Alzheimer's disease is a condition that destroys brain cells. People with this disease slowly lose the ability to learn, function, and remember. It is the most common cause of dementia. Dementia is a loss in mental abilities that is great enough to interfere with daily life.
Areas of the Brain Affected by Alzheimer's Disease
The cause of Alzheimer's is not yet known. Two factors that may play a role in the development of Alzheimer's disease are:
- Plaques—Abnormal deposits of a substance called beta amyloid in different areas of the brain.
- Neurofibrillary tangles—Twisted fibers (called tau fibers) within the nerve cells.
People who are over 65 years of age have an increased risk of Alzheimer's disease.
Other factors that may increase your chance of Alzheimer's disease include:
- Previous serious, traumatic brain injury
- Lower educational achievement
- Obesity in middle-age
- Down's syndrome
- Down's syndrome in a first-degree relative
- Women under age 35 who give birth to a child with Down's syndrome
- Family history of Alzheimer's disease
- Presence of a certain type of protein (APOE-e4)
- Elevated levels of homocysteine
- Coronary artery disease
Researchers are studying the following to see if they are related to Alzheimer's disease:
- Poor nutrition and vitamin deficiency in childhood
- Excess metal in the blood, especially zinc, copper, aluminum, and iron
- Certain viral infections
- High cholesterol
The disease begins as mild memory lapses. It will continue toward a profound loss of memory and function. Alzheimer's disease is divided into 3 stages:
- Early—Loss of memory, reasoning, understanding, or learning, but does not interfere with independence
- Intermediate—Increased mental loss, personality changes, and increased dependence on others for basic needs
- Severe—Loss of personality and bodily functions with total dependence on others for care
Increasing trouble remembering things, such as:
- How to get to familiar locations
- What the names of family and friends are
- Where common objects are usually kept
- How to do simple math
- How to do usual tasks, such as cooking, dressing, and bathing
- Having difficulty concentrating on tasks
- Having difficulty completing sentences due to lost or forgotten words—may progress to complete inability to speak
- Forgetting the date, time of day, or season
- Getting lost in familiar surroundings
- Having mood swings
- Being withdrawn, losing interest in usual activities
- Having personality changes
- Walking in a slow, shuffling way
- Having poor coordination
- Losing purposeful movement
There are no tests to confirm Alzheimer's. You will be asked about your symptoms and medical history. A physical exam will be done. Neurological, psychological, and mental status exams may be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests
- Urine tests
- Lumbar puncture to test the cerebrospinal fluid that surrounds the brain and spinal cord
Images may be taken of your bodily structures. This can be done with:
Your brain's electrical activity may be measured. This can be done with electroencephalogram (EEG).
There is no cure for Alzheimer's disease. There are no certain ways to slow its progression. Medication is available to treat some of the symptoms. The goal is to find a medication that can manage the symptoms or slow the condition's course.
Medications for Symptoms and Disease Progression
Medications that have been approved to reduce the symptoms of Alzheimer's disease include:
- Cholinesterase inhibitors—for mild-to-moderate Alzheimer's disease
- N-methyl-D-aspartate (NMDA) receptor antagonist—for moderate-to-severe Alzheimer's disease
Managing the disease includes:
- Creating an environment in which you can receive the care you need
- Keeping your quality of life as high as possible
- Keeping yourself safe
- Helping yourself learn to deal with the frustration of your uncontrollable behavior
- Providing a calm, quiet, predictable environment
- Providing appropriate eyewear and hearing aids, and easy-to-read clocks and calendars
- Playing quiet music
- Doing light, appropriate exercise to reduce agitation and relieve depression
- Encouraging family and close friends to visit frequently
Psychiatric symptoms may occur with Alzheimer’s disease. Your doctor may prescribe medication to treat:
- Confusion, paranoia, and hallucinations
Caring for a person with Alzheimer's disease is difficult and exhausting. The primary caregiver needs emotional support, rest, and regular breaks. The Alzheimer’s Association is an excellent resource for families and caregivers
There are no guidelines for preventing Alzheimer's disease because the exact cause is unknown. However, the following factors may help you reduce your risk of Alzheimer's disease:
- Eat a healthful diet that includes fish.
- Drink alcohol, but in moderation. This means no more than two drinks per day for a man, and one drink per day for a woman.
- Exercise regularly .
- Engage in mentally stimulating activities.
National Institute on Aging
Alzheimer Society Canada
Albanese E, Dangour AD, Uauy R, et al. Dietary fish and meat intake and dementia in Latin America, China, and India: A 10/66 Dementia Research Group population-based study. Am J Clin Nutr. 2009;90(2):392-400.
Alzheimer dementia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia. Updated August 27, 2016. Accessed September 30, 2016.
Alzheimer's disease medications fact sheet. National Institute on Aging website. Available at: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet. Accessed August 18, 2014.
Anstey KJ, Mack HA, Cherbuin N. Alcohol consumption as a risk factor for dementia and cognitive decline: Meta-analysis of prospective studies. Am J Geriatr Psychiatry. 2009;17(7):542-555.
Carillo MC, Blackwell A, Hampel H, et al. Early risk assessment for Alzheimer's disease. Alzheimers Dement. 2009;5(2):182-196.
Deweerdt S. Prevention: Activity is the best medicine. Nature. 2011;475(7355):S16-S17.
Gidoni R, Benussi L, Paterlini A, Albertini V, Binetti G, Emanuele E. Cerebrospinal fluid biomarkers in Alzheimer’s disease: The present and the future. Neurodegen Dis. 2011;8(6):413-420.
Green RC, Cupples LA, Go R, et al. Risk of dementia among white and African-American relatives of patients with Alzheimer disease. JAMA. 2002;287(3):329-336.
Hampel H, Frank R, Broich K, et al. Biomarkers for Alzheimer’s disease: Academic, industry, and regulatory perspectives. Nat Rev Drug Discov. 2010;9(7):560-574.
Hayden KM, Welsh-Bohmer KA. Epidemiology of cognitive aging and Alzheimer’s disease: Contributions of the Cache County Utah study of memory, health, and aging. Curr Top Behav Neurosci. 2012;10:3-31.
Neugroschl J, Sano M. An update on treatment and prevention strategies for Alzheimer’s disease. Curr Neurol Neurosci Rep. 2009;9(5):368-376.
Ruitenberg A, van Swieten JC, Wittemen JC, et al. Alcohol consumption and risk of dementia: The Rotterdam Study. Lancet. 2002;359(9303):281-286.
1/8/2010 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia: Snitz BE, O'Meara ES, et al. Ginkgo biloba for preventing cognitive decline in older adults: A randomized trial. JAMA. 2009;302(24):2663-2670.
5/4/2012 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia: Buchman AS, Boyle PA, et al. Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology. 2012;78(17):1323-1329.
9/3/2014 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia: Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed September 3, 2014.
10/17/2016 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia: Arvanitakis Z, Capuano AW, et al. Relation of cerebral vessel disease to Alzheimer's disease dementia and cognitive function in elderly people: a cross-sectional study. Lancet Neurol. 2016 Aug;15(9):934-943. .
Last reviewed August 2015 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.