Alzheimer's Disease | Definition, Causes, Symptoms, & Treatment
Alzheimer's Disease | Definition, Causes, Symptoms, & Treatment
Alzheimer’s Disease is one of the most common types of dementia. Although these two terms are used interchangeably by some, they refer to two different things. Dementia is a term used to describe symptoms such as memory decline, poor reasoning skills, impaired cognitive abilities, and more. While this may apply to Alzheimer’s as well, dementia has other types and causes including Lewy body dementia, vascular dementia, frontotemporal dementia, and many more.
According to the Australian Institute of Health and Welfare, there are up to 472,000 Australians living with dementia in 2021, which is equivalent to 15 out of 1,000 people. In New Zealand, on the other hand, the estimates in a report published in the Journal of the Alzheimer's Association show that 62,000 people are living with dementia. These figures for both countries are estimated to go higher in the coming years. With Alzheimer's Disease accounting for 60-70% of dementia cases, everyone needs to learn more about it especially when they have a loved one living with the disease. In this article, we are going to discuss Alzheimer's Disease, its definition, causes, symptoms, treatments, and how Tunstall can provide support to families and individuals living with this disease.
Alzheimer's Disease is a progressive brain disorder characterised by changes in the brain including tangles, amyloid plaques, and neurofibrillary, leading to neuron loss and their connections. Alzheimer's can cause loss of cognitive function, including reasoning and thinking, and changes in behaviour, which may affect their quality of life and ability to live independently. In this type of dementia, symptoms most often appear in the elderly and the rate of progression can vary among people. Some can sustain a relatively independent lifestyle, while others can experience severe impairment. Alzheimer's can manifest in various stages:
In the early stages of Alzheimer's, the individual may show changes in behaviour and mood, but they can function independently. The person may still be able to go to work or drive, and they can continue to be social. During this stage, memory lapses may already be experienced, however, the symptoms may not be apparent to friends and family.
In the moderate stage, the parts of the brain that controls language, sensory processing, reasoning, and conscious thought may already be damaged. The person may lose the ability to detect smells and sounds, and the decline in memory and confusion may worsen. This is the stage where the person with Alzheimer's fails to recognize friends and family. Learning new things or carrying out daily activities may also be affected.
In the advanced stage of Alzheimer's, plaque and tangles continue to spread throughout the brain which causes the brain tissues to shrink significantly and will lead to severe memory impairment and neuron loss. The tangles or protein fibre clumps inside neurons and also lead to cell death. People in the late stages of this condition will experience cognitive decline and they will not be able to communicate. They will be dependent on their friends, family, or medical professionals for their care.
Although there is no definitive cause for Alzheimer's, scientists believe that it is caused by abnormal protein build-up in and around brain cells. There are two proteins involved in the build-up in a person's brain cells - tau, which forms tangles, and amyloid, which forms plaques. As the plaques and tangles continue to build up, the brain cell functions become affected, leading to a decrease in neurotransmitters which are responsible for the connection and communication among brain cells.
In people with Alzheimer's, the levels of acetylcholine, a neurotransmitter, have been observed to be particularly low. Because of the protein build-up, various areas of the brain shrink and the first to be affected is usually the one responsible for memories. It is not known what exactly triggers these processes to begin, but scientists have found that they begin even years before the first appearance of symptoms.
Though the exact cause of Alzheimer's is unknown, several risk factors increase the chances of developing it:
A person’s age is considered a major risk factor for Alzheimer’s disease because older brains are less able to deal with stress than younger ones. It is said that after the age of 65, the likelihood of a person developing Alzheimer's doubles every five years. It is important to know, however, that Alzheimer's and dementia do not only affect older people. The early onset of Alzheimer's can affect people even at the age of 40.
If you have a parent or sibling with Alzheimer's, you are at high risk to develop the disease as well. Certain genes can make someone more likely to develop Alzheimer’s disease. For example, having a mutation in the APOE gene makes you twice as likely to develop Alzheimer‘s disease compared to someone without the same mutation. A genetic test can help identify those who are most likely to suffer from this condition. Researchers say that it could be used to predict whether someone is developing dementia, and even determine how severe the symptoms might become. Scientists believe that there are multiple causes of Alzheimer’s, including environmental factors such as lifestyle choices like diet and exercise. But scientists think that some cases of the disease are caused by changes in our DNA.
They found that certain variations in three genes – ApoE, BIN1, and TREM2 – are linked to Alzheimer’s. These genes affect the way proteins work inside cells, and researchers think that they play a role in making sure that brain cells function correctly. People inherit one copy of each of these genes from both parents. One of the genes, called ApoE, is involved in clearing away waste products from the brain. Another gene, called BIN1, helps regulate cell growth. And the third gene, TREM2, plays a role in immune system responses.
People with Down syndrome often develop Alzheimer's. Having three extra chromosomes (chromosome 21) has likely led to an increase in the number of genes that code for proteins involved in Alzheimer’s disease. People with Down syndrome usually develop symptoms of Alzheimer's disease 10 to 20 years earlier than the average person.
A study by S. Fleminger et al. published in the Neuropsychology Journal showed that people who have experienced traumatic brain injuries are more likely to develop dementia onset at an earlier age, as seen in their autopsy-confirmed Alzheimer's Disease cases. A similar study from the Journal of Neurology, Neurosurgery, and Psychiatry showed the same results. Researchers looked at 15 case-control studies and discovered that a large percentage of people with Alzheimer's disease have a history of head injury.
Heart disease has been linked to brain dysfunction which may lead to dementia and a significant increase in the amount of beta-amyloid protein in the brain which can trigger Alzheimer's. The same risk factors associated with cardiovascular disease may also increase the risk of Alzheimer's disease including lack of exercise, obesity, smoking or secondhand smoke, high cholesterol, type 2 diabetes, and high blood pressure.
Read more about dementia risks and what to do about them here: Dementia Risks and Care: 9 Steps You Can Take to Slow Down Dementia
Occasional memory lapses may be expected for everyone once in a while, however, the memory loss experienced by people with Alzheimer's disease is persistent and it is only expected to worsen as they grow older. Early common symptoms include difficulty remembering recent events, such as where a person puts things, forgetting how to complete simple tasks like tying shoes and having trouble recognizing faces. The person with this condition suffering from short-term memory loss might forget what day of the week it is and start losing track of time. They will not be able to remember conversations or appointments and they may even get lost in familiar places. They may repeat questions or statements, or ask the same question repeatedly. Forgetting the names of family members and friends can also be expected.
A person with Alzheimer's will have trouble concentrating and thinking. Abstract concepts such as numbers may also be hard for them to understand, therefore, managing their finances and paying bills may be a huge issue. In severe cases, they won't be able to recognize numbers. Their thinking may also be impaired so people with Alzheimer's may often have trouble finding the right words to say. Individuals with Alzheimer's also suffer from impaired judgement or reasoning and issues with their language skills so they may become dependent on others in their daily life for care.
People with this form of dementia often lose interest in activities they once enjoyed, and become agitated, depressed, forgetful, and aggressive. They may wander away from home or refuse to eat. Other behavioural changes include depression, apathy, social withdrawal, mistrust of others, irritability, aggression, loss of inhibitions and loss of sleep. Over time, they may begin to lose control of bodily functions, including bladder and bowel functions. As the disease progresses, people with dementia may experience physical deterioration, such as the inability to perform daily tasks, and difficulty walking, swallowing, speaking, and breathing.
While there is no singular test available for the diagnosis of Alzheimer’s, most doctors will usually examine a patient for several weeks to conclude their findings. During this period, they will ask questions about the person's family and medical history, perform a physical examination, order blood tests, order brain scans, and sometimes give the patient a memory test, though this varies from person to person. There are also new tests and techniques today that can detect Alzheimer’s disease before symptoms begin. These include genetic testing, biomarkers, neuroimaging, and cognitive assessments.
A diagnosis of Alzheimer's can be confirmed with a brain scan such as Magnetic Resonance Imaging (MRI) or Computerised Tomography (CT) scan. Genetic testing can help identify whether a patient has inherited a gene linked to Alzheimer's. Blood tests can reveal low levels of vitamin B12, folic acid and homocysteine, which are related to Alzheimer's. Cognitive screening tools evaluate a patient's ability to perform everyday tasks.
While there is currently no cure for Alzheimer’s disease, there are a variety of medications and treatments that can help manage and relieve the symptoms of people living with the disease.
The most common forms of medications used to treat Alzheimer’s include antidepressants, antipsychotics, anticonvulsants, sedatives and hypnotics, stimulants, anxiolytics, antihistamines and cholinesterase inhibitors. The medications may include donepezil, galantamine, rivastigmine, and memantine. Each one treats different symptoms associated with the disease. Donepezil helps improve memory; galantamine improves thinking skills; rivastigmine increases brain levels of acetylcholine, and memantine reduces nerve cell damage. Some people don't respond well to a single medication. For those patients, combining drugs may help.
Regular exercise, reduced alcohol consumption, a healthy diet, and even learning new skills can all have a positive effect on people living with Alzheimer's. Playing the piano, making crafts, and even learning a dance routine can help preserve someone's brain functions. When these lifestyle changes are implemented, a person with Alzheimer's can expect a better quality of life.
You can also read more about activities that can help here: 5 Stimulating and Helpful Home Activities for People With Dementia
Emotional and behavioural therapies can also help manage behavioural symptoms such as agitation, depression, aggression, mood swings, memory loss, paranoia, and more. In some behavioural interventions, care partners are taught how to recognize and respond to the person's behaviour using techniques to manage anger, agitation, impatience, and more.
Tunstall is well-equipped to give individuals with Alzheimer's Disease and their carers round-the-clock service to ensure a better quality of living. The symptoms associated with Alzheimer's can be managed effectively while remaining inside their own home through the help of our Connected Care solutions. Tunstall's mobile personal alarms are equipped with GPS which means carers can feel at ease knowing that they can have access to the location of their loved ones with Alzheimer’s at all times. The devices also have an SOS button which can generate an alarm call in case of a medical emergency so the wearer can be connected to a 24/7 Customer Care Centre. Open voice communication is available so the wearer can speak directly with one of our Customer Care Consultants whenever and wherever needed to get the best possible assistance.
We are dedicated to giving our clients the best care, services, and products to support them in maintaining independence while still enjoying life. Reach out to the Tunstall Healthcare team today so we can create a personalised solution for you.
Keep reading: 9 Ways to Create a Safe and Dementia-Friendly Home