Alzheimer’s Disease: Causes, Symptoms, and Management

Everyone wishes to age well. The human body undergoes a multitude of changes with age, and some related losses in memory and thinking are natural. But some conditions are not a normal part of aging, and one of them is Alzheimer’s disease.

What is Alzheimer’s disease?

Usually, memory loss and forgetfulness are associated with advancing age. But a severe form of memory loss that interferes with normal, daily functioning is diagnosed as dementia.

Dementia is a general term used for a set of symptoms that affects cognitive functions including memory, thinking, language, problem-solving, and other mental capabilities. Alzheimer’s is the most common type of dementia and was named after Alois Alzheimer, the doctor who first described this condition in 1906.

Alzheimer’s is a progressive condition that affects your brain and cannot be reversed or stopped. According to the Dementia India Report, it is estimated that India has close to four million cases of dementia, and this figure may double by 2030. Alzheimer’s disease forms a huge (50%–75%) chunk out of all cases of dementia. Although most Alzheimer’s cases are late-onset, setting in after the age of 60, early-onset Alzheimer’s occurs between the age of 30 and 60 and is considered a rare condition.

Causes

To date, research has not been able to find the exact cause of Alzheimer’s. However, factors such as genetics, lifestyle, and environment can influence susceptibility to Alzheimer’s. The microscopic changes in the brain begin years before the first symptoms of the disease manifest. 

Your brain is made up of billions of neurons. These are like building blocks that work together to send signals from one part of the brain to the other. These signals are needed to perform basic functions such as thinking, learning repetitive movements, language skills, remembering, and recalling memories. In Alzheimer’s disease, the connection between these neurons is lost, resulting in the loss of all functions. 

Some factors believed to cause Alzheimer’s are:

1. It is believed that certain proteins accumulate in the brain, forming abnormal structures called plaques and tangles. These structures cause damage to the neurons and eventually cause them to die, leading to loss of functional brain tissue. This slow damage often begins in the region of the brain that controls memory. It then progresses to other parts of the brain, manifesting as a variety of symptoms as seen in people with Alzheimer’s disease.

2. Another typical feature is the loss of connection between the cells. The brain contains chemical messengers that transmit signals between neurons. One such chemical is called acetylcholine. When the neurons get damaged, the acetylcholine decreases affecting the signal transmission between cells. It eventually leads to symptoms of Alzheimer’s disease.

3. By the final stage of Alzheimer’s disease, due to huge damage to the neurons, the brain regions begin to shrink, a condition known as brain atrophy. 

What can put you at a higher risk for Alzheimer’s?

A variety of factors can lead to Alzheimer’s disease. While some can be controlled, some are out of your hands.

Age: Old age does not cause Alzheimer’s per se, but it is the single most significant risk factor in Alzheimer’s. Late-onset type, which develops after the age of 60, is the most common. After 65, chances of developing Alzheimer’s doubles every five years. 

Family history: Certain genes that you inherit from your parents can put you at a higher risk of developing Alzheimer’s. While your risk increases if you have a first-degree relative diagnosed with this disease, most genetic factors remain unexplained and are complex.

Down’s syndrome: People who have Down’s syndrome are at a higher risk of developing Alzheimer’s when they get older. They carry a genetic defect that produces a protein, which plays an important role in the build-up of plaque in the brain.

Lifestyle and health problems: Several lifestyle factors that often lead to cardiovascular diseases, are also the risk factors for Alzheimer’s disease. Sedentary lifestyle, smoking, high cholesterol, and diabetes are some of them. 

Symptoms

As you get older, like any other body part, your brain ages too. Forgetfulness is a normal part of aging and may not always be a sign of Alzheimer’s disease. Therefore, symptoms of Alzheimer’s disease, much like all dementias, are mild to start with. As the damage progresses, these become severe enough to interfere with daily functioning. 

One of the common early signs of Alzheimer’s is impaired memory — particularly, new information or recent events. This is because damage usually starts in the area associated with learning and memory. 

As the disease progresses, some signs and symptoms to look out for are:

1. Forgetting recent conversations and/ or events
2. Misplacing items, or placing objects in odd places
3. Increased disorientation such as getting lost in familiar places
4. Delusions or paranoia about caretakers or family members
5. Asking repetitive questions
6. Poor judgement or decision-making skills
7. Trouble recognizing friends and family
8. Struggling to follow a conversation or pick the right word in conversations
9. Changes in mood such as anxiety, depression, mood swings, apathy, social withdrawal, and irritability

In advanced stages, Alzheimer’s patients may require full–time assistance in moving, eating, personal care, and other daily activities. Affected people may not easily recognize or address their problems, even as symptoms of the disease become obvious to family and friends. If you are experiencing these symptoms, it’s important that you seek immediate medical attention for prompt evaluation and diagnosis. 

Diagnosis 

Diagnosis is based on detailed history and neurological examination of the patient. As the patients themselves may not be able to give much information about their symptoms, it is advisable that someone closely associated or living with them accompany them for the doctor’s visits.

The doctor evaluates the patients for their ability to satisfactorily do activities of daily living (ADL) and assesses the mental state through few psychological tests.

Blood tests may be done to rule out other causes of  symptoms.

MRI or PET scans of the brain are required for confirmed diagnosis of Alzheimer’s disease.

Also read: How to Exercise Regularly and Stay Motivated

Can Alzheimer’s be prevented?

There is very little evidence available on the prevention of cognitive decline in Alzheimer’s disease currently. However, few activities may improve cognitive functions and overall quality of life. Effecting in enhancing the cognitive reserve, these activities may delay the onset of all age-related dementias, including Alzheimer’s disease. Such activities are:

1. Reading books
2. Learning a musical instrument
3. Learning a new language
4. Solving complex puzzles and crosswords
5. Teaching a class
6. Activities involving fine movements like knitting or quilting

Treatment for Alzheimer’s

There is no treatment for Alzheimer’s at the moment. However, some treatments, including medication, can slow down the progression of the disease and make the symptoms manageable. These medicines include drugs that help restore communication between brain cells, improve memory, and increase the ability to perform daily functions. However, results are highly variable and can, at best, be termed as moderate. It’s also important to keep medications in a secure, fixed place. 

Following a fixed routine and minimizing memory-dependant tasks can help ease daily functioning. Additionally, therapies such as cognitive-behavioral therapy or cognitive stimulation therapy can help deal with symptoms of depression and memory loss.

Tips for caregivers

To support the person’s well-being and managing symptoms of Alzheimer’s, you could include the following:

1. Engaging in regular physical activities help improve blood flow to the brain and have a positive impact on the mind
2. Playing puzzles, board games, reading, or playing a musical instrument helps keep the mind active and engaged
3. Joining a club, social group, such as dance groups, book clubs, exercise classes, or hobbies such as art and craft, music, or gardening can also keep the mind active
4. A sudden change in environment can cause confusion. Keep the surroundings familiar with known people and routine 
5. Talking about the past using photographs, music, or even personal possessions can help improve mood and overall well-being

It’s also important to include healthy amounts of physical exercise, nutritious food, and different activities to keep the brain functioning smoothly. In most cases, families and friends are able to take care of an Alzheimer’s patient. But it may become difficult as the disease progresses.

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