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Alzheimer's: Symptoms, Causes And Treatments

Anyone who has a loved one diagnosed with Alzheimer's disease (AD) will agree that the experience can be rather frustrating. The condition not only impacts adversely on the individual directly affected, but also on their loved ones. It is one of those medical issues that somewhat makes longer lifespan not necessarily a blessing.

You have come to the right place if you are in search of useful information on Alzheimer's for yourself or a loved one. Here, we discuss practically everything you need to know about the disorder, including symptoms, causes and treatments.

What is Alzheimer's Disease?

Also known as Alzheimer's dementia or simply Alzheimer's, AD is a neurodegenerative disease. This means it is a disorder that arises from progressive decline in neuronal function or death of neurons. It leads to gradual memory loss and drop in some other mental functions. Damage brought about by the condition is thought to be irreversible.

Decline in cognitive function and behavioral abilities worsens to an extent of interfering with daily living. The severity usually differs between patients. This, in turn, determines the type of symptoms that you may observe.

Alzheimer's disease is the most common form of dementia. Estimate has it that this accounts for up to 80 percent of cases of dementia. Majority of those affected are believed to be at least 65 years old. However, some cases can begin as early as the 40s or even 30s.

AD is one of the leading causes of death in the United States. Some estimates suggest that it is probably responsible for the most deaths, behind heart disease and cancer.

Brain Changes in Alzheimer's Disease

Scientists have been working on unraveling the changes in the brain that contribute to the development of Alzheimer's. They have made significant progress in this regard, especially in the more recent years. Research has shown reduction in neurons in cases of the disorder.

It is estimated that the human brain plays host to some 100 billion neurons (nerve cells). These are connected, forming numerous networks of communication. Different groups of neurons are responsible for different mental abilities, such as learning and thinking. They also facilitate the senses, such as hearing and seeing.

From this background, it is easy to see why a problem such as Alzheimer's develops when nerve cells die off. You start noticing decline in the functions that the eliminated neurons played roles in.

Before dying, nerve cells usually experience decline in efficiency as a result of damage. Scientists say the little changes can take place long – even several years – before you start noticing symptoms.

According to researchers, the damage to neurons seems to begin in the hippocampus, a part of the brain responsible for making memories. Other parts later become affected as the number of neurons reduces further. This leads to shrinkage of brain tissue.

Alzheimer's Symptoms

Memory issues – These are early tell-tale signs of possible Alzheimer's disease. The condition particularly makes it difficult for you to remember information you learned recently. While it is normal to find it a bit harder remembering things as you get older, a sudden and significant change is a cause for concern.

Things that you may notice more often as a result of memory problems in Alzheimer's include:

Regularly misplacing items, especially by placing them in odd places
Repeating questions that had been addressed
Difficulty in finding the right words to express things
Forgetting important appointments and events

Left unchecked, the disorder can worsen to the extent a patient forgets names of family members and regular objects.

Poor decision making – Alzheimer's patient can find it hard making the right and proper decisions. The disorder tells adversely on their ability to make good judgments. You may find it hard to take decisions that are ordinarily thought simple or instinctive, such as finding a safer route after learning of danger ahead.

Difficulty with clear thinking – This disorder makes it hard for you to think clearly. It brings about something of a mental fog. It becomes very tricky concentrating on anything and multitasking turns to something extremely difficult.

The condition makes abstract concepts and ideas tough to grasp. This may make it difficult to keep tabs on your finances as appropriate, among other consequences.

Other symptoms that may show up with Alzheimer's disease include:

Social withdrawal
Depression
Apathy
Sleep problems
Mood swings
Irritability
Aggressiveness
Disorientation
Delusions
Distrust of loved ones and caregivers
Difficulty in speaking

People with this disorder may not fully realize they have a problem. Their loved ones may be the first to notice the signs.

Stages of Alzheimer’s Disease

Symptoms of Alzheimer’s dementia varies from one patient to another. The particular ones you observe can give an idea of the stage of the disorder. This will be helpful in taking action to get prompt attention.

There are seven stages of Alzheimer’s, according to WebMD, with regard to changes in mental functions [1]. These are:

Normal outward behavior
Very mild changes
Mild decline
Moderate decline
Moderately severe decline
Severe decline
Very severe decline

At the early stages, AD symptoms may not be easily noticed, unless the affected person undergoes an imaging test of the brain. Everything appears normal on the outside.

It is from the third stage that symptoms that can be more reliably linked to this mental disorder start to manifest. Here, the individual begin to find it difficult remembering what they learned recently. He or she tends to become more disorganized.

At the “severe” stages, these symptoms become more troubling. The patient becomes even more forgetful. He finds it quite hard to remember things that some may consider impossible to forget. This include own phone number and home address. As time goes on, the patient starts to mistake one loved one for another.

Delusions, such as thinking an item is lost when it isn’t, begin to manifest. In extreme cases, an affected person can be hungry and thirsty without realizing the right action to take.

Researchers are working hard to find how to detect AD as early as possible. This will hopefully improve the chances of preventing the disorder from getting worse and causing irreversible damage.

Causes of Alzheimer’s

It is not always possible to tell the exact cause of Alzheimer’s disease. Scientists are still trying to understand what is responsible for it in most patients. However, the common idea is that it results from changes in the brain that have been on for many years before symptoms become noticeable. These, in turn, are caused by a combination of factors.

Talking about changes, two abnormal structures in the brain are thought to be the main culprits for Alzheimer’s disease. These are plaques and tangles. They combine to damage and kill brain cells.

Plaques – These are deposits of a protein known as beta-amyloid. Plaques amass between nerve cells in the brain. As a result, neurons may become damaged and die. This is how plaques are thought to contribute to Alzheimer’s.

Scientists, however, cannot tell with all certainty that these plaques indeed cause death of nerve cells. These are only suspected.

Tangles – These structures also come from a protein, a type known as tau. Alzheimer’s is believed to result from abnormal structure of this protein. Tau threads become twisted and accumulate within brain cells, possibly leading to their death.

It should be noted, though, that it is not entirely abnormal for people to have plaques and tangles as they get older. But these tend to be more significant in Alzheimer’s cases. They typically appear first in areas associated with memory as well.

Researchers believe that plaques and tangles may play a role in blocking communication between neurons in the brain. They could also make survival of these nerve cells more difficult.

Alzheimer’s Risk Factors

All people are not at the same risk of developing Alzheimer's disease. Some persons are more likely to have it than others. Let's examine some factors that increases the risk of you having this disorder.

Age

It is a widely known fact that Alzheimer's tend to affect the elderly the most. This doesn't mean the condition is all part of the aging process, though. The risk only increases as people grow older, especially from the age of 65 onward. Cases increase tremendously every successive decade after 60, according to Mayo Clinic [2].

For some time, it was more of a mystery why Alzheimer's disease was more common among the elderly. But scientists have now observed that it appears to be the result of changes in the brain over the years. These include activity of free radicals, atrophy in parts of the brain, and mitochondrial dysfunction.

Genetics

Alzheimer's is one of those conditions that appear to run in the family. Chances are that you may have it if a first-degree relative, such as your parent, has it. While scientists are yet to fully understand this genetic angle, they have found that mutations in one of three genes may cause a person to have this disorder.

The gene known as apolipoprotein E (APOE), which has several forms, is thought the biggest risk for now. A type called APOE e4 is particularly believed to significantly increase the risk of having Alzheimer's disease at an earlier age. In this case, the disorder develops as early as the 30s.

Down syndrome

Having Down syndrome makes a person more likely to develop Alzheimer's. Researchers believe this may have to do with the existence of three copies of Chromosome 21. The extra copy of this human autosome contains a gene that produces amyloid, which may contribute to nerve cell death in the brain.

Mayo Clinic states that symptoms of Alzheimer's disease usually become noticeable in Down syndrome patients about 10-20 years earlier, compared to the general population.

Mild cognitive impairment (MCI)

This is a condition that makes some persons have memory problems that are unusual for their age. A major difference from Alzheimer's is that these symptoms do not really hinder daily living.

Older individuals with MCI are at a greater risk of developing Alzheimer's disease. But this does not mean all will. The good news here is that you can prevent progression to the scary dementia by taking appropriate actions.

Gender

It turns out being a woman puts you at a greater risk of having Alzheimer's disease, just as is the case with depression and panic attacks. More women are diagnosed with the disorder than men. According to Mayo Clinic, this may be because they tend to live longer, among other reasons.

Other possible risk factors include:

Obesity
Past head trauma
Type 2 diabetes
Smoking (even mere exposure to secondhand smoke)
High cholesterol levels in the blood

Diagnosis of Alzheimer's

There are several techniques your doctor can use to examine if the symptoms you are showing are indeed those of Alzheimer's. But it is the decision of a medical professional to determine the appropriate methods because there is no particular test that confirms the disorder yet. According to Mayo Clinic, the most accurate diagnosis is possible only after death.

We discuss below some of the things you can expect as your doctor tries to make a diagnosis.

Medical history and examination

Your doctor will typically begin by asking you some relevant questions about your health and feelings. These will be aimed at knowing more about your overall health, behavioral changes (if any), and ability to perform daily tasks, among other things.

You will also need to undergo physical examination. You may as well expect to pass through some form of neurological assessment. Your doctor will assess your walking ability, balance, and coordination. You may also expect him to check your reflexes, how you get up out of a chair, and muscle strength.

Mental tests

Your doctor could perform a variety of tests to assess your mental functions. These include tests of memory, language, counting and problem solving. They may be in a short or long form, as though appropriate.

Medical tests

A series of blood and urine tests may be ordered. These can help to rule out other conditions that could possibly produce somewhat similar symptoms as Alzheimer’s. For instance, lack of some essential vitamins or thyroid problems can aggravate mental functions.

Brain scans

For better, more accurate diagnosis, your doctor may ask you to do brain imaging tests. These could enable him to identify abnormalities in the brain that may suggest possible Alzheimer's dementia. They also bring light to changes that may be associated more with some other medical conditions.

Among the brain imaging options are:

Computed tomography (CT) – This generates cross-sectional images of the brain. It is popularly used in the diagnosis of strokes and tumors. Doctors also use it to assess head injuries that can increase the risk of Alzheimer's.

Magnetic resonance imaging (MRI) – With this brain imaging technique, your doctor may be interested in ruling out other conditions that can give rise to memory problems and other mental issues. An MRI scan can also help to identify shrinkage in parts of the brain, such as seen in Alzheimer's patients.

Positron emission tomography (PET) – Results of a PET scan can reveal parts of the brain that are not working as they ought. Latest techniques also reveal the extent of the major culprits – plaques and tangles – in the brain. However, the newer PET methods are mainly used in research for now.

Cerebrospinal fluid sampling

Researchers have found that the cerebrospinal fluid can also be a tool for diagnosis of Alzheimer's disease. It is thought that it contains key biomarkers of the disorder. The protein neurogranin has been found to be in higher amounts in people with Alzheimer's.

Cerebrospinal fluid examination is an invasive procedure. It is restricted to special situations, such as when symptoms of dementia are noticed at a younger age or when they worsen very fast.

Genetic testing

This isn’t usually part of regular Alzheimer’s diagnosis. But it may be needed in cases of individuals with a family history of developing the disorder earlier.

Researchers are still working on finding more accurate methods of earlier detection and/or arriving at a diagnosis. Current investigations include saliva testing, proteins and protein patterns.

How is Alzheimer’s Disease Treated?

The typical approach to treatment of Alzheimer’s involves the use of medications. There are about five main offerings approved by the Food and Drug Administration for managing the disorder. But there is no known cure yet.

Mayo Clinic says there are two main types of medications that are used for treatment, namely: cholinesterase inhibitors and memantine.

Cholinesterase inhibitors – This class of drugs are mostly used to control mild to moderate symptoms of Alzheimer’s. They help to improve communication between brain cells by improving the amount of the neurotransmitter acetylcholine. Examples of cholinesterase inhibitors include Donepezil (Aricept) and rivastigmine (Exelon).

Memantine – More popularly known under the trade name Namenda, memantine is used for treating moderate to severe cases of Alzheimer’s disease. It can be used alone or in combination with cholinesterase inhibitors, such as Aricept.

In some cases, doctors do recommend antidepressants for people with Alzheimer’s. These drugs help to address the behavioral symptoms of the disorder.

Other Treatment Approaches

Medications are in no way sufficient for effective treatment of Alzheimer’s disease. This is a complex condition that a single intervention cannot successfully deal with. In addition to drugs, the following are some other things you will need to consider for treatment.

Nutrition

Foods that are known to be friendly to the heart are usually beneficial to people with Alzheimer’s. These can improve cognitive function and boost mood. A diet rich in fruits and vegetables and low in fat will be very beneficial. A patient will do well to avoid coffee and other beverages containing caffeine as much as possible. Instead, lots of water should be taken daily.

Loved ones of people with Alzheimer’s have an important role to play in this regard. On their own, patients may not pay much attention to a healthy diet or taking sufficient amount of water for proper hydration.

Exercise

Being active can offer anybody immense protection against Alzheimer’s disease, among other benefits. People who already have the disorder will find this beneficial as well. A daily walk lasting at least 30 minutes can make a difference in your mood and sleep quality. Exercise also enhances muscle, joint and heart health. It can also lower the risk of falls that patients are susceptible to.

Alternative medicine

A number of natural compounds, herbs and supplements are thought to be beneficial in the management of Alzheimer’s disease. These may not prevent the disorder but are believed to help in slowing its progression. They include curcumin, gingko biloba and Omega-3 fatty acids.

These natural ingredients, including vitamins, are often made available in supplement form. Two good examples of supplements that may help with symptoms of Alzheimer’s are BrainPill and CBD Pure. These boasts constituents that are highly regarded for improving cognitive function and mood as well. CBC Pure is a supplement made out of CBD oil while BrainPill is a nootropic.

Future Treatments

For now, the methods available for the treatment of Alzheimer’s mainly aim to address the symptoms. Researchers continue to work in search of more effective treatments that target more than just symptoms. They are interested in finding means of halting changes that can contribute to death of brain cells.

It is interesting to note that most of what is known about the disorder only came to light within the last two decades. At this pace, the hope is that it may not take very long before a revolutionary treatment is found.

Targets of future drugs that are currently under investigation include:

Plaques – Researchers are aiming at finding ways to block beta-amyloid from building up into plaques. This involves the use of drugs that imitate the effects of your body’s natural defense mechanism to dispose of beta-amyloid.

Aims of future therapies being investigated also include preventing beta-amyloid interacting with the protein Fyn. The interaction disrupts connections between neurons in the brain.

Tangles – There are ongoing clinical trials investigating ways to keep tau from tangling. The tangles formed from the twisting of this protein is a major abnormality in this condition.

Inflammation – Research is also being done to find ways to address inflammatory processes seen in Alzheimer’s with the hope that this will be beneficial to patients.

In recently published research, some scientists observed that a drug for Type 2 diabetes caused considerable reversal of memory loss in mice [3]. The findings revealed that the medication protected brain cells that are destroyed in Alzheimer’s. There is now plan by the researchers to test it on humans.

The best anyone can do for now is to try by all means necessary to guard against Alzheimer’s dementia. It has no known cure for now. While there is no sure-fire way to completely prevent it, experts say you can lower your risk of having the disorder by doing things that are friendly to your heart.

Drugs and other interventions only help to manage symptoms of Alzheimer’s. Safe environment, social support and mental stimulation alongside lifestyle changes will also help tremendously in managing the condition.

REFERENCES

Alzheimer's Disease: The 7 Stages of the Disease (https://www.webmd.com/alzheimers/guide/alzheimers-disease-stages)

Alzheimer's disease - Symptoms and causes - Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447)

A Diabetes Drug Has 'Significantly Reversed Memory Loss' in Mice With Alzheimer's (https://sciencealert.com/diabetes-drug-significantly-reversed-memory-loss-in-mice-with-alzheimer-s)

Alzheimer's Association - What Is Alzheimer's? (https://www.alz.org/what-is-alzheimers.asp)

Alzheimer's Association - Treatment Horizon (https://www.alz.org/treatment-horizon.asp)

Alzheimer's disease - Diagnosis and treatment - Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/diagnosis-treatment/drc-20350453)

Alzheimer's Disease Fact Sheet (https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet)

Alzheimer's treatments: What's on the horizon? - Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-treatments/art-20047780)

4 Hopeful Approaches to the Future of Alzheimer's Treatment | Mental Floss (http://mentalfloss.com/article/67187/4-hopeful-approaches-future-alzheimers-treatment)

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