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.
Medicines To Treat Challenging Behaviour
In the later stages of dementia, a significant number of people will develop what’s known as behavioural and psychological symptoms of dementia .
The symptoms of BPSD can include:
- increased agitation
- delusions and hallucinations
These changes in behaviour can be very distressing for both the person with Alzheimer’s disease and their carer.
If coping strategies do not work, a consultant psychiatrist can prescribe risperidone or haloperidol, antipsychotic medicines, for those showing persistent aggression or extreme distress.
These are the only medicines licensed for people with moderate to severe Alzheimer’s disease where there’s a risk of harm to themselves or others.
Risperidone should be used at the lowest dose and for the shortest time possible as it has serious side effects. Haloperidol should only be used if other treatments have not helped.
Antidepressants may sometimes be given if depression is suspected as an underlying cause of anxiety.
Sometimes other medications may be recommended to treat specific symptoms in BPSD, but these will be prescribed “off-label” .
It’s acceptable for a doctor to do this, but they must provide a reason for using these medications in these circumstances.
What Effects Can These Drugs Have
They can improve memory. They can also have general benefits including improving alertness and motivation.
It may take some months for there to be a noticeable improvement or slowing down of memory loss. Some people feel brighter in their mood and will be able to do things that were too hard for them, such as going shopping.
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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.
Treatment For Mild To Moderate Alzheimers
Treating the symptoms of Alzheimers can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimers symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.
Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimers disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimers progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimers may respond better to one drug versus another.
Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimers before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.
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How These Drugs Work
These drugs may work for some people but not others, and they do not stop the progression of Alzheimers disease. Instead, the drugs may delay it or help with symptom control for a period of time, particularly in the earlier stages of the disease. This action, in turn, may help patients with their attention and focus, cognitive abilities, memory, and communication skills.
Currently Studied Dmts For Ad
Amyloid-related mechanismsDMTs
The crucial step in AD pathogenesis is the production of amyloid , which forms SPs . The A derives from a protein overexpressed in AD, APP through sequential proteolysis by -secretase in the extracellular domain and -secretase in the transmembrane region. Full-length APP is first cleaved by -secretase or -secretase. The APP cleavage by -secretase leads to nonamyloidogenic pathway, whereas APP cleavage by -secretase leads to amyloidogenic pathway. Sequential cleavage of APP by BACE1 in the extracellular and -secretase in the transmembrane area results in the A production. Major sites of -secretase cleavage usually occur in positions 40 and 42 of A, thus A40 and A42 oligomers are the main products of the sequential APP cleavage, as the amyloidogenic pathway is favored in neurons because of the greater plentifulness of BACE1. On the contrary, the nonamyloidogenic processing is more favored in other cells without BACE1 predominance.5
Consequently, anti-amyloid DMTs have focused on 3 major MOAs: reduction of A42 production , reduction of A-plaque burden , and promotion of A clearance .10
Reduction of A42 production
-secretase inhibitors
BACE inhibitors
Two BACE inhibitors are still elaborated: elenbecestat in phase 2 and umibecestat in phase 3.4 The later agent is studied in asymptomatic individuals at risk of developing AD .45
-secretase modulators
Reduction of A-plaque burden
Aggregation inhibitors
Promotion of A clearance
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This is not the first time something like this has happened. When antibody-based Alzheimers drugs were first created, one of the major side effects was that a subset of patients developed lesions in their brains. The lesions were generally small but would cause swelling in the brain. This phenomenon was labeled amyloid-related imaging abnormalities . As of now, there are several procedures used to monitor ARIA in patients taking antibody-based Alzheimers drugs, but because ARIA is typically asymptomatic and rare, it hasnt stopped the progress of most clinical trials.
Since less than 10% of patients who received lecanemab during early trials developed any sign of ARIA, Eisei and Biogen plan to continue their clinical trials of lecanemab and will now be including patients on blood thinners. This will hopefully allow the biotech and pharmaceutical companies to fully establish what the risks are for patients taking lecanemab, especially patients that represent a more diverse trial population with different pre-existing conditions.
In addition to Aduhelm, Gantenerumab is a promising antibody-based treatment that is in the midst of a long-term clinical study. The overall goal of the study is to follow patients taking the drug over the course of four years to determine how the drug improves memory, daily function, and overall cognition.
What Is Known About Reducing Your Risk Of Alzheimers Disease
The science on risk reduction is quickly evolving, and major breakthroughs are within reach. For example, there is growing evidence that people who adopt healthy lifestyle habits like regular exercise and blood pressure management can lower their risk of dementia. 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. To learn more about the current state of evidence on dementia risk factors and the implications for public health, please read the following summaries on Cardiovascular Health, Exercise, Diabetes and Obesity, Traumatic Brain Injury , Tobacco and Alcohol, Diet and Nutrition, Sleep, Sensory Impairment, and Social Engagement or the Compiled Report .
Aging
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Referral To A Specialist
Your GP may refer you to a specialist memory assessment service to help with your diagnosis. Memory clinics are staffed by professionals from multiple disciplines who are experts in diagnosing, caring for and advising people with dementia and their families.
Memory clinic staff can include the following, depending on your local area:
- a nurse usually a trained mental health nurse who specialises in diagnosing and caring for people with dementia
- a psychologist a healthcare professional who specialises in the assessment and treatment of mental health conditions
- a psychiatrist a qualified medical doctor who has training in treating mental health conditions
- a neurologist a specialist in treating conditions that affect the nervous system
- a geriatrician a physician with specialist training in the care of older people
- a social worker a trained member of staff able to advise and assist with accessing social services within the local area
- an occupational therapist a member of staff with specialist skills in assessing and supporting people with dementia and their families with adjusting to disabilities
There’s no simple and reliable test for diagnosing Alzheimer’s disease, but the staff will listen to the concerns of both you and your family about your memory or thinking. They will assess your skills and arrange more tests to rule out other conditions.
Pd Dementia And Safety Concerns
Safety issues should be considered and monitored from the time of diagnosis. As PDD progresses, ensure that your loved one is not left alone and try to:
- Evaluate driving privileges before safety is a concern. Your doctor can make a driving evaluation referral.
- Work out legal and financial issues and safeguard finances. People with dementia are at greater risk of falling victim to scams and fraud.
- Minimize prescription risks. Confirm with the doctor the medication names and doses of the person with PD. If the person is in dementias early stages and capable, fill up their weekly pill box together and monitor use.
- Look into medical alert systems. These systems can be critical in the event of a fall or if your loved one wanders outside of the home. Many types of systems are available, from bracelets and pendants to smartwatches with fall detection and one-button connections to 911.
- Evaluate gun safety. If your loved one owns a firearm or has one in the home, consider bringing it up with their doctor and taking additional safety precautions.
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How Green Tea Red Wine Compounds Fight Off Toxic Plaques In Brain Linked To Alzheimers
MEDFORD, Mass. A new Alzheimers study has found two compounds that reduce the buildup of harmful plaques in the brain one of hallmarks of the disease. Importantly, these compounds are common ingredients in two popular drinks: green tea and red wine.
A team from Tufts University discovered that green tea catechins and resveratrol inhibit growth of sticky beta amyloid plaques. When this protein clumps together in the brain, it disrupts neural cells and leads to the telltale signs of Alzheimers, such as memory loss and confusion.
Previously, the same team discovered that the common herpes virus may play a role in causing these plaques to form in the brain. Using a 3D model of living human brain cells, the new study tested 21 different compounds which had the potential to slow Alzheimers progression. Some of these candidates tried to stop Alzheimers by acting as an antiviral agent against Alzheimers triggered by a herpes virus.
Finding such a compound that could diminish the plaques regardless of the virus component would be ideal, because that would show that regardless of the cause of Alzheimers, you might still see some kind of improvement, says lead researcher Dana Cairns, a research associate in the Kaplan Lab in the School of Engineering, in a university release.
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Treatment Of Alzheimer’s Disease
However, treatment of Alzheimer’s disease with either – or 2-adrenergic agonists has proven ineffective, and has even exacerbated pathology, suggesting that cognitive dysfunction cannot be wholly attributed to a loss of norepinephrine or adrenergic receptor activity (Riekkinen et al., 1999
G.Z. Feuerstein, … L.J. Rutkowski, in, 2007
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Can You Prevent Alzheimers Disease
There is no sure way to prevent Alzheimers disease. However, you can reduce the risk of Alzheimers disease by caring for your health:
- your heart whats good for your heart is good for your brain so stick to a healthy diet and dont smoke
- your body regular physical activity increases blood flow to the brain so maintain an active lifestyle
- your mind an active mind helps build brain cells and strengthens their connections so socialise, do things such as puzzles and crosswords, and learn new things, such as a language
What Are The Warning Signs Of Alzheimers Disease
Watch this video Memory 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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Reminiscence And Life Story Work
Reminiscence work involves talking about things and events from your past. It usually involves using props such as photos, favourite possessions or music.
Life story work involves a compilation of photos, notes and keepsakes from your childhood to the present day. It can be either a physical book or a digital version.
These approaches are sometimes combined. Evidence shows they can improve mood and wellbeing.
Find out how to live well with dementia and more useful information in the NHS Dementia Guide.
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
What Is Alzheimer’s Disease
Alzheimers disease is a brain disorder that cannot be stopped or reversed. The disease severely affects memory, thinking, learning and organizing skills and eventually affects a persons ability to carry out simple daily activities. Alzheimers disease is not a normal part of the aging process.
Alzheimers is a disease whose symptoms worsen over time. In fact, scientists believe the disease process may go on for 10 years or longer before the first symptoms of Alzheimers disease appear.
When memory problems do begin to be noticeable, they are often identified as mild cognitive impairment . At this stage, intellectual function is affected but the ability to function and live independently remain intact as the brain compensates for disease-related changes.
In some people, MCI can hold steady at this stage. However, people with MCI are at high risk for progressing to dementia. Alzheimers disease is the most common form of dementia. With dementia, in contrast to MCI, daily function is affected.
As dementia due to Alzheimers disease progresses to late stages, affected individuals cannot carry on a conversation, recognize family and friends, or care for themselves.
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Treatment Of Moderate To Severe Disease
The partial N-methyl-D-aspartate antagonist memantine is believed to work by improving the signal-to-noise ratio of glutamatergic transmission at the NMDA receptor. Blockade of NMDA receptors by memantine is thought to slow the intracellular calcium accumulation and thereby help prevent further nerve damage. This agent is approved by the FDA for treating moderate and severe AD.
Several studies have demonstrated that memantine can be safely used in combination with ChEIs. The combination of memantine with a ChEI has been shown to significantly delay institutionalization in AD patients. Studies suggest that the use of memantine with donepezil affects cognition in moderate to severe AD but not in mild to moderate AD. A once-daily, fixed-dose combination of memantine extended-release and donepezil was approved by the FDA in 2014. Dizziness, headache, and confusion are some of the most common side effects of memantine.
In June 2013, the FDA approved rivastigmine transdermal for severe AD. Approval was based on the ACTION study, in which a higher dose of the drug demonstrated statistically significant improvement in overall cognition and function compared with a lower dose .
How Alzheimers Disease Research Is Helping Scientists Find Ways To Better Diagnose Prevent Treat And Ultimately Cure Alzheimers
NORTHAMPTON, UK / ACCESSWIRE / November 10, 2022 / America’s Charities – There are over 6 million Americans living with Alzheimer’s disease today and by 2050, that number may reach over 14 million. This means it’s likely to affect people we know, including our friends and loved ones. Alzheimer’s Disease Research, a BrightFocus Foundation program, believes supporting early-career scientists’ bold ideas through research holds tremendous hope that one day, we will end this terrible disease.
Since Alzheimer’s Disease Research was founded, we have advanced innovative science by supporting over 860 projects involving more than 2,624 scientists. This work has led to better understanding of the causes and progression of Alzheimer’s, improved diagnostic tools, and important preventive measures people can take to help reduce their risk of this disease.
The test was developed by Alzheimer’s Disease Research grant recipients Phillip Verghese, PhD, and Joel Braunstein, MD, MBA, who built upon the work of previous grantees David Holtzman, MD, and Randall Bateman, MD. Dr. Braunstein said, “The best chance we have for treating Alzheimer’s disease will come from earlier detection and earlier intervention. We are grateful to Alzheimer’s Disease Research for being such a strong supporter every step of the way.”
If you’re a military or federal employee, you can support Alzheimer’s Disease Research through the Combined Federal Campaign . Our CFC number is 30518.
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