Highlights From The Canadian Chronic Disease Surveillance System
According to the World Health Organization, 47.5 million people live with dementia, including Alzheimer’s disease, worldwide.Footnote 1 As these conditions progress, they become highly debilitating for affected individuals and lead to major health impacts. With a growing and aging population, the number of Canadians living with dementiaFootnote i is expected to increase in future decades, with corresponding implications for health care needs and use. By 2031, it is projected that the total annual health care costs for Canadians with dementia will have doubled those from two decades earlier, from $8.3 billion to $16.6 billion.Footnote 2
Using data from the Canadian Chronic Disease Surveillance System , the Public Health Agency of Canada is able to conduct national surveillance for diagnosed dementia, including Alzheimer’s disease, to support the planning and evaluation of related policies, programs, and services. This fact sheet presents an overview of these new estimates on diagnosed dementia and highlights information on associated health impacts collected through the National Population Health Study of Neurological Conditions.Footnote 3
What Other Things Help
In addition to medications, there are various ways to help a person with AD. Research has shown that physical exercise helps to enhance brain health and improves mood and general fitness. A balanced diet, enough sleep, and limited alcohol intake are other important ways to promote good brain health. Other illnesses that affect the brain, such as diabetes, high blood pressure and high cholesterol, should also be treated if present.
Stage 6 Middle Dementia/moderately Severe Alzheimers Disease
People in this stage are often no longer aware of present events and unable to accurately remember the past. They progressively lose the ability to take care of daily living activities like dressing, toileting, and eating, but are still able to respond to nonverbal stimuli, and communicate pleasure and pain via behavior.
Agitation and hallucinations often show up in the late afternoon or evening. Dramatic personality changes such as wandering or suspicion of family members are common. Many cant remember close family members, but know they are familiar.
Duration: approximately 2.5 years.
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:
Age Distribution For Alzheimer Disease
The prevalence of AD increases with age. AD is most prevalent in individuals older than 60 years. Some forms of familial early-onset AD can appear as early as the third decade, but familial cases constitute less than 10% of AD overall.
More than 90% of cases of AD are sporadic and occur in individuals older than 60 years. Of interest, however, results of some studies of nonagenarians and centenarians suggest that the risk may decrease in individuals older than 90 years. If so, age is not an unqualified risk factor for the disease, but further study of this matter is needed.
Savva et al found that in the elderly population, the association between dementia and the pathological features of AD is stronger in persons 75 years of age than in persons 95 years of age. These results were achieved by assessing 456 brains donated to the population-based Medical Research Council Cognitive Function and Ageing Study from persons 69-103 years of age at death.
Studies have demonstrated that the relationship between cerebral atrophy and dementia persist into the oldest ages but that the strength of association between pathological features of AD and clinical dementia diminishes. It is important to take age into account when assessing the likely effect of interventions against dementia.
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Support For Family And Friends
Currently, many people living with Alzheimers disease are cared for at home by family members. Caregiving can have positive aspects for the caregiver as well as the person being cared for. It may bring personal fulfillment to the caregiver, such as satisfaction from helping a family member or friend, and lead to the development of new skills and improved family relationships.
Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimers disease at home can be a difficult task and may become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimers disease often need more intensive care.
Amyloid Hypothesis Versus Tau Hypothesis
A central but controversial issue in the pathogenesis of AD is the relationship between amyloid deposition and NFT formation. Evidence shows that abnormal amyloid metabolism plays a key pathogenic role. At high concentrations, the fibrillar form of Ab has been shown to be neurotoxic to cultured neurons.
Cultured cortical and hippocampal neurons treated with Ab protein exhibit changes characteristic of apoptosis , including nuclear chromatin condensation, plasma membrane blebbing, and internucleosomal DNA fragmentation. The fibrillar form of Ab has also been shown to alter the phosphorylation state of tau protein.
The identification of several point mutations within the APP gene in some patients with early-onset familial AD and the development of transgenic mice exhibiting cognitive changes and SPs also incriminate Ab in AD. The apolipoprotein E E4 allele, which has been linked with significantly increased risk for developing AD, may promote inability to suppress production of amyloid, increased production of amyloid, or impaired clearance of amyloid with collection outside of the neuron.
Autopsies have shown that patients with 1 or 2 copies of the APOE E4 allele tend to have more amyloid. Additional evidence comes from recent experimental data supporting the role of presenilins in Ab metabolism, as well as findings of abnormal production of Ab protein in presenilin-mutation familial Alzheimer disease.
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Treatment For Alzheimer’s Disease
At this stage, there is no cure and no treatment that can stop the Alzheimers disease progressing.Medications are available that can help to stabilise or slow the decline in memory and thinking abilities for a time, such as cholinesterase inhibitors and memantine. Other medications are available that might help with secondary symptoms like depression, anxiety and sleep disturbances.It is important to remember that all medications have side effects. People with Alzheimers disease may take a number of medications and your doctor can help you to understand how the different medications might interact with each other.Non-medication therapies, staying active and socially connected, as well as managing stress, can help people with Alzheimers disease. Education and professional support are important for people with Alzheimers disease and their families and carers.
Coping With A Diagnosis
A diagnosis of Alzheimers disease is the last thing anyone wants to hear. While it is undoubtedly a life-altering experience that will take both you and your family time to come to terms with, it doesnt mean that your life is over. Once you have a diagnosis and know what youre facing, you can start to take steps to slow the progression of the disease and ensure youre able to live your life as fully as possible for as long as possible.
Its important to give yourself time to process the myriad of emotions youre likely experiencing. Allowing yourself to feel even unpleasant emotions will allow the shock and distress of your diagnosis to eventually pass, and enable you to see a way forward. Its also important to reach out to others at this difficult time. The love and support of friends and loved ones can make a huge difference to your mood and outlook.
Similarly, pursuing activities that bring you meaning and joy can help bolster your sense of purposewhether thats engaging in favorite hobbies and interests, traveling, volunteering, or building your legacy by writing your memoirs or spending more time with your family.
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Why Alzheimers Is Called The Family Disease
by TEAM ALZLIVE Administrator
Alzheimers disease is often called a family disease, because the chronic stress of watching a loved one slowly decline affects everyone, reports The Family Caregiver Alliance.
The disease can run its course from two to 20 years and turn a fully functioning adult or senior citizen into a helpless individual.
The McGowan Institute for Regenerative Medicine in Pittsburgh, www.mirm.pitt.edu, points out that today, home-based care for Alzheimer patients may entail tremendous economic, emotional and even psychological costs. Family caregivers often give up time from work and forego pay to spend 47 hours per week on average with an affected loved one who frequently cannot be left alone.
In many ways, the effects of Alzheimers disease on the family can be as devastating as its effects on the patient.
Receiving the diagnosis is traumatic for everyone. The early effects of Alzheimers on the family consist largely of processing the diagnosis, learning about the disease and preparing for the future.
Individuals with AD may begin to say things and act in ways that are offensive and hurtful towards others. A gentle woman may become violent or a careful man become reckless, and as the Family Caregiver Alliance, caregiver.org, points out, family members need to learn to differentiate between the disease and your loved one in order to keep from internalizing these actions as purposefully inflicted wounds.
Down Syndrome And Alzheimers Disease
People with Down syndrome have a third copy of chromosome 21, instead of the usual two copies. This genetic change causes a collection of characteristics, including intellectual disability and some common physical traits.The APP gene that leads to the production of the beta-amyloid protein present in Alzheimers plaques is located on chromosome 21. This means that people with Down syndrome make one and a half times the amount of APP and, as a consequence, more beta-amyloid. This appears to be the cause of the earlier appearance of the brain changes typical of Alzheimers disease in people with Down syndrome.
Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
Alzheimers Disease Vs Mild Cognitive Impairment
Early dementia, also known as mild cognitive impairment , involves problems with memory, language, or other cognitive functions. But unlike those with full-blown Alzheimers, people with MCI are still able to function in their daily lives without relying on others.
According to the Alzheimers Association, about 15 to 20 percent of people over the age of 65 experience mild cognitive impairment. Many people with MCI eventually develop Alzheimers disease or another type of dementia. However, others plateau at a relatively mild stage of decline and are able to live independently. Some people with mild cognitive impairment even return to normal.
Symptoms of MCI include:
- Frequently losing or misplacing things.
- Frequently forgetting conversations, appointments, or events.
- Difficulty remembering the names of new acquaintances.
- Difficulty following the flow of a conversation.
It is not yet fully understood why MCI progresses to Alzheimers disease in some, while remaining stable in others. The course is difficult to predict, but in general, the greater the degree of memory impairment, the greater the risk of developing Alzheimers down the line.
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How Is Alzheimer’s Disease Diagnosed And Evaluated
No single test can determine whether a person has Alzheimer’s disease. A diagnosis is made by determining the presence of certain symptoms and ruling out other causes of dementia. This involves a careful medical evaluation, including a thorough medical history, mental status testing, a physical and neurological exam, blood tests and brain imaging exams, including:
What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
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What Is The Difference Between Dementia And Alzheimers Disease
Dementia is caused by different diseases that affect the brain. Alzheimers disease is the most common of these diseases. Some other common types of dementia include vascular dementia and dementia with Lewy bodies.
This means that dementia is not a disease in its own right. Dementia is the name for a group of symptoms that commonly include problems with memory, thinking, problem solving, language and perception.
While there is a relationship between dementia and Alzheimers disease, there are key differences between the two.
What To Do If You Suspect Alzheimers Disease
Getting checked by your healthcare provider can help determine if the symptoms you are experiencing are related to Alzheimers disease, or a more treatable conditions such as a vitamin deficiency or a side effect from medication. Early and accurate diagnosis also provides opportunities for you and your family to consider financial planning, develop advance directives, enroll in clinical trials, and anticipate care needs.
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Managing The Effects Of Alzheimers Disease
Medication is available which may help slow progression but it does not prevent or cure Alzheimers disease.
- People with Alzheimers may be prescribed a type of medication called cholinesterase inhibitors. There are three options: Donepezil, Rivastigmine or Galantamine
- These medications may improve concentration, which helps with memory, thinking and language. These effects can last for approximately 6-12 months, although there is now some evidence showing they can benefit a person for much longer. They support the communication between the nerve cells in the brain by preventing the breakdown of acetylcholine
- Memantine can also be prescribed in the moderate to severe stage of Alzheimers disease alongside one of the above medications. This medication blocks the effects of excess glutamate in the brain. Memantine can help with memory, reasoning, language and attention
Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care Tel. 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Respite and Carelink Centres Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
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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
Caring For Someone With Alzheimers Disease
Caring for someone with Alzheimers disease can be hard but also rewarding. Your emotional and physical support will be a great help when the person’s world seems confusing and hostile. Take advantage of the community support thats available for people with Alzheimers disease, their families and carers.
What Is Mild Cognitive Impairment
Mild cognitive impairment, or MCI, is a condition in which people have more memory problems than normal for their age but are still able to carry out their normal daily activities. A doctor can do thinking, memory, and language tests to see if a person has MCI. People with MCI are at a greater risk for developing Alzheimers disease, so its important to see a doctor or specialist regularly if you have this condition.
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
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Alzheimers Disease Is An Irreversible Progressive Brain Disorder That Slowly Destroys Memory And Thinking Skills And Eventually The Ability To Carry Out The Simplest Tasks In Most People With Alzheimers Symptoms First Appear In Their Mid
Alzheimers disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.
Alzheimers is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioningthinking, remembering, and reasoningand behavioral abilities to such an extent that it interferes with a persons daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a persons functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.
The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementiaa combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimers disease and vascular dementia.
Alzheimers disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps and tangled bundles of fibers .
Changes in the Brain