Who Is Affected By Alzheimer’s Disease

Down Syndromeand Other Intellectual Disabilities

Adults with Down syndrome are much more likely than the general population to develop dementia: after age 60, more than half will have dementia.6 People with other intellectual disabilities have rates of dementia similar to the general population however, like people with Down syndrome, they face additional challenges to getting care. The first challenge is assessing dementia when there is great variation in baseline functioning. People in this population are often cared for by their family members, who themselves are aging and perhaps facing declining health. Some stakeholders believe that it may be difficult to find supportive services to enable the person to live in the community.7

Impact Of Alzheimer’s Disease And Related Dementias

The National Plan identifies three specific populations that are disproportionally affected by Alzheimer’s disease: people with younger-onset dementia, racial and ethnic minorities, and persons with Down syndrome and other intellectual disabilities. These are diverse groups that are differentially impacted by Alzheimer’s disease and related dementias.

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.

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Alzheimers Is A Global Crisis That Requires A Global Solution

It is a grave threat to the worlds health and finances if not stopped. About 50 million people worldwide have some form of dementia, and someone in the world develops dementia every three seconds.

When the world has faced catastrophic challenges before, nations have marshaled significant resources behind clear goals and objectives to achieve great things. For example, the world committed to ambitious, aggressive, and well-funded efforts to prevent and treat HIV/AIDS, tuberculosis, and malaria. Those efforts have paid significant dividends in lives saved and economic development fostered.

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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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.

Treatment Of Alzheimer’s Dementia

2.5.1 Pharmacologic treatment

None of the pharmacologic treatments available today for Alzheimer’s dementia slow or stop the damage and destruction of neurons that cause Alzheimer’s symptoms and make the disease fatal. The U.S. Food and Drug Administration has approved five drugs for the treatment of Alzheimer’s â rivastigmine, galantamine, donepezil, memantine, and memantine combined with donepezil. With the exception of memantine, these drugs temporarily improve cognitive symptoms by increasing the amount of chemicals called neurotransmitters in the brain. Memantine blocks certain receptors in the brain from excess stimulation that can damage nerve cells. The effectiveness of these drugs varies from person to person and is limited in duration.

Many factors contribute to the difficulty of developing effective treatments for Alzheimer’s. These factors include the slow pace of recruiting sufficient numbers of participants and sufficiently diverse participants to clinical studies, gaps in knowledge about the precise molecular changes and biological processes in the brain that cause Alzheimer’s disease, and the relatively long time needed to observe whether an investigational treatment affects disease progression.

2.5.2 Non-pharmacologic therapy

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Active Management Of Alzheimer’s Dementia

• Appropriate use of available treatment options.
• Effective management of coexisting conditions.
• Providing family caregivers with effective training in managing the day-to-day life of the care recipient.
• Coordination of care among physicians, other health care professionals and lay caregivers.
• Participation in activities that are meaningful to the individual with dementia and bring purpose to his or her life.
• Having opportunities to connect with others living with dementia support groups and supportive services are examples of such opportunities.
• Becoming educated about the disease.
• Planning for the future.

To learn more about Alzheimer’s disease, as well as practical information for living with Alzheimer’s and being a caregiver, visit alz.org.

Economic Impact Of Dementia

The total estimated worldwide cost of dementia was US$ 818 billion in 2015, which represented 1.09% of global GDP at that time. The annual global cost of dementia is now above US$ 1.3 trillion and is expected to rise to US$2.8 trillion by 2050

This figure includes costs attributed to informal care , direct costs of social care and the direct costs of medical care .

Direct medical care costs account for roughly 20% of global dementia costs, while direct social sector costs and informal care costs each account for roughly 40%. The relative contribution of informal care is greatest in the African regions and lowest in North America, Western Europe and some South American regions, while the reverse is true for social sector costs.

This means that if global dementia care were a country, it would be the 14th largest economy in the world. More information is available in our World Alzheimer Report 2015.

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Family History And Genetics

Your risk of developing Alzheimer’s is somewhat higher if a first-degree relative your parent or sibling has the disease. Most genetic mechanisms of Alzheimer’s among families remain largely unexplained, and the genetic factors are likely complex.

One better understood genetic factor is a form of the apolipoprotein E gene . A variation of the gene, APOE e4, increases the risk of Alzheimer’s disease. Approximately 25% to 30% of the population carries an APOE e4 allele, but not everyone with this variation of the gene develops the disease.

Scientists have identified rare changes in three genes that virtually guarantee a person who inherits one of them will develop Alzheimer’s. But these mutations account for less than 1% of people with Alzheimer’s disease.

Disproportionate Impact On Women

Globally, dementia has a disproportionate impact on women. Sixty-five percent of total deaths due to dementia are women, and disability-adjusted life years due to dementia are roughly 60% higher in women than in men. Additionally, women provide the majority of informal care for people living with dementia, accounting for 70% of carer hours.

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Is Alzheimer’s Disease The Same As Dementia

Alzheimer’s disease is the most common cause of dementia in older adults, but it is only one type of dementia. Other conditions can also cause memory loss.

The dementia of Alzheimers disease is caused by the build-up of proteins in and around brain cells that form clumps and tangles, causing the cells to malfunction and die. The two specific proteins in AD are amyloid and tau . These changes typically start in the memory center of the brain, which is why memory loss is often an early symptom in Alzheimers disease.

In Alzheimer’s disease, amyloid plaques form around cells and make it hard for neurons to communicate with each other. Source: Alzheimers AssociationIn normal brains, tau holds cell components together, but in Alzheimers disease the tau comes loose, forming threads that tangle together. These changes interfere with the neurons ability to function. Source: National Institute on Aging Alzheimers Disease Education and Referral Center

Alzheimers disease is called a neurodegenerative dementia because the build-up of proteins does not stop, brain cells continue to die, and symptoms continue to worsen gradually over time. Although memory loss is usually the first and most prominent symptom, over time Alzheimer’s disease can impact communication, problem solving, way-finding, mood, and behavior. In some less common forms of Alzheimer’s disease, cell changes start in other areas of the brain, causing problems with other thinking abilities to show up first.

Do Genes Cause Diseases

Genetic mutations can cause diseases. If a person inherits a genetic mutation that causes a certain disease, then he or she will usually get the disease. Sickle cell anemia, cystic fibrosis, and some cases of early-onset Alzheimer’s disease are examples of inherited genetic disorders.

Other changes or differences in genes, called genetic variants, may increase or decrease a person’s risk of developing a particular disease. When a genetic variant increases disease risk but does not directly cause a disease, it is called a genetic risk factor.

Identifying genetic variants may help researchers find the most effective ways to treat or prevent diseases such as Alzheimer’s in an individual. This approach, called precision medicine, takes into account individual variability in genes, environment, and lifestyle for each person.

The expression of geneswhen they are switched on or offcan be affected, positively and negatively, by environmental and lifestyle factors, such as exercise, diet, chemicals, or smoking. The field of epigenetics is studying how such factors can alter a cell’s DNA in ways that affect gene activity.

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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.

References

Alzheimer’s Disease: Brain Changes Symptoms And Treatment

ByCari Nierenbergpublished 19 June 19

Alzheimer’s disease is a progressive brain disorder that causes problems with memory, thinking and behavior in older adults. The disorder affects an estimated 5.7 million Americans, and is the fifth-leading cause of death in people ages 65 and older, according to the Centers for Disease Control and Prevention .

Alzheimer’s disease is often used as a synonym for dementia, which is a devastating loss of memory and cognitive function in older people, said Dr. Brad Hyman, a neurologist and director of the Massachusetts Disease Research Center at Massachusetts General Hospital in Boston. Dementia is an umbrella term for impaired memory thinking skills, and Alzheimer’s is a specific form of dementia. Alzheimer’s disease is responsible for 50-70% of all dementia cases, according to Alzheimers.net.

The first case of Alzheimer’s was described in 1906 by Dr. Alois Alzheimer, a German neurologist. Alzheimer identified two of the disease’s key physical traits when he examined a woman’s brain tissue under a microscope after her death: He found abnormal protein clumps and tangled bundles of nerve fibers .

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Referral To A Specialist

Your GP may refer you to a specialist memory assessment service to help with your diagnosis. Memory clinics are staffed by professionals from multiple disciplines who are experts in diagnosing, caring for and advising people with dementia and their families.

Memory clinic staff can include the following, depending on your local area:

• a nurse usually a trained mental health nurse who specialises in diagnosing and caring for people with dementia
• a psychologist a healthcare professional who specialises in the assessment and treatment of mental health conditions
• a psychiatrist a qualified medical doctor who has training in treating mental health conditions
• a neurologist a specialist in treating conditions that affect the nervous system
• a geriatrician a physician with specialist training in the care of older people
• a social worker a trained member of staff able to advise and assist with accessing social services within the local area
• an occupational therapist a member of staff with specialist skills in assessing and supporting people with dementia and their families with adjusting to disabilities

There’s no simple and reliable test for diagnosing Alzheimer’s disease, but the staff will listen to the concerns of both you and your family about your memory or thinking. They will assess your skills and arrange more tests to rule out other conditions.

Risk Factors For Alzheimer’s Dementia

The vast majority of people who develop Alzheimer’s dementia are age 65 or older. This is called late-onset Alzheimer’s. Experts believe that Alzheimer’s, like other common chronic diseases, develops as a result of multiple factors rather than a single cause. Exceptions are cases of Alzheimer’s related to uncommon genetic changes that increase risk.

2.7.1 Age, genetics and family history

The greatest risk factors for late-onset Alzheimer’s are older age,, genetics, and having a family history of Alzheimer’s.-

Age

Age is the greatest of these three risk factors. As noted in the Prevalence section, the percentage of people with Alzheimer’s dementia increases dramatically with age: 3% of people age 65-74, 17% of people age 75-84 and 32% of people age 85 or older have Alzheimer’s dementia. It is important to note that Alzheimer’s dementia is not a normal part of aging, and older age alone is not sufficient to cause Alzheimer’s dementia.

Genetics

• One in 10 people age 65 and older has Alzheimer’s dementia.,,
• The percentage of people with Alzheimer’s dementia increases with age: 3% of people age 65-74, 17% of people age 75-84, and 32% of people age 85 and older have Alzheimer’s dementia. People younger than 65 can also develop Alzheimer’s dementia, but it is much less common and prevalence is uncertain.

3.1.1 Underdiagnosis of Alzheimer’s and other dementias in the primary care setting

3.1.2 Prevalence of subjective cognitive decline

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Alzheimers Disease Signs And Symptoms

Symptoms of Alzheimers disease include memory loss beyond what is normal with aging, especially difficulty remembering new information or recent events, repeating questions, and forgetting important dates problems with completing everyday tasks misplacing items and trouble concentrating, problem-solving, or making decisions. As the condition progresses, people can become confused, irritable, and suspicious. They will gradually lose their independence and require an increasing level for care over time. Ultimately, they become fully dependent on others.

Estimates Of The Number Of People With Alzheimer’s Dementia By State

Table lists the estimated number of people age 65 and older with Alzheimer’s dementia by state for 2020, the projected number for 2025, and the projected percentage change in the number of people with Alzheimer’s between 2020 and 2025.,

• Created from data provided to the Alzheimer’s Association by Weuve et al.,

As shown in Figure , between 2020 and 2025 every state across the country is expected to experience an increase of at least 6.7% in the number of people with Alzheimer’s. These projected increases in the number of people with Alzheimer’s are due solely to projected increases in the population age 65 and older in these states. Because risk factors for dementia such as midlife obesity and diabetes can vary dramatically by region and state, the regional patterns of future burden may be different than reported here. Based on these projections, the West and Southeast are expected to experience the largest percentage increases in people with Alzheimer’s dementia between 2020 and 2025. These increases will have a marked impact on statesâ health care systems, as well as the Medicaid program, which covers the costs of long-term care and support for many older residents with dementia, including more than a quarter of Medicare beneficiaries with Alzheimer’s or other dementias.

FIGURE 3

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Sexual Differences In Incidence

Some studies have reported a higher risk of AD in women than in men other studies, however, including the Aging, Demographics, and Memory Study, found no difference in risk between men and women. Almost two thirds of Americans with AD are women. Among AD patients overall, any sexual disparity may simply reflect womens higher life expectancy. Among those who are heterozygous for the APOE E4 allele, however, Payami et al found a twofold increased risk in women.

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.
• Smoking
• Obesity

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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