Alzheimer's disease: Causes, Symptoms, Diagnosis and Treatment

Alzheimer's disease is a brain condition that worsens with time. It is characterized by changes in the brain that result in protein accumulation. Brain cells gradually die, and the brain shrinks as a result of Alzheimer's disease. The most prevalent cause of dementia, which is a progressive deterioration in thinking, behavior, memory, and social skills, is Alzheimer's disease. These changes impact a person's capacity to function.

Over time, memory, thinking, learning, and organizing abilities deteriorate as a result of Alzheimer's disease. The majority of dementia cases are caused by this, and those who are affected are often older than 65. Alzheimer's has no known treatment, however, some drugs and therapies can temporarily help manage symptoms.

One of the disease's early symptoms is forgetting recent discussions or experiences. It eventually develops into severe memory issues and the inability to carry out daily duties.
 Medications can either alleviate symptoms or decrease their course. Programs and services can benefit people with the illness and those who care for them.

What is the disease Alzheimer's?

Alzheimer's disease (pronounced "alz-HAI-mirs") is a brain disorder that gradually impairs memory, thinking, learning, and organizing abilities. It eventually impacts a person's capacity to do fundamental daily tasks. The most typical cause of dementia is Alzheimer's disease (AD).

Alzheimer's disease symptoms get worse over time. The illness process, according to researchers, may begin 10 years or more before the first symptoms manifest. Over 65s are most frequently affected by AD.

As far as dementia goes, Alzheimer's disease is the most prevalent.

The disease is gradual, starting with mild memory loss and potentially progressing to the loss of communication and environmental awareness.

The brain regions that are responsible for thought, memory, and language are affected by Alzheimer's disease.

It can significantly impair a person's capacity to carry out daily tasks.

Also Read: Epilepsy: Seizures Types, Symptoms, Causes, Diagnosed and Treatment

Who is affected by Alzheimer's disease?

People over 65 are most commonly affected by Alzheimer's disease. The likelihood that you will have Alzheimer's increases as you get older than 65.

Alzheimer's disease can strike some people before they are 65 years old, usually in their 40s or 50s. Alzheimer's disease with early onset is what this is. It's unusual. Only 10% of instances of AD had an early beginning.

What phases of Alzheimer's are there?

Based on symptoms, Alzheimer's disease organizations and medical professionals use a variety of terminology to define the illness's stages.

The phases of AD all have the same progression of symptoms that increase over time, despite the differences in terminology.

However, no two people with AD have the same experience. The stages of Alzheimer's disease will be experienced by each patient differently. Not every person will experience all the changes. Since stages may overlap, it can occasionally be challenging for caregivers to classify a person with AD in a particular stage.

Some businesses and services describe the stages of dementia instead of Alzheimer's disease:

Alzheimer's disease is in its early stages.

• Alzheimer's disease-related mild cognitive impairment (MCI).
• Mild dementia brought on by Alzheimer's disease
• Severe dementia brought on by Alzheimer's.
• Other businesses and services define the stages more broadly as follows:
• Mild. Moderate. Severe. Or:
• Early.
• Middle.
• Late.

Ask your doctor or the doctor who cares for your loved one what they mean when they use particular terminology to describe the stages of Alzheimer's disease.

What exactly is early-stage Alzheimer's disease?

Typically, preclinical research on Alzheimer's disease is the only stage that is mentioned by providers. Asymptomatic individuals with AD in the preclinical period often have no symptoms.

Nevertheless, their brains are evolving, and this period can extend for several decades. Because they are still working at a high level, individuals in this stage are typically not yet diagnosed with Alzheimer's.

Since amyloid protein deposits in the brain interfere with the brain's communication system, there are now brain imaging tests that can find these deposits before symptoms appear.

What symptoms and indicators are present in Alzheimer's disease?

Depending on the stage of the illness, Alzheimer's disease (AD) has different indications and symptoms. Generally speaking, AD symptoms include a steady decline in all, most, or part of the following:

• Memory loss that interferes with daily life, such as asking the same questions or becoming lost in a familiar setting.
• Language.
• Recognizing the link between space and visual form.
• Personality and behavior.
• Losing things and not being able to go back and find them.

Memory loss and other Alzheimer's symptoms might make it difficult for people to recognize their mental deterioration. For family members, these symptoms could be more visible. Anyone displaying signs of dementia should consult a doctor as soon as possible.

Alzheimer's dementia symptoms of the mild stage

The mild stage of AD is when symptoms first become apparent. The most prevalent early sign is forgetting newly acquired information, particularly recent events, locations, and names.

Other mild Alzheimer's symptoms and indicators include:

• Finding it tough to communicate one's feelings in words.
• More frequently than usual misplacing or losing things.
• Having trouble organizing or making arrangements.
• Having trouble coming up with solutions.
• Taking longer to finish daily routine tasks.
• Most persons with mild AD can typically travel to familiar places and recognize faces without any trouble.

Symptoms of Alzheimer's disease in its middle stage

The most advanced stage of Alzheimer's, moderate, can endure for many years. People with intermediate Alzheimer's disease frequently need care and support.

In this period, a person might:

• Have worsening disorientation and memory loss, frequently forgetting dates or information from their lives, such as their phone number or their place of attendance.
• Have a rising sense of uncertainty regarding the season, location, and day of the week.
• Possess a weak short-term memory.
• Have considerable trouble identifying your loved ones.
• Retell the events, stories, or thoughts that are currently on your mind.
• Become more agitated or act out, among other personality changes. As the illness worsens, they could exhibit anxiety, apathy, or depression.
• Form false suspicions about loved ones, friends, and caregivers.
• Develop fecal (bowel) incontinence and urine incontinence.
• Have issues falling asleep.
• Start to stray away from their home.
• Have trouble with basic math.

Need assistance with self-care activities like bathing, grooming, taking a shower, and using the restroom.

Alzheimer's disease severe stage symptoms

Dementia symptoms are really bad when Alzheimer's disease is advanced. In this stage, patients require intensive care.

When Alzheimer's disease is severe, the person frequently:

• Has a very nonexistent memory.
• Oblivious to their surroundings.
• Needs assistance with all daily activities, including eating, sitting up, and walking.
• They become unable to converse. They start to speak only in short sentences or phrases.
• Becomes more susceptible to infections, notably skin, and pneumonia.

For comfort, hospice care can be acceptable at this time.

What causes Alzheimer's disease?

Alzheimer's disease is brought on by an aberrant protein accumulation in the brain. Both amyloid protein and tau protein accumulate in the brain, which results in the death of brain cells.

Over 100 billion nerve cells and other cells make up the human brain. Together, the nerve cells carry out all of the communications required to carry out tasks like thinking, learning, remembering, and planning.

According to scientists, amyloid protein assembles into bigger aggregates known as plaques inside your brain cells. Tau tangles are made of twisted tau protein fibers. These plaques and tangles obstruct nerve cell communication, which stops the nerve cells from performing their functions.

The signs of Alzheimer's disease are caused by the continual, progressive loss of the nerve cells. The hippocampus, which governs memory, is where nerve cell loss typically begins in the brain before spreading to other regions.

Despite ongoing research, scientists are still unsure of the precise reason why these proteins accumulate. They currently think that a genetic mutation might be the root of early-onset Alzheimer's. They believe that a complicated succession of brain alterations that could take place over many years is what causes late-onset Alzheimer's. The root cause is probably a result of a mix of genetic, environmental, and behavioral factors.

Diagnosis:

Several techniques are used by medical professionals to identify Alzheimer's disease in patients with memory problems. This is because dementia and other Alzheimer's symptoms can be caused by numerous different illnesses, particularly neurological conditions.

An Alzheimer's diagnosis begins with a professional gathering information about your health and everyday activities. Your healthcare professional might also consult a close relative or carer for their perspective on your symptoms. They'll enquire into:

• General wellbeing.
• Current pharmaceuticals.
• Medical background.
• The capacity to perform daily tasks.
• Mood, behavior, and personality changes.
• Moreover, a supplier will
• Perform a neurological and physical examination.

Conduct a mental health examination that includes tests for language, basic math, problem-solving, memory, and attention.

To rule out further potential causes of the symptoms, order common medical tests including blood and urine checks.

To confirm an Alzheimer's diagnosis or rule out other probable illnesses, request brain imaging tests such as a brain CT, brain MRI, or positron emission tomography.

Complications:

It may be more difficult to manage other medical illnesses when Alzheimer's symptoms, such as memory loss, language loss, impaired judgment, and other brain changes, are present. An individual suffering from Alzheimer's disease could not be capable of:

• Express your pain to someone.
• Explain the signs and symptoms of another disease.
• Adhere to a treatment plan.
• Describe the side effects of medications.

Changes in the brain start to impact bodily processes as Alzheimer's disease progresses into its last stages. Swallowing, balance, and bladder and bowel control may all be impacted by the alterations. These consequences may result in additional health issues like:

• Putting liquid or food in the lungs.
• Pneumonia, the flu, and other illnesses.
• Falls.
• Fractures.
• Bedsores.
• Dehydration or inadequate nutrition.
• Diarrhea or constipation.
• Dental issues including tooth decay or mouth sores.

Treatment:

Alzheimer's disease has no known cure, however, some drugs can momentarily prevent the symptoms of dementia from getting worse. Behavioral symptoms can also be helped by medications and other treatments.

It may be feasible to retain everyday functioning for a while by starting Alzheimer's treatment as soon as possible. Current treatments, however, cannot halt or reverse AD.

Treatment is extremely customized because AD has varied effects on each individual. To choose the most effective course of therapy, medical professionals consult with Alzheimer's patients and the individuals who care for them.

To treat the signs of Alzheimer's disease, the U.S. Food and Drug Administration (FDA) has approved two classes of medication:

• NMDA antagonists, 
• Cholinesterase inhibitors, and so on.

Acuranumab (AduhelmTM), the first Alzheimer's disease, disease-modifying treatment, has received accelerated FDA approval. Your brain's amyloid deposits are lessened with the aid of the drug.

Researchers examined the impact of the novel drug aducanumab on patients with early-stage Alzheimer's disease. As a result, it might only benefit those who are just starting.

Cholinesterase :

The following cholinesterase inhibitors can assist in treating the signs and symptoms of mild to moderate Alzheimer's disease:

• Aricept® (donepezil). Using this to treat moderate to severe AD is also FDA-approved.
• Exelon (Rivastigmine).
• Razadyne® (galantamine).

Acetylcholinesterase, the enzyme that breaks down acetylcholine, is inhibited by these medications. One of the substances that facilitates communication between nerve cells is acetylcholine. Some of the symptoms of Alzheimer's disease are thought to be caused by low levels of acetylcholine, according to researchers.

These medications can lessen some behavioral signs of Alzheimer's disease and help with some memory issues.

These drugs don't treat Alzheimer's disease or stop it from getting worse.

NMDA antagonists

The FDA has given memantine (Namenda®) approval to treat mild to severe Alzheimer's disease. It keeps some brain cells in better health.

Memantine users with Alzheimer's disease do better in ordinary everyday tasks like eating, walking, using the restroom, bathing, and clothing themselves, according to studies.

Managing shifts in behavior

If your loved one has been diagnosed with Alzheimer's disease, you can make changes to their surroundings and behavior to keep them comfortable. One can:

• Keep the surroundings comfortable for them. Don't alter their living space's design or layout.
• Observe how they are doing.
• Offer solace-inducing items like a favorite stuffed animal or blanket.
• If they're stressed out, try to divert their focus.
• Try to avoid confrontation.

No medication has been approved for the management of behavioral symptoms in Alzheimer’s dementia. Certain medications may help in some people, including:

• Antidepressants: These medications can be used to treat depression, anxiety, restlessness, and violence.

• Anti-anxiety medications: These meds can ease agitation.

• Anticonvulsants: These medicines can occasionally be used to alleviate hostility.

• Neuroleptics (antipsychotics): These medications can be used to treat agitation, hallucinations, and paranoia.

Healthcare practitioners normally only administer these drugs for brief periods when behavioral issues are severe since they can have unpleasant or potentially harmful side effects (such as dizziness, which could result in falls). Or just after your loved one has first tried less risky non-drug treatments.

Clinical studies

Alzheimer's disease and potential cures are continuously being investigated by scientists. Inquire with your doctor whether clinical trials might help you or a loved one.

People frequently have more options to take part in clinical trials or other research studies when they receive an early diagnosis.

Prevention:

Can I reduce my risk of developing Alzheimer's?

While some risk factors for Alzheimer's cannot be controlled, such as age and heredity, you may be able to manage other risk factors to help reduce your risk.

Risk elements for Alzheimer's disease include:

Age (becoming older is the major risk factor).

• Genetics.
• A brain injury.
• Depression.
• Both cerebral and cardiovascular conditions.
• A high blood pressure level.
• High cholesterol.
• Diabetes.
• Smoking.
• Obesity.

According to research, leading a healthy lifestyle can help keep your brain young and prevent cognitive decline. The methods listed below may assist in lowering your risk of getting Alzheimer's disease:

• Play board games, read, solve crossword puzzles, play an instrument, or engage in other activities that need "brain power" to keep your mind sharp.

• Get moving: Exercise improves oxygen and blood flow to the brain, which may have an impact on the health of the brain's cells. If you are engaging in activities that enhance your risk of suffering a head injury, wear protective headgear.

• Keep in touch with friends and family and participate in group activities like church services, exercise classes, reading clubs, and community service to be socially engaged.

• Healthy eating: Adopt a nutritious diet that incorporates antioxidants, Eat a Mediterranean-style diet that is high in fresh vegetables, healthy fats, and foods low in saturated fat.

• If you have any concerns about your potential for acquiring Alzheimer's disease, speak with your healthcare professional.

References:

• Livingston G, et al. Dementia prevention, intervention, and care: 2020 report of The Lancet Commission. The Lancet. 2020; doi:10.1016/S0140-6736(20)30367-6.

• Alzheimer’s Association. Stages of Alzheimer’s (https://www.alz.org/alzheimers-dementia/stages). Accessed 12/10/2022.

• Alzheimer’s Association. What is Alzheimer’s Disease? (https://www.alz.org/alzheimers-dementia/what-is-alzheimers) Accessed 12/10/2022.

• National Institute on Aging. Alzheimer’s Disease Fact Sheet. (https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet) Accessed 12/10/2022.

• National Institute on Aging. What are the Signs of Alzheimer’s Disease? (https://www.nia.nih.gov/health/what-are-signs-alzheimers-disease) Accessed 12/10/2022.

• Kumar A, Sidhu J, Goyal A, et al. Alzheimer Disease (https://www.ncbi.nlm.nih.gov/books/NBK499922/). [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 12/10/2022.