How Is Alzheimers Diagnosed And Treated
Doctors may ask questions about health, conduct cognitive tests, and carry out standard medical tests to determine whether to diagnose a person with Alzheimers disease. If a doctor thinks a person may have Alzheimers, they may refer the person to a specialist, such as a neurologist, for further assessment. Specialists may conduct additional tests, such as brain scans or lab tests of spinal fluid, to help make a diagnosis. These tests measure signs of the disease, such as changes in brain size or levels of certain proteins.
There is currently no cure for Alzheimers, though there are several medicines approved by the U.S. Food and Drug Administration that can help manage some symptoms of the disease along with coping strategies to manage behavioral symptoms. In 2021, FDA provided accelerated approval for a new medication, aducanumab, that targets the protein beta-amyloid, which accumulates abnormally in the brains of people with Alzheimers. The new medication helps to reduce amyloid deposits, but has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.
Most medicines work best for people in the early or middle stages of Alzheimers. Researchers are exploring other drug therapies and nondrug interventions to delay or prevent the disease as well as treat its symptoms.
What Are The Types Of Dementia
Dementias are often broken down into two main categories — Alzheimer type or non-Alzheimer type. Dementias of the Alzheimers disease type are defined by the symptoms of memory loss plus impairment in other brain functions, such as language function inability to move the muscles associated with speech or perception, visual or other inabilities to recognize speech or name objects .
Non-Alzheimer dementias include the frontotemporal lobar degenerations, which are further broken down into two main types. One type primarily affects speech. An example is primary progressive aphasia syndromes. The other type is defined by changes in behavior, including lack of feeling, emotion, interest or concern loss of a social filter personality change and loss of executive functions . In both of these frontotemporal lobe dementias, memory loss is relatively mild until later in the course of the disease.
Other non-Alzheimers disease dementias include vascular disorders , dementia with Lewy bodies, Parkinson’s dementia, and normal pressure hydrocephalus.
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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Symptoms Of Alzheimers Disease
Alzheimers disease typically starts slowly and the symptoms can be very subtle in the early stages. As the disease progresses, symptoms become more noticeable and interfere with daily life. The disease affects each person differently and the symptoms vary.Common symptoms include:
- persistent and frequent memory loss, especially of recent events
- vagueness in everyday conversation
- being less able to plan, problem-solve, organise and think logically
- language difficulties such as finding the right word and understanding conversations
- apparent loss of enthusiasm for previously enjoyed activities
- taking longer to do routine tasks
- becoming disoriented, even in well-known places
- inability to process questions and instructions
- deterioration of social skills
- emotional unpredictability
- changes in behaviour, personality and mood.
Symptoms vary as the disease progresses and different areas of the brain are affected. A persons abilities may fluctuate from day to day, or even within the one day, and can become worse in times of stress, fatigue or ill health.The stages of Alzheimers disease progress from mild Alzheimers disease to moderate Alzheimers disease and then severe Alzheimers disease. During severe Alzheimers disease, people need continuous care. The rate of progression between these stages differs between people.
We May Finally Know What Causes Alzheimers And How To Stop It
Alzheimers disease has destroyed neurons in the right-hand brain above
Jessica Wilson/Science Photo Library
AFTER decades of disappointment, we may have a new lead on fighting Alzheimers disease. Compelling evidence that the condition is caused by a bacterium involved in gum disease could prove a game-changer in tackling one of medicines biggest mysteries, and lead to effective treatments or even a vaccine.
As populations have aged, dementia has skyrocketed to become the fifth biggest cause of death worldwide. Alzheimers constitutes some 70 per cent of these cases , yet we dont know what causes it. The condition, which results in progressive loss of memory and cognitive function, usually over a decade or so, is devastating both to those who have it and to their loved ones.
The condition often involves the accumulation of two types of proteins called amyloid and tau in the brain. As these are among the earliest physical signs of the disease, the leading hypothesis since 1984 has been that the condition is caused by the defective control of these proteins, especially amyloid, which accumulates to form large, sticky plaques in the brain.
The bulk of research into understanding and treating Alzheimers has centred on this amyloid hypothesis. Huge sums of money have been invested in experiments involving mice genetically modified to produce amyloid, and in developing drugs that block or destroy amyloid proteins, or sometimes degraded tangles of tau.
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How Is Alzheimers Disease Diagnosed
Unfortunately, there is no single test that can confirm Alzheimers disease. A diagnosis comes after careful assessment. This may involve:
- a detailed medical history
- urine and blood tests
- medical imaging, such as an MRI scan to assess shrinking of the brain
After eliminating other possible causes of symptoms , a clinical diagnosis of Alzheimers can be made.
An early diagnosis allows your doctor to work out if there is another cause of your symptoms that may be treatable. If a diagnosis of Alzheimers disease is most likely, you can start to discuss medical treatment and further assistance to help slow the degenerative process.
Take Part In Dementia Research
There are many dementia research projects and clinical trials going on around the world, many of which are based in the UK.
If you have a dementia diagnosis or are worried about memory problems, you can help scientists understand more about it, and develop possible treatments, by taking part in research.
Carers can also take part, as there are studies into the best ways to care for someone with a dementia diagnosis.
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What Are The Symptoms Of Early
For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.
Withdrawal from work and social situations
Changes in mood and personality
Severe mood swings and behavior changes
Deepening confusion about time, place, and life events
Suspicions about friends, family, or caregivers
Trouble speaking, swallowing, or walking
Severe memory loss
Causes Of Dementia With Lewy Bodies
Lewy bodies are tiny clumps of a protein called alpha-synuclein that can develop inside brain cells.
These clumps damage the way the cells work and communicate with each other, and the brain cells eventually die.
Dementia with Lewy bodies is closely related to Parkinson’s disease and often has some of the same symptoms, including difficulty with movement and a higher risk of falls.
Read more about dementia with Lewy bodies.
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Dementia Can Be Hard To Diagnose Early On
Dr. William Nields, medical director of Cognitive Health Centers in Sarasota, Florida told US News, “The symptoms are very subtle in the beginning and almost unnoticeable. For that reason, most people are not diagnosed with Alzheimer’s or one of the other many brain diseases that causes dementia until they’ve already progressed into their mid-stage.” He also stated, “In the case of Alzheimer’s Disease, beta amyloid plaques may be building up in the brain 20 years before dementia, and years before symptoms are even present,” Nields says. Dementia is typically diagnosed after “significant cognitive decline has occurred and a person has difficulty caring for themselves.”
Research Into Other Causes Of Dementia
Dementia is also associated with other conditions such as AIDS, Creutzfeld-Jakob disease, chronic alcohol abuse, Down Syndrome, Huntingtons disease and Parkinsons disease.
- A genetic component has been found for a very rare subtype of Creutzfeld-Jakob disease.
- Individuals with Down Syndrome have an extra copy of chromosome 21, which contains the gene for the Amyloid Precursor Protein, increasing their likelihood of developing Alzheimers disease.
- Huntingtons disease is caused by a mutation in the gene that codes for the huntingtin protein. Everyone who inherits the mutated version of this gene will eventually develop the disease. Dementia occurs in the majority of cases.
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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.
How Does Alzheimers Develop
Research suggests that changes in the brain can occur up to ten years before a person starts to show symptoms of Alzheimers disease. The symptoms are usually mild at the beginning and gradually worsen over time. These may include:
- difficulty remembering recent events while having a good memory for past events
- poor concentration
- difficulty recognising people or objects
- poor organisation skills
- slow, muddled or repetitive speech
- withdrawal from family and friends
- problems with decision making, problem solving, planning and sequencing tasks
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Research Into The Cause Of Frontotemporal Dementia
Frontotemporal dementia is the name given to a group of dementias when there is degeneration in one or both of the frontal or temporal lobes of the brain. The behavioural variant of frontotemporal dementia involves the frontal lobes and includes Picks disease. The language variant involves the temporal lobes and includes Progressive non-fluent aphasia and Semantic dementia.
The genetics of frontotemporal dementia are not fully understood and are the subject of ongoing research. About 30% of people with frontotemporal dementia have a family history of the disease. Only about 15% have a known genetic mutation that causes the disease. Mutations have been identified in the MAPT and PGN genes on chromosome 17, which code for the tau and progranulin proteins respectively. Other genes such as VCP and CHMP2B have been found to be affected in several rare cases of the disorder.
These gene mutations are inherited in an autosomal dominant pattern. This means that each child of someone with the mutation has a 50% chance of inheriting it. Those with the mutation are destined to develop the dementia. Together, the MAPT and PGN gene mutations account for about half of the cases of familial frontotemporal dementia. This means that there are other responsible genes yet to be discovered.
For more information about research into frontotemporal dementia, visit the website of Frontier research group on frontotemporal dementia at Brain Mind Centre.
Alzheimer’s Disease Is The Leading Cause Of Dementia
Alzheimer’s is a progressive disease of the brain that causes memory loss and can and a decline in social, thinking and behavioral skills. According to Dr. Wally Wazni, Neurologist and Medical Director of the Comprehensive Stroke Center with Dignity Health St. Mary in Long Beach, it’s the leading cause of dementia. He explains, “The most common cause of cognitive decline in adults age 35 and older is Alzheimer’s disease. Alzheimer’s is usually a disease of the elderly and the chances of getting it increases tremendously with age over 65 years. For people between 65 and 70 the risk is 2 in every 100 people have dementia. As we age, our risk roughly doubles every five years. This means that someone over 90 years old has a 33 % chance of having dementia.” He adds, “We have been making strides at treatment for Alzheimer’s disease. Most notably is Aducanumab is approved by the US Food and Drug Administration for the treatment of mild Alzheimer’s. Aduhelm is an amyloid beta-directed antibody indicated to treat Alzheimer’s disease. Aducanumab reduces amyloid beta plaques, the accumulation of which is a defining pathophysiological feature of Alzheimer’s disease. While Aduhelm appears highly effective in reducing brain amyloid levels, it is uncertain that patients will actually benefit clinically from treatment. In addition, aducanumab has known risks that require close monitoring with clinical and imaging assessments.” Keep reading to see if you’re at risk.
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Can Genes Cause Dementia
Around 1 in 4 people aged 55 years and over has a close birth relative with dementia. Find out what part genes play in dementia and how genetics can affect the risk of developing the condition.
It is well known that children can take after their parents for example, in the way they look. This is partly because many of the key characteristics of a person are passed down from parents to children in their genes.
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.
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Prevention And Lifestyle Changes That Help Reduce The Risk Of Dementia
With a few key lifestyle changes, we can reduce the risk of dementia according to Dr. Michael Hirt, Board Certified Nutrition from Harvard University and Board Certified in Internal Medicine and is with The Center for Integrative Medicine in Tarzana California. He also states that s Alzheimer’s is the number cause of dementia, “which is linked to a gene which in turn can be activated by excessive dietary sugar, fat, and alcohol. A simple blood test can determine if you have this genetic variant, and if you do, changing your diet today can change your destiny tomorrow.” He recommends the following:
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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Research Into The Cause Of Alzheimers Disease
The role of plaques and tangles in Alzheimers disease
The biological causes of Alzheimer’s disease are not fully understood and research continues to examine factors involved in the development of Alzheimer’s disease.
The two most common hallmarks of Alzheimer’s disease in the brain are beta-amyloid plaques and neurofibrillary tangles. The role of plaques and tangles in Alzheimer’s disease is not fully understood. Both are present in the brains of older people who do not have Alzheimer’s disease, although they are more widespread and predominant in the brains of people with Alzheimer’s disease. Research is ongoing to determine more about the role of both plaques and tangles in the development of Alzheimer’s disease.
In Alzheimer’s disease, sticky beta-amyloid fragments clump together and form the basis of plaques. Recent research suggests that smaller clumps of beta-amyloid known as oligomers may actually be more toxic than the plaques. Researchers continue to study many aspects of beta-amyloid to establish its role in Alzheimer’s disease, including the mechanisms of plaque formation, and how plaques might be removed from the brain.
The genetics of Alzheimer’s disease
Comprehensive information about the research into the genetics of Alzheimers disease is available at the AlzGene website.
Genes that cause Alzheimers disease
Genetic risk factors for Alzheimers disease
The role of inflammation in Alzheimers disease
Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.
This can happen as a result of:
- narrowing and blockage of the small blood vessels inside the brain
- a single stroke, where the blood supply to part of the brain is suddenly cut off
- lots of “mini strokes” that cause tiny but widespread damage to the brain
Not everyone who has a stroke will go on to develop vascular dementia.
Read more about vascular dementia.
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