Alzheimer’s disease is the most common form of progressive dementia that leads to increasing problems in behavior, memory and thinking. Dementia is a group of brain disorders that cause the loss of intellectual, social and memory abilities that lead to interference in the activities of daily living. Alzheimer’s disease causes the connections between brain cells to progressively deteriorate and die which leads to advancing decrease in brain functions. While age is the most common risk for Alzheimer’s disease, it’s important to remember that Alzheimer’s disease is not considered a normal part of the aging process.
Research has suggested that Alzheimer’s disease is caused by brain structures called plaques, which are deposits of protein fragments that collect in the spaces between nerve fibers and tangles, which are twisted protein fibers that build up inside brain cells. While everyone develops tangles and plaques, people who are diagnosed with Alzheimer’s disease develop plaques and tangles in a progressive and expected manner. Plaques and tangles begin to develop in the brain of someone who has Alzheimer’s disease in the areas that control memory and spread to other areas of the brain.
Proper management and medication can slow the progress of Alzheimer’s disease to promote a positive quality of life and increase independence. Alzheimer’s disease does not have a cure, so management of the disease and supportive services will be necessary for family and loved ones as soon as a diagnosis is made.
Although Alzheimer’s disease is progressive it does not impede all activities of daily life immediately. Instead, the disease progresses over the span of several years in three stages: mild, moderate and severe Alzheimer’s disease. Prompt diagnosis and treatment can increase the quality of life during these stages. Generally speaking, the following are guidelines for what to expect during these stages:
Mild Alzheimer’s disease begins when a person loses the ability to remember something that has just been learned. It may be harder and harder to recall other things, make proper decisions and move about a previously known environment. It may be hard for others to see these changes and write them off as “part of getting older,” even though it is part of Alzheimer’s disease. This stage of Alzheimer’s disease can last many years and often people can live independently during this time with the support of loved ones, doctors and local area support groups.
Moderate Alzheimer’s disease is the longest part of the Alzheimer’s disease process and may last many years for some. People with moderate Alzheimer’s disease have increasing problems with memory and the ability to communicate. During this stage, many people have difficulties thinking clearly and speaking in a way that makes sense to others. Loved ones and trusted caregivers may not always be recognized and often people in this stage of Alzheimer’s cannot place where they are. Activities of daily living such as eating or bathing become increasingly challenging and personality may begin to change. Some people in this stage of Alzheimer’s disease often become riddled with anxiety or too depressed to get out of bed while others become angry and violent, striking out at caregivers and loved ones. Some begin to believe that others are lying to them or stealing from them. During moderate Alzheimer’s disease, living alone will be a challenge, and living with a family member or a residential care setting will be more appropriate.
Severe or late-stage Alzheimer’s disease is marked by further decline in memory, thinking skills and ability to care for oneself. Many people forget who they are and where they are and are only able to speak a few words to others. Eating, bathing and dressing will require assistance. Wandering activities increase which often leads to placement in a residential care facility.
While these are the general stages of Alzheimer’s disease, it is important to recall that the disease will progress differently in each person. Most people diagnosed with Alzheimer’s disease will live about eight years following diagnosis, although this may be a function of age at diagnosis. It’s important to make these years the best they can be for everyone involved.
Statistics
The incidence of Alzheimer’s disease rises exponentially as a person ages. Overall it’s estimated that about 5.2 million people in the US have Alzheimer’s disease, a number that is comprised of 5 million people age 65 and older and approximately 200,000 people under the age of 65 years old. Right now, it’s estimated that a person in the United States is diagnosed with Alzheimer’s disease every 68 seconds, a number that is expected to rise drastically. It’s been predicted that by the year 2050, 15 million people in the United States will have been diagnosed with Alzheimer’s disease.
Co-Occurring Disorders:
- Mental illness
- Psychosis
- Cardiovascular disease
- Depression
- Anxiety
- Delirium
Causes
As is the case with many illnesses of the brain, a single root cause for an illness can be challenging to ascertain. It’s likely that Alzheimer’s disease is the result of a combination of environmental, genetic, and lifestyle factors that affect the brain as it ages.
Genetic: It’s estimated that less than 5% of diagnoses of Alzheimer’s disease are caused by specific genetic mutations. There are two types of genes that play a role in Alzheimer’s disease diagnosis: risk genes and deterministic genes. Risk genes increase the chances that you will develop Alzheimer’s disease and deterministic genes ensure that you will develop Alzheimer’s disease. While not directly correlated, the risk for developing Alzheimer’s disease appears to have a familial link – a parent or sibling with Alzheimer’s disease may increase the likelihood for developing Alzheimer’s disease. However, having a direct family member who has Alzheimer’s disease does not ensure that you will develop the disease.
Biological: Women are more likely to develop Alzheimer’s disease although it is unclear whether this correlation is due to the fact that women live longer than men. People who have heart conditions, irregular heartbeats, high cholesterol or other cardiovascular problems are at a higher risk for developing Alzheimer’s disease.
Environmental: Boxers and others who have engaged in activities that lead to severe or repeated trauma to the head have a greater likelihood for developing Alzheimer’s disease.
Psychological: While not fully understood, it’s generally accepted that people who have lived a life full of learning and stimulating social engagement are at a lower risk for developing Alzheimer’s disease. It appears that the more ways in which a person stimulates their brain over their lifetime the less likely it is that they will develop Alzheimer’s disease.
Signs and Symptoms
It’s important to note that no two cases of Alzheimer’s disease are alike, yet Alzheimer’s disease does follow a progression. The following are the most common symptoms of Alzheimer’s disease:
Mood:
- Unable to concentrate on single task no matter how often the task has been done before.
- Feeling depressed
- Mood swings
- Irritability
- Aggression
Behavioral:
- Wandering
- Loss of inhibitions
- Withdrawing from loved ones
- Worsening memory loss
- Asking the same question repeatedly
- Inability to recall something recently learned
- Problems speaking and writing
- Forgetting names of loved ones
- Not knowing where you are
- Putting items in odd locations and forgetting where they’ve been placed
- Forgetting events and not later recalling them
Physical:
- Loss of bowel or bladder control
- Problems swallowing
- Changes in sleep patterns
- Trouble eating or drinking
- Inability to navigate environment
- Falling
- Trouble walking
- Loss of muscular coordination
- Changes in ability to perform activities of daily living like bathing and eating
Psychological:
- Paranoia – belief that others are lying to you or stealing from you
- Aggressive violent behavior
- Extreme anger
- Lashing out at others
- Acting in a way that is different from normal personality
- Psychosis
- Hallucinations
- Delusions
Effects of Alzheimer’s Disease
In order to manage this chronic and progressive illness, early intervention, diagnosis, treatment and management is vital to protecting the safety of people who have Alzheimer’s disease and those around them. Effects of Alzheimer’s disease may include:
- Infections – especially bladder and kidney infections related to incontinence
- Wandering – which can lead to unsafe conditions for someone with Alzheimer’s disease
- Falls – as the disease progresses, so does the ability to use large and small muscles. Falls in the elderly can cause serious complications
- Abuse – due to the violent mood swings and verbal and physical abuse that someone who has Alzheimer’s disease may display, they are at a higher risk for abuse.
- Malnutrition - during the later stages of Alzheimer’s disease, individuals lose the ability to feel hunger and feed themselves. This can lead to malnutrition.
- Injuries – from falls or altercations with others