Alzheimer's Disease

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

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Definition

Alzheimer's disease is a progressive condition that destroys brain cells and structures. People with Alzheimer's disease slowly lose the ability to learn and remember.

Causes

The cause of Alzheimer's disease is not yet known. Studies suggest that two main mechanisms may cause the disease:

Plaques - abnormal deposits of a substance called beta amyloid in areas of the brain

Neurofibrillary Tangles - twisted fibers within nerve cells

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Age: 85 and older
• Previous serious brain injury
• Down's syndrome or other types of mental retardation
• Giving birth to a child with Down's syndrome
• Family members with Alzheimer's disease

Researchers are studying the following to see if they are related to Alzheimer's disease:

• Poor nutrition and vitamin deficiency in childhood
• Exposure to electromagnetic fields
• Excess metal in the blood, especially zinc, copper, aluminum, and iron
• Certain viral infections

Symptoms

Symptoms of Alzheimer's disease come on gradually. They begin as mild memory lapses, and progress to profound loss of function. Alzheimer's disease is divided into three stages: Early, Intermediate, and Severe.

Symptoms include:

• Increasing trouble remembering things, such as
  • How to get to familiar places
  • The names of friends and family members
  • Where common objects are usually kept
  • Simple math
  • How to perform tasks, such as cooking, dressing, bathing, etc.
• Trouble concentrating on tasks
• Trouble completing sentences, due to lost or forgotten words (progresses to a complete inability to speak)
• Inability to remember the date, time of day, season
• Mood swings
• Withdrawal, loss of interest in usual activities
• Slow, shuffling walk
• Poor coordination
• Slowness and then loss of purposeful movement

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no tests to diagnose Alzheimer's disease. The doctor will ask many questions to rule out other causes of your symptoms.

Tests to rule out other medical conditions may include:

• Neurological exam
• Psychological and mental status testing
• CT scan - a type of x-ray that uses a computer to make pictures of the brain
• MRI scan - a test that uses magnetic waves to make pictures of the brain
• Electroencephalogram (EEG) - a test that measures electrical currents in the brain
• Blood tests

Treatment

There are no treatments to cure Alzheimer's disease and no certain ways to slow its progression. Researchers are studying various drugs to see if they can improve the symptoms of Alzheimer's disease or slow its course.

Medications for Symptoms and Disease Progression

Medications being used and studied include:

• Cholinesterase inhibitors
• Anti-oxidants (vitamin E)
• Estrogen
• Monoamine oxidase inhibitors
• Anti-inflammatory agents
• Gingko biloba (herbal supplement)

Lifestyle Management

Managing the disease includes:

• Creating an environment in which you can receive the care you need
• Optimizing your quality of life
• 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, easy-to-read clocks and calendars
• Playing quiet music
• Light, appropriate exercise to reduce agitation and relieve depression

Psychiatric Medications

Medications for severe psychiatric symptoms include:

• Antidepressants - to treat depression
• Anxiolytics - to treat anxiety
• Antipsychotics - to treat severe confusion, paranoia, and hallucinations

Caregiver Support

Caring for a person with Alzheimer's disease is extremely difficult and exhausting. The primary caregiver needs emotional support, as well as regular respite.

Prevention

There are no guidelines for preventing Alzheimer's disease because the cause is unknown.

Organizations

Alzheimer's Association
http://www.alz.org/

Alzheimer's Disease Education and Referral Center
http://www.alzheimers.org/

SOURCES:

American Academy of Neurology

Textbook of Clinical Neurology, 1st ed. W. B. Saunders Company, 1999.

Conn's Current Therapy 2001, 53rd ed. W. B. Saunders Company, 2001.

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Last reviewed June 2001 by Medical Review Board