Types Of Alzheimer’s Disease
Nearly everyone with Alzheimerâs disease will eventually have the same symptoms — memory loss, confusion, trouble with once-familiar tasks, and making decisions. While the manner of the disease development remains unclear, all forms of Alzheimer’s appear to share overproduction and/or decreased clearance of a type of protein called amyloid beta peptides. Though the effects of the disease are similar, there are two main types.
- Early-onset Alzheimer’s. This type happens to people who are younger than age 65. Often, theyâre in their 40s or 50s when theyâre diagnosed with the disease. Itâs rare — up to 5% of all people with Alzheimer’s have early-onset. People with Down syndrome have a higher risk for it.Scientists have found a few ways in which early-onset Alzheimerâs is different from other types of the disease. People who have it tend to have more of the brain changes that are linked with Alzheimerâs. The early-onset form also appears to be linked with a defect in a specific part of a personâs DNA: chromosome 14. A form of muscle twitching and spasm, called myoclonus, is also more common in early-onset Alzheimer’s.
- Late-onset Alzheimer’s. This is the most common form of the disease, which happens to people age 65 and older. It may or may not run in families. So far, researchers havenât found a particular gene that causes it. No one knows for sure why some people get it and others donât.
Attention And Language Impairment
While memory challenges can be involved in early onset Alzheimers, signs that something could be wrong can be much broader. In fact, experts note that memory loss, which is closely associated with Alzheimers, may actually be less prominent in people with early onset Alzheimers.
Instead, people with early onset Alzheimers often complain about difficulties finding words in conversation. They can experience problems with attention and orientation, as well as with simple math.
In the aggregate, patients with early-onset Alzheimers Disease, compared to similarly impaired patients with late-onset Alzheimers Disease, have better memory recognition scores and semantic memory but worse attention, language, executive functions, ideomotor praxis, and visuospatial skills, a research paper by Dr. Mario Mendez noted.
Key Points About Early
Alzheimer disease commonly affects older people, but early-onset Alzheimer disease can affect people in their 30s or 40s.
It affects memory, thinking, and behavior.
Although there is no known cure, early diagnosis and treatment can lead to better quality of life.
Stay healthy with a good diet and regular exercise.
Avoid alcohol and other substances that may affect memory, thinking, and behavior.
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Genetic Risk Factors To Consider
For most people with early-onset and late-onset Alzheimers, the disease appears to be caused by a combination of genetics, lifestyle, and environmental influences interacting in ways that are still not clearly understood.
Researchers have made progress in identifying genes that raise the risk of both early-onset and late-onset Alzheimers.
Having a variant of the apolipoprotein E gene increases the odds of developing Alzheimers in people of all ages, though it does not mean someone will definitely get the disease. People with this variant, APOE e4, are not only more vulnerable to Alzheimers, but symptoms tend to appear at a younger age.
A subset of cases of Alzheimers in young adults between 7 and 12 percent have a rare form that is directly caused by mutations in three specific genes.
Anyone who inherits one of these mutations has a very strong probability of developing Alzheimers at a young age.
The three mutations linked to this form of early-onset Alzheimers amyloid precursor protein , presenilin 1, and presenilin 2 result in the production of abnormal proteins associated with Alzheimers disease.
Problems With Vision And Spatial Awareness
Alzheimers disease can sometimes cause , making it difficult for people to judge distances between objects. The person may find it hard to distinguish contrast and colors or judge speed or distance.
These vision problems combined can affect the persons ability to drive.
Typical aging also affects eyesight, so it is essential to have regular checkups with an eye doctor.
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Mood Or Personality Changes
Someone with Alzheimers disease may start to experience a change in mood . They can feel irritable, confused, anxious, or depressed. They may also lose interest in things they used to enjoy.
They could become frustrated with their symptoms or feel unable to understand the changes taking place. This may present as aggression or irritability toward others.
Beyond Memory Loss: How To Handle The Other Symptoms Of Alzheimer’s
There is a lot of talk about the emotional pain patients and caregivers suffer when a loved one loses memories to Alzheimers. But what about the other symptoms? Here are tips from a Johns Hopkins expert on what to watch for and how to manage.
#TomorrowsDiscoveries: From Dysfunctional Cells to Disease Dr. Rong Li
Dr. Li and her team investigate how cells consolidate their damaged proteins and prevent them from spreading freely, in order to understand how to better treat diseases such as Alzheimers and ALS. Another of their interests is how chromosomes are divided up when one cell becomes two. Learning more about how the process can go wrong could lend insight into cancer development.
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How To Cope With Your Physical Health
Alzheimers disease causes your health to deteriorate. These are some strategies that can help you cope physically:
- Get regular health check-ups: Seeing your healthcare provider regularly to evaluate the progression of your condition, discuss your symptoms, adjust your medication, and check for other health conditions can help ensure that youre getting the appropriate treatment.
- Get your flu shots: Alzheimers disease can make you more susceptible to pneumonia and the flu. Taking your flu shots regularly can help prevent you from falling ill.
- Take medication as prescribed:Taking your medication consistently and reporting any side effects to your healthcare provider can help you manage symptoms.
- Stay active: Marottoli recommends staying as socially engaged and physically and mentally active as possible.
- Follow a healthy lifestyle: Maintain a healthy lifestyle, exercise regularly, and follow a balanced, healthy diet such as the Mediterranean diet, says Marottoli.
- Take steps to prevent falls: Alzheimers disease can make you more prone to falling and injuring yourself. Clearing any clutter from the floor, avoiding loose clothing that can trip you up, wearing sturdy shoes, and leaving a light on at night can help prevent falls.
How Can You Prevent Early
As the exact cause of Alzheimers is still unknown, theres no sure-fire way to prevent the condition. But Dr. Jones says making healthy lifestyle choices, like eating a nutritious diet and staying active, benefits your brain, just as they do your heart or any other organ in your body.
Everything a cardiologist has ever told you about ways to keep your heart healthy is also true for the brain because the brain has blood vessels, which need to stay healthy. And so that means a nutritious diet, exercise, and a good nights sleep, he says.
Social interaction is also key for your overall brain health, which Dr. Jones says is admittedly challenging right now, since the coronavirus continues to take on new variants. But he recommends keeping up with friends and family or just staying active in your community as much as you can.
If we could bottle up all these lifestyle things into a pill for prevention, we believe that would be highly effective, says Dr. Jones.
On top of lifestyle changes, the Food & Drug Administration granted accelerated approval for the first Alzheimers drug in 18 years just this past June. Aducanumab, also known as Aduhelm, is shown to improve mild to moderate Alzheimers by removing the buildup of amyloid in the brain.
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Signs Of Mild Alzheimers Disease
In mild Alzheimers disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family. Problems can include:
- Memory loss
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Increased sleeping
- Loss of bowel and bladder control
A common cause of death for people with Alzheimers disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.
There is currently no cure for Alzheimers, though there are medicines that can treat the symptoms of the disease.
Confusion In Actions Or Words
6Another consequence of the weakening of short-term memory, which is primarily affected by dementia, is confusion in words or actions. Trying to open an apartment with a car key, not recognizing recent acquaintances, confusing the events of the past day all this can be manifestations of incipient dementia.
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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 .
Richard Marottoli Md Mph
The key is to get help, first with the practical aspects, but also with the emotional aspects. Counseling can help you cope emotionally.
Counseling can help with:
- Accepting the diagnosis: Being diagnosed with a terminal illness at an early age can cause you to experience a range of emotions, such as shock, numbness, anger, disbelief, grief, and fear. Counseling can help you cope with these emotions and accept the diagnosis.
- Planning for the future: Its critical to plan for the later stages of the disease and beyond, and make arrangements. Counseling can provide the support you need while you get your affairs in order.
- Adjusting your expectations: Alzheimers disease can make it harder to do things that you were once able to do with ease. This can cause shame and embarrassment and you may find yourself hiding these incidents from loved ones. Counseling can help you adjust your expectations and focus on your abilities rather than your disabilities.
- Offering different perspectives: Alzheimers disease can alter your perception of yourself and your relationships with your loved ones. Counseling can provide different perspectives and help you maintain a positive outlook.
- Managing symptoms: Counseling can help manage some of the cognitive and behavioral symptoms of Alzheimers disease. You may also find complementary practices such as Tai chi and brain exercises such as puzzles helpful.
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Frequently Misplacing Items And Not Being Able To Retrace Steps
Most people will lose items at some time, but they are usually able to locate them again by searching in logical locations and retracing their steps.
However, someone with Alzheimers disease may forget where they placed an item, especially if they put it in an unusual place. They may also be unable to retrace their steps to find the missing item. This can be distressing and cause the person to believe that someone is stealing from them.
Women Might Be At Higher Risk
Age is the major risk factor for Alzheimers disease, and women on average live longer than men.
However, longevity alone does not fully explain why two-thirds of Alzheimers patients are women. Even after taking into account the difference in longevity, some studies have suggested that women are still at a higher risk.
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What Happens In The Early Stage Of Dementia
Dementia affects everyone differently and early symptoms are often relatively mild and not always easy to notice.
Many people at the early stage of dementia stay largely independent and only need a bit of assistance with daily living. It is important to focus on what the person can do and not to take over and do things for them. Instead, try doing things with them, for example helping the person develop a routine, reminder lists and prompts, and use technology.
For more information for people living with dementia, see the ‘Keeping active and involved‘ page.
The early stage of dementia is when many people choose to make plans for the future, while they still have the ability to do so. This includes making a Lasting power of attorney , and advance decisions and advance statements to ensure their wishes and preferences are made clear.
Do Treatments Add Time To Life Expectancy
Experts simply dont know whether treatments help a person live longer with Alzheimers disease. AD and other similar dementias progress no matter what. Treatments like medications and therapies have been conclusively shown to help manage symptoms, meaning they make it easier to live with the disease, but they do not reverse symptoms. The memory of a person with dementia who takes medications like cholinesterase inhibitors, for example, will be slightly better than the memory of someone who is not on medication. Quality of life therefore improves with treatment. This means better years with dementia, but probably not more years.
Withdrawing From Work And Social Life
People with early onset Alzheimers, who were once industrious and focused at their challenging jobs, may begin noticing a drop in concentration, motivation or productivity thats out of character for them. They may also find themselves isolating from family, friends, coworkers or hobbies that they used to previously enjoy.
How Is Alzheimers Disease Treated
Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.
Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.
Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.
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Getting The Right Diagnosis
Getting an early-onset Alzheimers diagnosis can be difficult because doctors dont typically look for the disease in younger people.
Instead, healthcare professionals may blame symptoms on stress, menopause, depression, or other conditions.
As a result, patients grappling with confusing symptoms may not get the treatment they need.
Younger people with atypical Alzheimers face an even bigger challenge in getting an accurate diagnosis.
To understand whats causing symptoms, a doctor should conduct a thorough investigation that includes a detailed family history, physical and neurological tests, a cognitive assessment, and possibly a brain-imaging scan to rule out conditions like a stroke or brain tumor.
Physicians may also use genetic testing to help diagnose early-onset Alzheimers disease.
What Is Younger Onset Dementia
Younger onset dementia is used to describe any form of dementia that develops in people under the age of 65. Dementia has been diagnosed in people in their 50s, 40s and even in their 30s. It is sometimes called early onset dementia.
Younger onset dementia is similar to other types of dementia in many ways. The same problems generally occur, but the disease can have a different impact on a younger person because they are more likely to be employed full time, raising a family or financially responsible for a family.
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Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team