How Does Alzheimer’s Disease Affect The Brain
Scientists continue to unravel the complex brain changes involved in Alzheimers disease. Changes in the brain may begin a decade or more before symptoms appear. During this very early stage of Alzheimers, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimers as well.
The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimers, damage is widespread and brain tissue has shrunk significantly.
Impact On Families And Carers
In 2019, informal carers spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming . Physical, emotional and financial pressures can cause great stress tofamilies and carers, and support is required from the health, social, financial and legal systems. Fifty percent of the global cost of dementia is attributed to informal care.
Autoimmune Disorders Are More Common In Women
The last piece of the puzzle is that women are about twice as likely to have an autoimmune disease compared to men. The reason for this difference is not entirely clear, but it is clear that the immune system is generally stronger in women than men, and many autoimmune diseases are more common during pregnancy. It may be that womens stronger immune system developed through evolution to protect the fetus from infections. So, as part of their stronger immune systems, women may end up having more amyloid plaques than men.
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Who Is Most At Risk Of Dementia
Dementia is the most feared diagnosis in the over 55s in the UK, affecting around 850,000 people across the country. You often ask us why some people develop the condition and others dont, and whether its possible to predict who will go on to get dementia.
Predicting who will develop dementia is not an easy process. Risk factors for diseases like Alzheimers are hugely complex and include age, genetics and lifestyle. These three influencers dont act alone either they interact and are likely to vary in importance at different stages of your life.
Understanding who is most at risk of diseases like Alzheimers and why, is key to shaping prevention initiatives but also for identifying those who may benefit most from future therapies. Here are just a few examples of the groundbreaking research in this area being presented at the Alzheimers Association International Conference in Toronto.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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Recent Studies Of Trends In Dementia Incidence And Prevalence
A growing number of studies, at least nine over the past 10 years, have shown a declining risk for dementia incidence or prevalence in high-income countries, including the US, England, The Netherlands, Sweden, and Denmark. The Rotterdam Study, an ongoing population-based prospective cohort study, has provided the most direct evidence that improved cardiovascular risk factor control may be leading to healthier brains. Dementia incidence decreased in cohorts of older adults in Rotterdam between 1990 and 2010, and brain magnetic resonance imaging performed in more recent cohorts shows significantly less brain atrophy and fewer vascular-related brain lesions compared with MRI performed in the earlier cohorts .
Causes Of Alzheimers Disease
Researchers are rapidly learning more about the chemical changes that damage brain cells in Alzheimers disease. Apart from the few with familial Alzheimers disease, it is not known why some people develop Alzheimers disease and others do not. It is likely that a number of factors contribute to development of the disease, including environmental, genetic and health factors.Alzheimers disease is characterised by specific changes in the brain that include the formation of amyloid plaques and neurofibrillary tangles . An abnormal build-up of a protein called beta-amyloid causes amyloid plaques to form outside the brain cells. Inside the brain cells, another protein called tau builds up and causes neurofibrillary tangles.These protein accumulations disrupt messages within the brain because they damage connections between brain cells. The brain cells eventually die and brain volume shrinks. These brain changes occur gradually and actually begin many years before the symptoms of Alzheimers disease occur. The brain is able to compensate for the early damage, but eventually the damage becomes too great and brain function is affected.
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Bredesens Holes In The Roof: A Prevention
Over 4 decades, Dr. Dale Bredesen sought a cure for Alzheimers in a laboratory. Instead, he discovered at least 36 possible contributors .
These lifestyle factors take patients down a path toward amyloid-beta plaque buildup, leaving them at a higher risk of Alzheimers.
Bredesen explains these factors as holes in the roof, places where the risk of developing Alzheimers can seep in. This integrative medicine approach highlights areas where preventative care can help patch potential holes and lower risk factors.
He found that most people he saw with dementia had between 20-25 of these 36 holes he identified. This led him to believe that his prevention-driven approach could help patch up the roof and even reverse or slow symptoms.
While this protocol is not a cure for Alzheimers, most cases treated this way see improvements in brain function and memory, preserving precious years with family members and caregivers.
Much of Bredesens holes in the roof approach can be examined using Dr. Bredesens 6 subtypes to classify Alzheimers disease cases.
What Can You Do
Although there is no effective treatment or proven prevention for Alzheimers and related dementias, in general, leading a healthy lifestyle may help address risk factors that have been associated with these diseases.
Researchers cannot say for certain whether making the above lifestyle changes will protect against dementia, but these changes are good for your health and are all part of making healthy choices as you age.
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Will I Get Alzheimer’s
After hearing all this information, the question we’ve probably all asked ourselves remains: will I get Alzheimer’s?
The simple answer is that, unfortunately, there’s no real way to tell. There are a number of risk factors that can increase your chances of developing the condition, but it is very rare that these factors will guarantee that you will get Alzheimer’s at some point.
Much more research is needed into the causes and risk factors associated with Alzheimer’s disease, but the good news is that this research is going on right now. The Jackson Laboratory is one such institution leading the charge with cutting edge discoveries, a strong focus on personalized medicine, and our renowned JAX Center for Dementia and Alzheimer’s Research.
Another institution internationally known for its research and charity is the Alzheimer’s Association. If you are concerned about signs or symptoms of dementia in yourself or a loved one, we recommend turning first to the Alzheimers Association Help & Support page. This page includes a many helpful articles, ways to connect with local support groups, and a 24/7 hotline for any Alzheimers and dementia related questions.
Referral To A Specialist
Your doctor 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.
Assessing your mental abilities
Tests
Read more about tests for diagnosing dementia .
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Ages 85 And Older Women Most At Risk
COVID-19 survivors had a 69% higher risk of a new diagnosis of Alzheimer’s disease within 1 year of infection than their uninfected peers . Participants aged 85 years and older and women were at particularly high risk .
“Our findings call for research to understand the underlying mechanisms and for continuous surveillance of long-term impacts of COVID-19 on Alzheimers disease,” the authors wrote.
The team said it’s not clear whether COVID-19 triggers or accelerates development of Alzheimer’s disease, noting that SARS-CoV-2 has been associated with inflammation and central nervous system disorders.
“The factors that play into the development of Alzheimers disease have been poorly understood, but two pieces considered important are prior infections, especially viral infections, and inflammation,” coauthor Pamela Davis, MD, PhD, said in a Case Western press release.
Subtypes Of Alzheimers Disease
Alzheimers is the most common out of all of the types of dementia, and its characteristics can be far-ranging. When looking for root causes, its helpful to break the disease down into subtypes according to Dr. Bredesens approach.
The second word in quotes found in each subtype comes from Ayurvedic medicine, which has touched on these points for many years.
Bredesen describes the 6 subtypes of Alzheimers as follows:
Many patients ask: what is the most common cause of dementia? The most common cause of dementia is likely inflammation, but many underlying triggers compound on one another to lead to the development of this disease.
Various triggers from head injuries to insulin issues can contribute to an increased risk of dementia, and its common for patients to fall into more than one subtype.
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Stages Of Alzheimers Disease
People with Alzheimers disease differ in the patterns of problems they experience and in the speed with which their abilities deteriorate. Their abilities may change from day to day, or even within the same day. What is certain is that the persons abilities will deteriorate sometimes rapidly over a few months, sometimes more slowly, over a number of years.Some of the features of Alzheimers disease are classified into three stages. It is important to remember that not all of these features will be present in every person, nor will every person go through every stage. But these stages are still a useful description of the progression of Alzheimers disease.At all stages of Alzheimers disease, treatments and support services are available. Use these to make sure of the best possible quality of life for everyone affected by Alzheimers disease.
Can Alzheimer’s Disease Be Prevented
As the exact cause of Alzheimer’s disease isn’t clear, there’s no known way to prevent the condition. However, there are things you can do that may reduce your risk or delay the onset of dementia, such as:
- stopping smoking and cutting down on alcohol
- eating a healthy, balanced diet and maintaining a healthy weight
- staying physically fit and mentally active
These measures have other health benefits, such as lowering your risk of cardiovascular disease and improving your overall mental health.
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Signs And Symptoms Of Alzheimer’s Disease
Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers. Some people with memory problems have a condition called mild cognitive impairment . With MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimers, but not all of them do so. Some may even revert to normal cognition.
The first symptoms of Alzheimers vary from person to person. For many, decline in nonmemory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimers. More research is needed before these techniques can be used broadly and routinely to diagnose Alzheimers in a health care providers office.
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of biological ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of cognitive decline and dementia by being physically active, not smoking, avoiding harmful use of alcohol,controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity and air pollution.
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Practical Tips For People With Alzheimer’s
If you have Alzheimer’s disease, you may find it useful to:
- keep a diary and write down things you want to remember
- pin a weekly timetable to the wall
- put your keys in an obvious place, such as in a large bowl in your living room
- have a daily newspaper delivered to remind you of the day and date
- put labels on cupboards and drawers
- keep useful telephone numbers by the phone
- write yourself reminders for example, put a note on the front door to remind you to take your keys with you if you go out
- programme people’s names and numbers into your telephone
- set the alarm on your watch to act as a reminder
- install safety devices such as gas detectors and smoke alarms throughout your home
It may also be helpful to get in touch with a local or national Alzheimer’s or dementia support group, such as the Alzheimer’s Society, for more information and advice about living with Alzheimer’s disease.
Find Alzheimer’s support services in your area and read more about living well with dementia .
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.
You can find more information about caring for yourself and access a helpful care planning form.
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Am I At Risk Of Alzheimers Disease
Alzheimers disease is a devastating disease that affects the brain. This disease typically progresses slowly but ultimately ends up destroying memory, thinking skills, and the ability to carry out the simplest tasks. It is a devastating disease, but the good news is some things may help decrease the risk of developing it.
What is Alzheimers Disease?
Alzheimers disease is a type of dementia that affects memory, thinking, and behavior. It is the most common type of dementia. Dementia is a general term used to explain cognitive and memory loss that interferes with routine daily tasks. Alzheimers specifically is a build-up of amyloid and Tau proteins in the brain that interfere with its normal function.
What Are The Early Signs And Symptoms Of Alzheimer’s Disease
Now that we’ve discussed the scientific definitions, let’s turn to the warning signs. According to the experts at the Alzheimer’s Association, there are 10 major early signs and symptoms of Alzheimer’s to watch out for, and they are as follows:
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