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.
Is Dementia A Disease
Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimers disease is the most common type of dementia. Though dementia mostly affects older adults, it is not a part of normal aging.
What Are The Symptoms Of Alzheimers Disease
Symptoms of Alzheimers disease vary from person to person and worsen over time. Symptoms of the disease include:
- Memory loss. This is usually one of the first symptoms of Alzheimers disease.
- Putting objects in odd places
- Confusion about events, time and place
- Repeating questions
For more information on the stage of disease, click here.
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Are There Medicines To Treat Ad
Though there is no cure for AD yet, there are medications that help manage the symptoms. There are two general types of medications used to treat AD, the cholinesterase inhibitors and one NMDA receptor antagonist . These medications can help improve cognition, but they do not reverse or slow down the disease process in the brain. Often times, people with AD can have mood changes, such as depression or irritability. These can be managed by medications like the ones used for depression or anxiety.
Pathophysiology Of Alzheimers Disease
The presence of extracellular plaques of insoluble -amyloid peptide and neurofibrillary tangles of P-tau in neuronal cytoplasm is the hallmark of AD . Although the mechanisms by which these changes lead to cognitive decline are still debated, these deposits are believed to lead to atrophy and death of neurons resulting from excitotoxicity processes , collapse in calcium homeostasis, inflammation and depletion of energy and neuronal factors. As a result of this process, damage to neurons and synapses involved in memory processes, learning and other cognitive functions lead to the aforementioned cognitive decline .
According to amyloid cascade theory , the cerebral accumulation of A peptide, resulting from the imbalance between production and clearance of this protein, is the main event causing the disease, being other events observed resulting from this process .
The A peptide, which has 36 to 43 aminoacids, is derived from amyloid precursor protein enzymatic proteolysis, a physiologically produced protein that plays important roles in brain homeostasis . The APP gene is located on chromosome 21, which explains the higher incidence of early-onset AD in individuals with 21 trisomy and in individuals with APP gene locus duplication . It is believed that overexpression of APP results in an increase of cerebral A peptide, and consequently, in its deposition .
Reduced capacity of degradation of tau protein by the proteasome, in a process induced by A peptide
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How Is Alzheimer’s Different From Other Forms Of Dementia
Alzheimer’s disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy. Brains affected by Alzheimer’s disease often show presence of the following:
Fiber tangles within nerve cells
Clusters of degenerating nerve endings
Another characteristic of Alzheimer’s disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and somatostatin.
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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.
What Neurotransmitters Play A Role In Alzheimers Disease
Two neurotransmitters involved in memory and learningcalled acetylcholine and glutamateappear to play a role in Alzheimers disease. On the one hand, plaques appear to stimulate the production of chemicals that break down ACH, leading to their depletion. On the other, the progressive death of brain cells triggers the overproduction of glutamate, which overexcites brain cells and eventually kills them.
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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.
Causes Of Death In People With Alzheimer’s Disease
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts.
The Alzheimer’s Association notes that Alzheimer’s disease is the sixth leading cause of death in the United States. It also points out that out of the top 10 causes of death, it’s the only one without an effective treatment or cure.
The Centers for Disease Control and Prevention also highlights Alzheimer’s as a significant cause of death, pointing out that between 1999 and 2014, deaths attributed to Alzheimer’s rose by 55%.
One of the challenges in tracking deaths from Alzheimer’s is that Alzheimer’s disease is not always identified as the cause of death on a death certificate. Sometimes, the conditions that develop from Alzheimer’s are listed instead as primary on the death certificate. In other cases, Alzheimer’s may have never been officially diagnosed. These challenges in tracking Alzheimer’s deaths are demonstrated in one study that found that deaths from Alzheimer’s in people over the age of 75 may be as high as six times the count officially recorded.
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Other Relevant Factors And Conclusion
The main pathophysiological mechanisms of AD are amyloidosis and tau-related neurodegeneration, and have specific topographical and chronological pathways. For instance, brain amyloidosis starts in neocortical regions and then affects subcortical structures . On the other hand, neurodegeneration first appear on locus coeruleus and then spreads through transentorrinal area and neocortical regions . Cognitive and behavioral features of AD are significantly correlated to the topographical distribution of neurofibrillary tangles.
There is great variability in topographical patterns of pathological findings in AD, causing great phenotypical variability , with atypical presentations of the disease . It is not clear how risk and beneficial factors may modulate the topographical progression of amyloidosis and neurodegeneration.
How Does Dementia Affect The Brain
Youve probably never given much thought to how your brain controls all your bodily functions, why would you? That is until you find one or two everyday things not going as smoothly as before, or you are having tests to see if you have dementia or another neurological condition. But the parts of day-to-day life that are becoming more of a struggle give an idea of the part or parts of the brain not working as they should, or in the case of dementia, the type you have.
This is because the brain is separated into different regions and each region has a different function. When cells are damaged in a particular part of the brain, the function it performs wont be carried out in the same way as before. There are so many different types of dementia because dementia is an umbrella term for lots of progressive neurodegenerative disorders. These different dementias affect different parts of the brain, in different ways, causing the wide range of symptoms that are associated with the conditions that cause dementia, such as memory loss, communication problems, reduced ability to manage day to day activities, and hallucinations.
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What Are The 10 Warning Signs Of Dementia
The 10 warning signs of dementia
- Sign 1: Memory loss that affects day-to-day abilities.
- Sign 2: Difficulty performing familiar tasks.
- Sign 3: Problems with language.
- Sign 4: Disorientation to time and place.
- Sign 5: Impaired judgement.
- Sign 6: Problems with abstract thinking.
- Sign 7: Misplacing things.
What Are Risk Factors
- Risk factors are aspects of your lifestyle, environment and genetic background that increase the likelihood of getting a disease.
- Risk factors on their own are not causes of a disease. Rather, risk factors represent an increased chance, but not a certainty, that dementia will develop.
- Similarly, having little or no exposure to risk factors does not necessarily protect a person from developing dementia.
There are some risk factors that can be changed, and some that cannot â read on to know which are which!
Read about risk factors for dementia in our downloadable, print-friendly infosheet.
This sheet also contains strategies and lifestyle changes that can help you reduce your risk of developing dementia.
What Is The Main Cause Of Dementia
Your brain is made up of neurons that pass messages around the brain from the rest of the body. When you do something as simple as lifting your arm, it fires electrical signals between the neurons to tell the arm to move.
As we get older there can be a build-up of proteins, known as plaques, on these neurons in the brain, called tangles. This stops the neurons from being able to communicate properly because they are no longer touching, so the electrical messages are slowed down or stopped. It works a bit like the plaque you get on your teeth, which stops your tongue from being able to touch the surface of the teeth.
This protein build-up can happen to any older person but is more widespread in the brains of people with Alzheimers dementia.
Proteins called Lewy Bodies are seen in brains of people with Parkinsons disease dementia and Lewy body dementia.
In Vascular Dementia there can be issues with the blood supply to parts of the brain which stop those neurons from working.
What Is The Outlook For People With Alzheimers Disease
Alzheimers disease gets worse over time and is ultimately fatal. Persons with Alzheimers disease live, on average, four to eight years after diagnosis. Some patients can live as long as 20 years after diagnosis. The course of the disease varies from person to person.
Last reviewed by a Cleveland Clinic medical professional on 03/18/2019.
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What Is The Burden Of Alzheimers Disease In The United States
- Alzheimers disease is one of the top 10 leading causes of death in the United States.2
- The 6th leading cause of death among US adults.
- The 5th leading cause of death among adults aged 65 years or older.3
In 2020, an estimated 5.8 million Americans aged 65 years or older had Alzheimers disease.1 This number is projected to nearly triple to 14 million people by 2060.1
In 2010, the costs of treating Alzheimers disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4
Death rates for Alzheimers disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimers disease, has been shown to be under-reported in death certificates and therefore the proportion of older people who die from Alzheimers may be considerably higher.6
How Does Dementia Progress
Due to the nature of the illness being progressive there will be further decline over time. This will vary from person to person and support should be personalised for what issues present for that individual.
Each type of dementia affects a different part of the brain in the early stages but as it progresses, they tend to become more similar
Over time the proteins will continue to build up in the brain and will spread from the area they originated in to other regions. So as dementia progresses and the proteins increase, the less your brain will communicate with itself, and day to day life becomes more difficult.
This spread of proteins is how Alzheimers caused dementia progresses from short term memory loss to losing the ability to walk in the later stages, and why it is, sadly, a terminal condition.
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What To Do If You Experience Symptoms
If you experience any Alzheimer’s disease symptoms, you should see your healthcare provider. “Notify your primary clinician for an initial evaluation to determine the extent of the problem and to check for possible contributing factors. In some circumstances, referral to a more specialized dementia center may be warranted,” says Dr. Marrottolia. Detecting the disease as early as possible can be helpful in planning for the future and creating an effective treatment plan. And to get through this pandemic at your healthiest, don’t miss these35 Places You’re Most Likely to Catch COVID.
Causes Of Alzheimer’s Disease
Alzheimer’s disease is the most common type of dementia.
Alzheimer’s disease is thought to be caused by the abnormal build-up of 2 proteins called amyloid and tau.
Deposits of amyloid, called plaques, build up around brain cells. Deposits of tau form “tangles” within brain cells.
Researchers do not fully understand how amyloid and tau are involved in the loss of brain cells, but research into this is continuing.
As brain cells become affected in Alzheimer’s, there’s also a decrease in chemical messengers involved in sending messages, or signals, between brain cells.
Levels of 1 neurotransmitter, acetylcholine, are particularly low in the brains of people with Alzheimer’s disease.
Medicines like donepezil increase levels of acetylcholine, and improve brain function and symptoms.
These treatments are not a cure for Alzheimer’s disease, but they do help improve symptoms.
Read more about treatments for dementia.
The symptoms that people develop depend on the areas of the brain that have been damaged by the disease.
The hippocampus is often affected early on in Alzheimer’s disease. This area of the brain is responsible for laying down new memories. That’s why memory problems are one of the earliest symptoms in Alzheimer’s.
Unusual forms of Alzheimer’s disease can start with problems with vision or with language.
Read more about Alzheimer’s disease.
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Medications For Cognitive Symptoms
No disease-modifying drugs are available for Alzheimers disease, but some options may reduce the symptoms and help improve quality of life.
Drugs called cholinesterase inhibitors can ease cognitive symptoms, including memory loss, confusion, altered thought processes, and judgment problems. They improve neural communication across the brain and slow the progress of these symptoms.
Three common drugs with Food and Drug Administration approval to treat these symptoms of Alzheimers disease are:
- donepezil , to treat all stages
- galantamine , to treat mild-to-moderate stages
- rivastigmine , to treat mild-to-moderate stages
Another drug, called memantine , has approval to treat moderate-to-severe Alzheimers disease. A combination of memantine and donepezil is also available.
Contributing Factors To Alzheimer’s Disease
“Scientists do not yet fully understand what causes Alzheimer’s disease,” the CDC says. “There likely is not a single cause but rather several factors that can affect each person differently.” These include:
- Family history
- Potentially, diet, lifestyle and environment
“Experts agree that in the vast majority of cases, Alzheimer’s, like other common chronic conditions, probably develops as a result of complex interactions among multiple factors, including age, genetics, environment, lifestyle and coexisting medical conditions,” the Alzheimer’s Association says.
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