Alzheimer Disease Causes, Symptoms, Treatment And Frequently Asked Questions

We all forget things at times as we age. But if our memory problems interfere in our routine and disturbs our routine, it could be a sign of something more serious like Alzheimer’s or dementia. Dementia is not a specific condition but it refers to the range of symptoms where a person cannot think or remember things and their behaviour disrupts their daily life. Let's find out how Alzheimer's and dementia are different? What are Alzheimer symptoms? How is the treatment for Alzheimer’s disorder carried out? 

Here are some of the most frequently asked questions about Alzheimer’s disease:

1. What is Alzheimer’s disorder?

Alzheimer’s disease is a progressive and irreversible brain disorder that gradually damages memory and thinking skills leading to difficulty in carrying out simple tasks. Most people get Alzheimer symptoms for the first time in their mid-60’s. 

2. Which best describes Alzheimer?

Alzheimer is characterized by symptoms such as memory loss, confusion, language troubles and unpredictable behaviour. The most defining feature of Alzheimer’s is the formation of plaques and tangles in the brain. Another important feature is the loss of connection between the nerve cells that eventually impairs brain signaling.

3. What is the difference between Alzheimer’s and dementia?

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The terms Alzheimer’s and dementia can be quite confusing as both the conditions involve problems with memory and thinking. The truth is Alzheimer disease causes dementia in the majority of the older patients. Alzheimer disease accounts for approximately 60-80% of total dementia cases.

4. What do Alzheimer’s, Parkinson and mad cow disease have in common?

Though Alzheimer’s, Parkinson and mad cow disease are three different diseases, they do have one thing in common. The proteins and genes involved in these diseases might be different but they follow a similar process of progression. When proteins alter their shape or structure, they become self-destructive. These altered forms of proteins are referred to as prions. In these diseases, the proteins become prions and they start spreading from cell-to-cell, damaging the brain altogether.

5. How to prevent Alzheimer?

You can reduce the risk of Alzheimer disease by making a healthy choice for your food and lifestyle. Follow these tips in your daily life to minimize your risk:

• Perform cardio exercises. These workouts boost your circulation and enhance the blood flow to your brain.
• If you have a smoking habit, seek help from professionals to quit.
• Eat a healthy and balanced diet that is high in fruits and vegetables and low in fats. Mediterranean and DASH diet plans might help.
• Do not ignore your social life.
• Ensure that you sleep for a quality time every day.
• Seek help from mental health professionals if you have stress, depression or anxiety.

6. How to care for an Alzheimer patient at home?

Caring for a patient suffering from Alzheimer can be physically, financially and emotionally draining. It is important to be aware of the disease and the challenges of caretaking as the disease progresses. Here are the few things to do while taking care of an Alzheimer patient at home:

Initial stage:

• In the earlier stages, Alzheimer patients would need to be reminded of bills, names, words, etc. Instead of doing it all by yourself, encourage them to maintain a notebook or diary to remember things.
• Motivate them to be physically active and follow a proper diet by following the routine along with them. Eating well and managing stress helps both of you.

Middle stages:

• In this stage, you will have added responsibilities and you might not be able to do it all alone. Seek help if you need and join a support group. You will hear people sharing experiences similar to yours and learn how to tackle the challenges of caretaking.
• Reach out to a friend, family member or a volunteer organization for help with daily chores of caregiving. Take frequent breaks for yourself and ensure that your health is normal.
• Involve your loved ones in daily activities like watering plants, walking, etc.

Late stages:

• Talk to your friends, family members or therapist about how you feel about your loved one’s health, caretaking and how you feel in general.
• Stay physically active by exercising for at least 30 minutes everyday.
• Visit your physician for a regular health check-up and find ways to manage extreme stress.
• Practice relaxation techniques like yoga, meditation, journaling and deep breathing.

7. What are the odds of inheriting a dominant gene for Alzheimer’s disease?

The genes associated with development of early onset Alzheimer disease are APP, PSEN1 and PSEN2. Most people develop late-onset Alzheimer’s disease that usually shows symptoms in the mid-60s. Presence of one of the apolipoprotein E genes increases the risk of Alzheimer. However, people without this gene can also develop the disease. For example, people with down syndrome can also develop Alzheimer’s disease due to the fault in the chromosomes.

8. What are Alzheimer disease causes?

Genetics, age, gender, medical conditions and lifestyle contribute to the development of Alzheimer’s. Genetic mutation is likely to be the cause in early-onset Alzheimer’s disease. Late-onset Alzheimer’s occurs due to various changes that take place in the brain over decades.

9. What increases a person’s susceptibility to Alzheimer’s disease?

There are two types of Alzheimer’s namely early-onset and late-onset Alzheimer’s disease. The following factors decide the risk of getting diagnosed with Alzheimer’s disorder depending on each individual:

• Age: Age is one of the biggest risk factors for Alzheimer’s disease. People above 65 years of age are at a greater risk of Alzheimer’s. This risk doubles every five years.
• Gender: Though the exact reason is not known, women are two times higher risk than men when they cross 65 years. Possible reason could be the decline in the hormone estrogen after women attains menopause.
• Environmental factors: Medical conditions like diabetes, stroke and heart problems aggravate the risk of Alzheimer’s. High blood pressure, high cholesterol levels, obesity and depression are also possible risk factors that contribute to the development of Alzheimer’s.
• Lifestyle factors: People who follow a healthy and active lifestyle into their middle age are less likely to develop Alzheimer’s. A good nutritious diet, regular physical activity, active social life and participation in mentally stimulating activities boost a person’s brain health and keeps them healthy as they age.

10. What does Alzheimer do to the brain?

Our brain consists of the regions medial temporal lobe comprising the entorhinal cortex and hippocampus. These regions are the most vulnerable to nerve damage and cell loss. Aβ and tau are two proteins that accumulate in the brain way before the Alzheimer symptoms appear. Aβ protein accumulation forms plaques outside the cell while tau protein forms tangles inside the cells. Plaque formation occurs earlier but tangles form as brain capacity declines. These two proteins cause direct damage as they interrupt nerve signals, increase oxidative stress and cause nerve inflammation.

11. How do Alzheimer disease patients feel and think?

It is important for patients to be aware of their diagnosis because they get an explanation for their symptoms. But this awareness comes at a cost. Once they know that they have Alzheimer’s disease, they undergo periods of stress with their new diagnosis. They fear forgetting their loved ones, losing independence, relying on others for everything and financial burden.

12. What are the early warning signs of Alzheimer’s?

Alzheimer symptoms develop gradually over many years and one day the condition becomes severe. Before you jump into a conclusion, check for these early Alzheimer symptoms:

• Memory problems interfering in daily life
• Difficulty planning things and solving problems
• Difficulty completing simple tasks
• Confusion with time or place
• Trouble understanding visual images
• Unusual problems with speaking or writing
• Missing things and not knowing how to trace them back
• Poor judgement
• Isolating from work and social activities
• Mood or personality changes

13. What are the Alzheimer symptoms?

The Alzheimer symptoms differ according to the stage of the disease. As the disease progresses to advanced stages, it becomes more difficult to manage things that seem normal to other people. Let us understand the Alzheimer symptoms according to its stages ranging from mild to severe:

a) Mild Alzheimer symptoms:

In mild form of alzheimers, patients experience greater memory loss and ability to think. Many people are diagnosed for the first time at this stage. Some of the most commonly occurring symptoms include:

• Trouble handling money and paying bills
• Wandering and getting lost even in familiar places
• Repeating questions
• Forgetting recent conversations
• Taking longer to complete routine tasks
• Behavioural changes

b) Moderate Alzheimer symptoms:

In this stage, damage occurs in the part of the brain that regulates the language, reasoning and thinking processes. Memory loss and confusion worsen. Following are the symptoms that occur during this stage of the disease:

• Confusion
• Language problems
• Problems recognizing family members and friends
• Inability to learn new things
• Difficulty performing simple tasks like dressing up
• Imagining things that are not there
• False beliefs that contradict with reality
• Extreme fear
• Impulsive behaviour

c) Severe Alzheimer symptoms:

In this stage of the disease, the brain damage worsens so much that the brain tissues begin shrinking significantly and several plaques and tangles form throughout the brain. A person remains bedridden until the body functions stop. The classic symptoms of this stage include:

• Inability to communicate
• Complete dependence on others
• Bedridden 

14. What is the only definitive diagnostic test for Alzheimer’s disease?

The definitive diagnosis of Alzheimer’s is possible only after death by examining the brain tissue during post mortem. Other tests will be conducted to rule out the possibilities of other health issues. Initially, the doctor will conduct physical examination and diagnostic tests that involves the following processes:

• Blood and urine tests will be conducted to find the causes of your problem and rule out other possibilities. 
• Magnetic Resonance Imaging (MRI) shows a detailed image of the brain structure. When this test is performed at regular intervals, it is possible to detect the early changes in the brain structure.
• Computerised Topography (CT) scan shows the thickness of a specific part of the brain that thins out in Alzheimer patients.
• Single Photon Emission Computed Tomography (SPECT) scan measures the flow of blood to the brain. This test can be helpful as Alzheimer patients have nerve damage that disturbs blood flow to the brain.

15. What do Alzheimer’s patients die from?

Alzheimer is a progressive disease and as the disease rapidly progresses to a severe stage, the damage takes over the entire cortex part of the brain. In the severe stage, the patient becomes extremely weak, dehydrated and devoid of sufficient nutrition and movement. In the advanced stages, patients have a very weak immunity and become easily prone to infections. These are the conditions where Alzheimer causes death in individuals:

• Pneumonia
• Heart attack
• Dehydration
• Malnutrition
• Injuries and fractures due to falling
• Blood clot formation
• Bed sores
• Stroke
• Kidney failure
• Blood infections

16. How to cure Alzheimer disease?

Since it is a complex health issue that does not have any drug or other intervention to successfully cure it, treatment of Alzheimer’s disorder aims to alleviate symptoms. Here are some medications indicated for the treatment of Alzheimer’s disorder:

Medications for treatment of Alzheimer’s disorder:

a. Cognitive symptoms:

Cholinesterase inhibitors: Cholinesterase inhibitors are the first choice of medication for the treatment of Alzheimer’s disorder. It works to minimize cognitive symptoms like memory loss, language problems, etc., in mild to moderate stages of Alzheimer’s.

• Donepezil
• Rivastigmine
• Galantamine

N-methyl-d-aspartate glutamate antagonists (NMDA antagonists): This medicine is used either alone or in combination with cholinesterase inhibitors, generally in later stages of the disease. It delays deterioration in patients with moderate-to-severe Alzheimer-induced dementia. Memantine blocks the excessive amount of a substance called glutamate in the brain.

• Memantine

b. Behavioural symptoms:

In addition to brain function decline, behavioural and psychiatric symptoms are also a common occurrence in Alzheimer’s. Generally behavioural symptoms do not require medications but in some cases, medications like Cholinesterase inhibitors and memantine could help minimize behavioural and psychiatric symptoms. Other medications usually prescribed for behavioural symptoms include:

Antidepressants:

• Citalopram 

Anti-psychotics:

• Quetiapine
• Risperidone
• Olanzapine
• Haloperidol