Symptoms and Signs of Alzheimer’s Disease

In the United States, Alzheimer’s disease is one of the significant causes of death. According to recent projections, it may come in third place among all causes of death for seniors, just behind cancer and heart disease.

The most typical cause of dementia in older persons is Alzheimer’s disease. The loss of cognitive abilities, such as thinking, remembering, and reasoning, as well as behavioral skills, can affect a person’s day-to-day functioning and is known as dementia. The intensity of dementia varies. At the mildest stage, it is just starting to interfere with a person’s functioning. At the most severe level, a person must entirely rely on others for assistance with daily activities.

Depending on the kinds of possible brain alterations, the causes of dementia can change. Lewy body dementia, frontotemporal diseases, and vascular dementia are among the other types of dementia. In addition, people frequently develop mixed dementia, a fusion of two or more kinds of dementia. For instance, some persons have both vascular dementia and Alzheimer’s disease.

The name Alzheimer comes from Dr. Alois Alzheimer. Dr. Alzheimer observed alterations in the brain of a subject who had passed away from an uncommon mental disease in 1906. Memory loss, linguistic difficulties, and unpredictable conduct were some of her symptoms. He examined her brain after she passed away and discovered aberrant aggregates (now called amyloid plaques) and twisted fiber bundles (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still a hallmark of Alzheimer’s.

The Brain And Alzheimer’s

Scientists are still examining the brain alterations associated with Alzheimer’s disease. Before symptoms show, changes in the brain may start 10 years or earlier. The brain is undergoing harmful alterations at this early stage of Alzheimer’s, including aberrant protein buildups resulting in amyloid plaques and tau tangles. In addition, formerly healthy neurons stop working, lose their connections to neighboring neurons, and eventually die. Additional complex brain alterations may also influence Alzheimer’s disease.

The hippocampus and the entorhinal cortex, two brain regions crucial for memory formation, appear to be the first areas of the brain to sustain injury. More areas of the brain are damaged and shrink as more neurons die. As a result, brain tissue has dramatically shrunk, and there has been extensive damage by the time Alzheimer’s reaches its last stage.

Symptoms And Signs Of Alzheimer’s Disease

An initial indication of Alzheimer’s-related cognitive decline is memory issues. Mild cognitive impairment (MCI) is a condition some people with memory issues experience. People with MCI have more significant memory issues than typical for people of their age. Still, their symptoms do not significantly impact their daily lives. MCI is also associated with problems with movement and the sense of smell. Alzheimer’s disease is more likely in older MCI patients. Some people might even resume their regular thinking.

Individuals with Alzheimer’s experience different initial symptoms. Many believe the disease’s very early stages may show up as deteriorating non-memory cognition. Examples include word-finding, vision/spatial problems, and impaired thinking or judgment. To identify early brain alterations in patients with MCI and those who may be at higher risk for Alzheimer’s, researchers examine biological indicators in brain imaging, cerebrospinal fluid, and blood). More study is needed to regularly use these methods to diagnose Alzheimer’s.

Alzheimer’s Disease Stages

Symptoms Of Mild Alzheimer’s Disease

Memory loss and other cognitive problems get worse as Alzheimer’s gets worse. Wandering and getting lost can be a problem, as can having difficulties managing money and paying bills, asking questions repeatedly, taking longer to do everyday duties, and changing their personality and conduct. Frequent diagnoses occur in this period.

Symptoms Of Moderate Alzheimer’s Disease

This stage of the disease involves brain damage to the regions responsible for language, cognition, conscious thought, and sensory processing, including the capacity to recognize sounds and scents. As disorientation and memory loss worsens, it gets harder for people to identify their loved ones.

They might be unable to adapt to new circumstances, learn new things, or perform complex chores like getting dressed. In addition, individuals in this stage may exhibit impulsive behavior and have hallucinations, delusions, and paranoia.

Symptoms Of Severe Alzheimer’s Disease

Plaques and tangles eventually cover the entire brain, and the brain’s tissue diminishes. People with advanced Alzheimer’s disease are wholly reliant on others for their care and cannot communicate. As the body slows down, the person may spend most of the time in bed.

Why Does Alzheimer’s Disease Occur?

Scientists have made enormous strides toward understanding Alzheimer’s disease in recent years, and the impetus is still building. Even still, researchers are unsure of the exact causation of Alzheimer’s in most cases. A genetic mutation might be the root cause of early-onset Alzheimer’s in affected individuals. The complicated chain of brain alterations that lead to late-onset Alzheimer’s may occur over many years. Numerous genetic, environmental, and lifestyle factors are likely contributing factors. Depending on the individual, each of these characteristics may play a different role in elevating or lowering the chance of getting Alzheimer’s.

Understanding Alzheimer’s Disease

Researchers are conducting investigations to learn more about the biological characteristics of Alzheimer’s disease. For example, researchers can now observe changes in brain structure and function and the growth and spread of aberrant tau and amyloid proteins in the living brain, thanks to advancements in brain imaging technology. In addition, examining changes in the brain and bodily fluids years before Alzheimer’s symptoms manifest means researchers are exploring the earliest stages of the disease process. The results of these investigations will aid in diagnosing Alzheimer’s and understanding its causes.

Why older persons are disproportionately affected by Alzheimer’s disease is one of its essential riddles, and brain-aging researchers are investigating. For instance, researchers are learning how the damage caused by Alzheimer’s disease may result from age-related changes in the brain that injure neurons and other types of brain cells. These aging-related alterations include mitochondrial malfunction, blood vessel damage, inflammation, atrophy (shrinking) of specific brain regions, and blood vessel damage (a breakdown of energy production within a cell).

Genes And Alzheimer’s Disease

Most persons with Alzheimer’s have the late-onset form of the disease in which symptoms become apparent in their mid- 60s or later. Although apolipoprotein E (APOE) is a gene that raises the risk, researchers have not yet identified a specific gene that causes late-onset Alzheimer’s. One of the variants of this gene, APOE 4, increases a person’s risk of getting Alzheimer’s and is linked to an earlier age at which the disease manifests itself. However, some people without the APOE 4 gene may also get Alzheimer’s, and having the gene doesn’t guarantee a person will get the illness.

Links also exist between a person’s risk for late-onset Alzheimer’s and our DNA.

Less than 10% of patients with Alzheimer’s have early-onset dementia, which strikes between the ages of 30 and 60. One of three genes can change due to inheritance in some situations. Others appear to be affected by other genetic factors, according to studies.

Most people living with Down syndrome develop Alzheimer’s, possibly due to the extra copy of chromosome 21 found in Down syndrome patients, which contains the gene responsible for producing dangerous amyloid.

Visit www.nia.nih.gov/health/alzheimers-disease-genetics-fact-sheet for additional information about Alzheimer’s disease genetics research.

Health, Environmental, And Lifestyle Factors Related To Alzheimer’s Disease

According to research, various variables other than heredity may affect how Alzheimer’s develops and progresses. For instance, there is a lot of interest in the connection between cognitive decline and disorders such as diabetes, high blood pressure, heart disease, and stroke. Ongoing research will aid our understanding of whether and how lowering risk factors for these disorders may also lower the risk of Alzheimer’s.

A balanced diet, regular exercise, social interaction, and mentally engaging activities are all related to maintaining good health as people age.

These elements might also lower the likelihood of cognitive deterioration and Alzheimer’s disease. Researchers are using clinical studies to examine some of these hypotheses.

How Is An Alzheimer’s Diagnosis Made?

Doctors employ various techniques and instruments to help them evaluate whether a patient with memory issues has Alzheimer’s disease.

For an Alzheimer’s diagnosis, clinicians may:

• Inquire about the person’s general health, use of prescription and over-the-counter medications, food, previous medical issues, capacity to carry out daily activities, and changes in behavior and personality with the person as well as a family member or friend.
• Give tests on language, problem-solving, counting, and remembering.
• Perform standard medical examinations, such as blood and urine testing, to look for further potential reasons for the issue.
• To confirm an Alzheimer’s diagnosis or rule out other potential causes of symptoms, have brain scans such as computed tomography, magnetic resonance imaging, or positron emission tomography performed.

Repeating these tests may explain how the patient’s memory and cognitive abilities change over time.

People who experience memory and thinking difficulties should consult their doctor. The symptoms may be something else, such as a stroke, tumor, Parkinson’s disease, sleep disturbances, medication side effects, an infection, or another form of dementia.

Some of these ailments might be treatable and even curable.

If diagnosed with Alzheimer’s, starting treatment as soon as feasible in the disease course may assist in maintaining everyday functioning for a while. In addition, a timely diagnosis aids families in making plans. They can deal with monetary and legal issues, potential safety concerns, learn about living situations, and create support networks.

An early diagnosis also gives patients greater chances to take part in clinical trials or other studies looking at potential new Alzheimer’s treatments.

Joining Clinical Trials For Alzheimer’s Disease

One approach in the battle against Alzheimer’s is to sign up for a clinical trial as a volunteer. For studies to produce significant results for a wide range of people, participants must be of various ages, sexes, races, and ethnicities.

Everyone may be eligible to participate in clinical trials and studies, including people with MCI or Alzheimer’s disease, as well as healthy volunteers with or without a family history of the condition. Participants in clinical studies on Alzheimer’s disease assist researchers in understanding how the brain changes with healthy aging and Alzheimer’s disease. To participate in the more than 250 ongoing Alzheimer’s-related clinical trials and studies, at least 270,000 volunteers are required.

The federal government coordinates research on Alzheimer’s via the National Institute on Aging (NIA). Alzheimer’s Disease Research Centers across the U.S. research the disease’s causes, diagnosis, and treatment. The agency also sponsors the Alzheimer’s Clinical Trials Consortium, which accelerates and expands investigations and therapies in Alzheimer’s and associated dementias.

To find out more about Alzheimer’s medical research:

• Discuss any local studies with your healthcare practitioner that might be appropriate for you.
• Speak with local Alzheimer’s Disease Research Centers at www.nia.nih.gov/health/alzheimers-disease-research-centers.
• To learn more about taking part in Alzheimer’s research, find a study near you, and see participant interviews, visit the Alzheimers.gov Clinical Trials Finder at www.alzheimers.gov/clinical-trials.
• Visit www.nia.nih.gov/about/stay-connected to sign up for email notifications on new trials.
• Sign up for a registry to be invited to participate in studies at www.nia.nih.gov/health/registries-and-matching-services-clinical-trials.

Visit www.nia.nih.gov/health/clinical-trials to learn more about taking part in clinical trials.

What Is The Treatment For Alzheimer’s?

Due to Alzheimer’s complexity, it is doubtful that any one medication or other treatment will be able to treat everyone who has the condition.

Researchers are looking into options for delaying or preventing the disease and treating its symptoms. Scientists are creating and evaluating several potential therapies in ongoing clinical trials. Drug therapy for various illness interventions is being researched, along with non-drug strategies like exercise, diet, cognitive training, and combinations. We will probably need a variety of choices for treating Alzheimer’s, just as we have various treatments for cancer and heart disease. Precision medicine, or providing the appropriate care at the right moment, is likely crucial.

Alzheimer’s treatments currently emphasize managing behavioral symptoms, treating the underlying disease process, and assisting patients in maintaining mental function.

Drugs For Maintaining Mental Function

The U.S. Food and Drug Administration (FDA) has approved several drugs to treat Alzheimer’s symptoms. Signs of mild to moderate Alzheimer’s are managed using donepezil, rivastigmine, and galantamine. The rivastigmine patch, memantine, donepezil, and a medicine that combines the two are all used to treat mild to severe Alzheimer’s symptoms. All of these medications function by controlling neurotransmitters, which are the substances that communicate between neurons. They might aid in treating some behavioral issues and symptom reduction.

However, the underlying illness process is unaffected by these medications. Therefore, they may be helpful for a brief time and are successful for some people but not everyone.

Drugs To Treat The Primary Disease Process

The first FDA-approved disease-modifying drug for Alzheimer’s is aducanumab. The medicine, although unproven on clinical outcomes like the advancement of dementia or cognitive decline, helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimer’s. Tests, such as a PET scan or a cerebrospinal fluid analysis, could check for signs of amyloid plaques and determine if the patient is a good candidate for the proposed treatment.

The FDA’s Accelerated Approval Program resulted in the approval of aducanumab. After approval, a further investigation is necessary to verify the projected clinical benefit of this method. The FDA may revoke drug approval if the follow-up trial cannot demonstrate clinical benefit. Early 2030 is the anticipated timeframe for releasing the findings from the aducanumab phase 4 clinical trial.

Evaluations of many other disease-modifying drugs for people with mild cognitive impairment or early Alzheimer’s are underway.

Behavioral Symptom Management

Sleeplessness, wandering, agitation, anxiety, and hostility are typical behavioral signs of Alzheimer’s disease. Scientists are discovering the causes of these symptoms and researching new drug and non-drug management strategies. According to research, addressing behavioral symptoms can help caregivers and patients with Alzheimer’s disease feel more comfortable.

Support For Family Members And Caregivers

Providing physical, emotional, and financial support for someone with Alzheimer’s can be expensive. In addition, balancing daily care responsibilities, family dynamics shifts, and choices regarding placement in a care facility can be challenging.

One crucial long-term approach is to educate yourself on the illness.

Programs that inform families on the many stages of Alzheimer’s disease and how to handle challenging behaviors and other caregiving issues might be helpful.

Other strategies that could help carers manage the stress of caring for a loved one with Alzheimer’s include effective coping mechanisms, solid support systems, and respite care. For instance, maintaining an active lifestyle has both psychological and physical advantages.

For some caregivers, finding a support group to join is a crucial lifeline. These support groups allow carers to seek emotional support, voice worries, exchange experiences, get advice, and find respite. Many organizations fund offline and online support groups for family members and individuals with early-stage Alzheimer’s.

Visit www.nia.nih.gov/health/alzheimers/caregiving for further details, or read Alzheimer’s Caregiving.

Information Regarding Alzheimer’s Disease

National Institute for Aging Alzheimer’s and associated Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers

The NIA ADEAR Center provides information and publications about Alzheimer’s disease and associated dementias for families, caregivers, and medical professionals, including details on caregiving, clinical trials, and research. Staff members respond to calls, emails, and written requests for information and direct callers to regional and national resources.

Visit the ADEAR website to identify clinical trials, find out more about Alzheimer’s and associated dementias, and subscribe to email updates.

Alzheimers.gov
www.alzheimers.gov
Discover tools and information on Alzheimer’s and associated dementias from across the federal government by visiting the Alzheimers.gov portal.

Association for Alzheimer’s
800-272-3900
866-403-3073
info@alz.org
www.alz.org

American Alzheimer’s Foundation
866-232-8484
info@alzfdn.org
alzfdn.org

Eldercare Finder
800-677-1116
eldercarelocator@n4a.org
eldercare.acl.gov

Family Caregiver Alliance
800-445-8106
www.caregiver.org

MedlinePlus
Medical National Library
www.medlineplus.gov