Lewy bodies involves both body symptoms such as motor and muscle weakness and rigidity, as well as brain symptoms like making decisions, memory impairment, and attention span.
In dementia with Lewy bodies, the brain symptoms develop before the body symptoms, at the same time or less than a year after the body symptoms present.
Progression: Dementia with Lewy bodies can vary quite a bit, even from day to day. However, in general the disease starts slowly and worsens gradually.
Prognosis: Average life expectancy depends on many factors but is estimated to be approximately 5 to 8 years after diagnosis.
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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.
Stages Of Alzheimers Disease: 7
In addition to the three stages of Alzheimers, your doctor may also use a diagnostic framework with five, six, or seven levels. Progression through these stages usually lasts from 8 to 10 years, but again, differs from person to person and can stretch out for as long as 20 years.
Sample 7-stage model of Alzheimers disease:
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When Someone You Love Has Alzheimer Disease
You might feel sad or angry or both if someone you love has Alzheimer disease. You might feel nervous around the person, especially if he or she is having trouble remembering important things or can no longer take care of himself or herself.
You might not want to go visit the person, even though your mom or dad wants you to. You are definitely not alone in these feelings. Try talking with a parent or another trusted adult. Just saying what’s on your mind might help you feel better. You also may learn that the adults in your life are having struggles of their own with the situation.
If you visit a loved one who has Alzheimer disease, try to be patient. He or she may have good days and bad days. It can be sad if you can’t have fun in the same ways together. Maybe you and your grandmother liked to go to concerts. If that’s no longer possible, maybe bring her some wonderful music and listen together. It’s a way to show her that you care and showing that love is important, even if her memory is failing.
Medications To Treat The Underlying Alzheimer’s Disease Process
Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.
Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.
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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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Other Causes Of Alzheimers Symptoms
Other conditions can mimic early Alzheimers symptoms, such as:
Central nervous system and other degenerative disorders, including head injuries, brain tumors, stroke, epilepsy, Picks Disease, Parkinsons disease, and Huntingtons disease.
Metabolic ailments, such as hypothyroidism, hypoglycemia, malnutrition, vitamin deficiencies, dehydration, and kidney or liver failure.
Substance-induced conditions, such as drug interactions, medication side-effects, alcohol and drug abuse.
Psychological factors, such as depression, emotional trauma, chronic stress, psychosis, chronic sleep deprivation, and delirium.
Infections, such as meningitis, encephalitis, and syphilis.
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