How Alzheimer’s Disease Is Treated
There’s currently no cure for Alzheimer’s disease, but medicines are available that can help relieve some of the symptoms.
Various other types of support are also available to help people with Alzheimer’s live as independently as possible, such as making changes to your home environment so it’s easier to move around and remember daily tasks.
Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
Read more about treating Alzheimer’s disease.
Insights Into The Biology And Genetics Underlying Alzheimers Disease
Although autosomal dominant mutations account for a very small proportion of cases of Alzheimers disease, the discoveries from these young onset families had, and continue to have, profound implications. The amyloid cascade hypothesis was proposed, which posits that accumulation of amyloid- is the initiating event in Alzheimers disease pathogenesis . This hypothesis has had a major influence on research and motivated the development of therapies that aim to reduce production of amyloid- or increase its clearance from the brain. Identification of familial Alzheimers disease mutations also provided the information necessary to make transgenic animals in which these therapies could be tested, some with dramatic effect, before going in to a series of trials in humans. Ironically, these initial clinical trials tended to exclude the familial patients that had contributed to the ideas and models on the basis of their young age.
How Alzheimer’s Disease Got Its Name
In 1906, Alois Alzheimer gave a lecture outlining the symptoms of Auguste as well as the changes he saw in her brain following her death. In 1907, this lecture was published. However, it wasn’t named after Alzheimer until 1910 when Emil Kraepelin wrote about the case of Auguste D in a psychiatric textbook and first referenced it as “Alzheimer’s disease.”
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Important Resources For Alzheimer’s Caregivers
And much of the research into Alzheimers over the past decade has been riddled with disappointment. Early on, autopsies of people with Alzheimers disease revealed their brains were full of clumps of protein called amyloid plaques. But experimental drugs meant to target and kill amyloid have flopped and failed in large clinical trials.
While researchers press on with potential pharmaceutical therapies, there is growing evidence that a combination of certain lifestyle factors may help stave off memory decline.
This past summer, scientists reported that people who exercise regularly, refrain from smoking, engage in activities that stimulate their brain and eat a diet rich in fruit, vegetables and healthy oils have a lower risk of developing Alzheimers dementia.
The key, researchers said, was to engage in all of those behaviors, not just one. Tight control of blood pressure has also been shown to help delay symptoms of dementia.
Whats more, doctors agree that an early diagnosis can help delay its progression. Signs of a potential problem include:
Changes in mood or personality
Confusion with time and place
Difficulty completing daily tasks
Trouble with speaking or writing
It was President Reagan who, 11 years before his own diagnosis, declared November as National Alzheimers Awareness Month, a time dedicated to raise awareness for not only the disease, but also, the heavy burden shouldered by those who love and care for patients.
What Are The Signs Of Alzheimer’s Disease
Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimers disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimers disease, people seem to be symptom-free, but toxic changes are taking place in the brain.
Damage occurring in the brain of someone with Alzheimers disease begins to show itself in very early clinical signs and symptoms. For most people with Alzheimersthose who have the late-onset varietysymptoms first appear in their mid-60s. Signs of early-onset Alzheimers begin between a persons 30s and mid-60s.
The first symptoms of Alzheimers vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers disease. Decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. And some people may be diagnosed with mild cognitive impairment. As the disease progresses, people experience greater memory loss and other cognitive difficulties.
Alzheimers disease progresses in several stages: preclinical, mild , moderate, and severe .
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What Causes Alzheimer’s Disease
The cause of Alzheimer’s disease is not known. The “amyloid cascade hypothesis” is the most widely discussed and researched hypothesis about the cause of Alzheimer’s disease. The strongest data supporting the amyloid cascade hypothesis comes from the study of early-onset inherited Alzheimer’s disease. Mutations associated with Alzheimer’s disease have been found in about half of the patients with early-onset disease. In all of these patients, the mutation leads to excess production in the brain of a specific form of a small protein fragment called ABeta . Many scientists believe that in the majority of sporadic cases of Alzheimer’s disease there is too little removal of this A protein rather than too much production. In any case, much of the research in finding ways to prevent or slow down Alzheimer’s disease has focused on ways to decrease the amount of A in the brain.
Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
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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.
Caring For Someone With Alzheimers Disease
Alzheimerâs disease is called a family disease, because the chronic stress of watching a loved one slowly decline affects everyone. An effective treatment will address the needs of the entire family. Caregivers must focus on their own needs, take time for their own health, and get support and respite from caregiving regularly to be able to sustain their well-being during this caregiving journey. Emotional and practical support, counseling, resource information, and educational programs about Alzheimerâs disease all help a caregiver provide the best possible care for a loved one.
Absolutely the easiest thing for someone to say and the hardest thing to accept is the advice to take care of yourself as a caregiver. As stated by one caregiver, âThe care you give to yourself is the care you give to your loved one.â;It is often hard to see beyond the care tasks that await you each morning.
Through training, caregivers can learn how to manage challenging behaviors, improve communication skills, and keep the person with Alzheimerâs safe. Research shows that caregivers experience lower stress and better health when they learn skills through caregiver training and participate in a support group . Participation in these groups can allow caregivers to care for their loved one at home longer.
Now it is time to take action, and take stock of the people, services, and information that will help you provide care. The earlier you get support, the better.
Hammer Of The Witches
In the Middle Ages, mental illnesses such as depression or dementia were regarded as a kind of punishment necessarily imposed by God for sins comitted. As the reason for dementia was not elucidated rationally in this period, it was considered that abnormal activities and mental symptoms generated in the dementia patients were due to demon-possession, and thus naturally subject to hatred. Patients with dementia were representative victims of a witch hunt that was widespread over the 14th to 15th centuries.
In 1486, Malleus Maleficarum was published by Heinrich Kramer and Jacob Sprenger who were priests of the Dominican order in the Roman Catholic Church. This book contained the criteria to identify witches, instructions and methods for trial and execution of a sentence, as a textbook of a witch hunt approved by Pope Innocent VIII. It was revised dozens of times and spread throughout the world in various languages. Hundreds of thousands have been burned dreadfully at the stake since the book was published.
People designated as witches according to the criteria defined in the Hammer of the Witches, were mainly mental patients, and most of them were women with symptoms such as paranoia, mania, schizophrenia, epilepsy and senile dementia. For no other reason than their mental instability, they became victims of a witch hunt and a great number of people across Europe were burned to ashes on the rack.
Science Moving Toward Earlier Alzheimers Diagnosis And Treatment
Keith Black, MD, is the chairman of the department of neurosurgery and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles. He reviewed the findings for WebMD. Black says the new study supports the notion that changes in the brain that lead to Alzheimerâs disease may begin years, or even a decade, before a person has symptoms.
âCan we diagnose it at 60 rather than at 75, and can we intervene at early stages to slow disease progression so they donât develop memory loss until age 95? This would be a therapeutic home run,â he says.
We are not there yet, but there are drugs and early screening tests in the pipeline, he says.
Dean Hartley, PhD, agrees. He is an associate professor of neurosciences and a neuroscience researcher at Rush University Medical Center in Chicago. The new findings âtake us closer to trying to find out when the disease begins, and then we can begin to follow the progression and start to look at drugs,â he says.
There are other questions that need to be answered, says Sam Gandy, MD, PhD. He is the Mount Sinai chair in Alzheimer’s disease research at Mount Sinai School of Medicine in New York City. âThe finding emphasizes one area that we still understand poorly: why some people are very sensitive to amyloid poisoning and lose in the face of relatively low amyloid buildup.â
Plenty of people can resist amyloid for decades and we would really like to understand why, he says.
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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.
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.
Alzheimer Auguste D And The Defining Of A Disease
. Reprinted from The Lancet, 349, Maurer et al., Auguste D and Alzheimer’s disease, 1546-9, 1997, with permission from Elsevier.
Alzheimer presented the clinical and pathological findings from Auguste D.s case at the meeting of Southwest German Psychiatrists held in Tübingen, in 1906 and his lecture was published under the title A Characteristic Disease of the Cerebral Cortex the following year. He described and beautifully recorded characteristic changes in the neurofibrils revealed by the Bielschowsky silver stain at autopsy. Thick fibrils accumulated in apparently normal-appearing cells until eventually, the nucleus and cytoplasm disappeared, and only a tangled bundle of fibrils indicated the site where once the neuron had been located. Severe neuronal loss was observed and over the entire cortex, and in large numbers especially in the upper layers, miliary foci could be found which represented the sites of deposition of a peculiar substance. Many years later, hyperphosphorylated tau was found to be the key component of the tangles and amyloid- the peculiar substance that formed the core of the plaques. Psychoanalytic studies presented at the meeting received more attention than Alzheimers paper and were the ones to get reported in the local press. However, in 1910 Kraepelin coined the term Alzheimers disease in the eighth edition of his Handbook of Psychiatry, declaring it to be a specific clinical-pathological disease entity.
What Are Some Risk Factors For Alzheimers Disease
Risk factors for the development of Alzheimers disease include:
- Age. Increasing age is the primary risk factor for developing Alzheimers disease.
- Genetics . There is a certain gene, apolipoprotein E that is associated with late-onset Alzheimers disease. Other genes have been associated with early-onset Alzheimers disease.
Researchers believe the presence of the last five risk factors mentioned above might reduce the clearance of amyloid protein from the brain, which then increases the risk of developing Alzheimers disease. In particular, the presence of a number of these risk factors at the same time and while the person is in his or her 50s is associated with a higher risk of Alzheimers disease.
There may be some ways to reduce the risk of mental decline. In general, living a healthy lifestyle protects the body from strokes and heart attacks and is believed to also protect the brain from cognitive decline. Scientists cant absolutely prove the cause and effect of the following factors, but studies have shown a positive association.
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Final Stages Of Alzheimer’s
In the final stages, people may lose the ability to feed themselves, speak, recognize people and control bodily functions. Memory worsens and may become almost non-existent. Constant care is typically necessary. On average, those with Alzheimer’s live for 8 to 10 years after diagnosis, but this terminal disease can last for as long as 20 years.