by Melissa Chichester
There are 5 million people living with Alzheimer’s disease, a fatal brain disorder that is the 6th leading cause of death in the United States[1]. A form of dementia, Alzheimer’s disease impairs cognitive abilities until it severely interferes with daily life. While this disease cannot be stopped or reversed, recognizing it in its earliest stages can help families and diagnosed individuals prepare for the future.
In 1906, Dr. Alois Alzheimer discovered brain changes in a patient who passed away from mental illness characterized by signs of confusion, memory loss, and unpredictable behavior. These brain changes included considerable neurofibrillary tangles around nerve cells[2]. In 1910, the disease was first named by Dr. Alzheimer’s colleague, psychiatrist Emil Kraepelin, in the 8th edition of his book, Psychiatrie, but it wasn’t recognized as the leading cause of dementia until 1976. In 1994, President Ronald Reagan announced that he was diagnosed with Alzheimer’s disease.
Researchers believe that Alzheimer’s disease is caused by a variety of factors. Age is thought to be the biggest risk factor, affecting 32% of people over age 85 [3]. Gender and ethnicity both have an impact on risk factors, as 2/3 of Americans with Alzheimer’s disease are women, while African Americans are twice as likely as whites to develop it. Family history may also play a role, especially if a parent or sibling has been diagnosed. Risk factors for cardiovascular disease, including high cholesterol and diabetes, can also pose an elevated risk for the development of Alzheimer’s [4].
Because there are differences between Alzheimer’s disease and other types of dementia, the processes of diagnosis may take several weeks. This diagnosis usually requires a group of doctors to evaluate the patient’s family and psychiatric history, in addition to conducting blood tests to rule out other conditions. Cognitive tests examine language, memory, and problem-solving skills, and can determine abilities that are still available to the patient, like driving and managing money. Testing also includes family member interviews, brain imaging exams, and checking for vitamin deficiencies[5].
In the early stages of Alzheimer’s disease, a person may experience frequent memory lapses, like trouble remembering names, loss of reading comprehension, and forgetting important dates or events. During this time, friends and family members may notice changes as well. As the disease progresses, nerve damage results in the patient exhibiting more pronounced changes like increasing suspicion of others, easy agitation, forgetting their personal history, wandering, losing track of time, and needing assistance to use the bathroom. During the final and most severe stage of Alzheimer’s disease, individuals lose essential functions, including the ability to swallow, walk, and carry on a conversation.
Because Alzheimer’s disease has no cure, caregivers focus on keeping the patient comfortable for as long as possible. While this may include the use of anti-anxiety and anti-depression medications, creating a safe environment is among the most important aspects of the treatment plan. This includes installing handrails in bathrooms and stairways, removing clutter, and keeping photographs of loved ones in view. Reducing the number of mirrors in the home is also helpful, as Alzheimer’s patients are often confused or even startled by them. Exercise is also important in helping those with Alzheimer’s sleep better, and maintains joint and heart health. Walking, riding a stationary bike, and chair exercises are all options for someone with Alzheimer’s, depending on their stage of the disease. A doctor will provide guidance on what exercises are safe, and if they can be done alone or with the aid of a caregiver.
If you suspect that you or a loved one may be experiencing the first stages of Alzheimer’s disease, do not hesitate to contact your primary care physician.