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Alzheimer’s Disease – Symptoms, Causes, Treatments

The essential facts about Alzheimer’s

Alzheimer’s is a disease and it’s not a normal part of aging.

Alzheimer’s disease is the most common form of dementia, affecting about 1 in 8 people over the age 65.

It causes 60 – 80% of all dementia cases and is the 6th leading cause of death in the United States.

Let’s explain what Alzheimer’s disease is, including common symptoms, causes, and treatment options.

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive brain disease, this means that it worsens over time. It destroys a person’s memory as well as thinking skills and in later stages, physical functions. The disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all of its functions.

In the early stages of the disease, memory loss and other symptoms can be mild. In late-stage Alzheimer’s, people can no longer communicate or even respond to their environment.

The age that most people with Alzheimer’s will become symptomatic is mid-60s. Although about 5% develop symptoms before the age of 65 (approx. 200,000 Americans). When this occurs prior to age 65, it’s referred to as early-onset Alzheimer’s.

Scientists are unsure as to what actually causes Alzheimer’s, but they suspect the brain damage and symptoms come from amyloid plaques and tau tangles in the brain.

Plaques are deposits of amyloid proteins that build up. Tangles are twisted fibers of tau protein that build up inside nerve cells.

Persons with Alzheimer’s disease will experience physical symptoms as well as cognitive ones due to the neurons in the brain which stop functioning, lose connections with other neurons, and die off. These neurons are needed to send messages between different areas of the brain and from the brain to parts of the body.

The part of the brain that’s responsible for forming memories, is typically where the damage begins. As more neurons die, more parts of the brain are affected.

In the final stages of Alzheimer’s disease, the damage will have spread throughout the brain and the brain itself has shrunk significantly.

 Alzheimer’s symptoms

Difficulty remembering newly learned information is the most common early symptom of Alzheimer’s diseases.

Trouble finding the right words, vision or spatial issues, and impaired reasoning or judgment are also symptoms that most will notice.

One of the biggest and most difficult challenges with people in the earlier stages, is that they may not even recognize that they have a serious problem beginning.

Other common symptoms include:

  • Memory loss that disrupts daily life; difficulty with everyday tasks
  • Confusion with time or place
  • Trouble focusing
  • Feeling confused or frustrated, especially in the evening 
  • Trouble communicating – following or joining a conversation, or repeating themselves
  • Changes in mood or personality – outbursts of anger, anxiety, and depression
  • Feeling disoriented and/or getting lost easily 
  • Physical problems, like a strange walk or poor coordination

A higher level of care in needed as Alzheimer’s spreads throughout the brain and as symptoms increase in severity.

More advanced symptoms include:

  • Mood and changes in behavior 
  • More serious memory loss and behavior changes
  • Disorientation and increasing confusion about events, time, and place
  • Paranoia or suspicion toward family, friends, and/or professional caregivers
  • Troubles with dressing, bathing, and using the toilet
  • Difficulty speaking, swallowing, and walking
  • Inability to recognize or name family members or people close to them

Alzheimer’s vs dementia

Dementia is not a single disease; it’s an overall term that covers a wide range of specific medical conditions, including Alzheimer’s disease (which accounts for 60-80% of cases).

Disorders grouped under the general term “dementia” are caused by abnormal changes in the brain which are characterized by impairment of at least two brain functions, such as memory loss and judgement. 

Alzheimer’s disease is a degenerative brain disease that is caused by complex brain changes following cell damage. It leads to dementia symptoms that gradually worsen over time. It is the most common cause of dementia and refers to a collection of symptoms. Alzheimer’s is a type of dementia.

Dementia is caused when the brain is damaged by stroke, multiple TIA’s (transient ischemic attacks or mini strokes), injury, or diseases like Alzheimer’s.

There are also 8 other types of dementia you may not be aware of. 

Causes of Alzheimer’s disease

Scientists still don’t understand what causes Alzheimer’s disease in most people.

Early-onset Alzheimer’s is often caused by genetic mutations.

Late-onset Alzheimer’s seems to be caused by changes in the brain that develop over decades. The causes probably include genetic, environmental, and lifestyle factors.

It’s unknown as to why the disease primarily affects older people.

There could be something in the relationship between cognitive decline and health conditions such as heart disease, stroke, high blood pressure, diabetes, and obesity.

It’s possible that reducing the risk of these conditions could also reduce the risk of Alzheimer’s.

Doctors recommend living a healthy lifestyle to help reduce the risk of cognitive decline and Alzheimer’s disease. That includes healthy eating, regular exercise, maintaining social connections, and staying mentally active.

Alzheimer’s treatment and life expectancy

Treatment
At this time, there is no cure for Alzheimer’s. But there are FDA approved medications that may improve quality of life for both the person with Alzheimer’s and their family.

Three drugs used to treat Alzheimer’s are all in one family, called cholinesterase inhibitors, which boost brain levels of acetylcholine:

  • Galantamine (Razadyne®)
  • Rivastigmine (Exelon®)
  • Donepezil (Aricept®)

The FDA has given accelerated approval for two drugs that may slow the progression of mild Alzheimer’s and are only indicated for people with mild disease:

  • Lecanemab (Lequembi®)
  • Aducanumab (Aduhelm®)

Memantine (Namenda®) is the only drug currently approved by the FDA to treat symptoms due to moderate to severe stages of Alzheimer’s disease.

The above drugs could help delay, reduce, or stabilize Alzheimer’s symptoms like memory loss and confusion. They may also help control some behavioral problems. 

Life expectancy
Alzheimer’s disease typically progresses in three stages. 

An early stage with minimal symptoms, a middle stage of increasing cognitive impairment, and a final stage where the person needs help with all activities of living and may not be able to communicate or engage with the world.

On average, a person with Alzheimer’s lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors.