Medications To Maintain Mental Function In Alzheimer’s Disease
Several medications are approved by the U.S. Food and Drug Administration to treat symptoms of Alzheimers. Donepezil, rivastigmine, and galantamine are used to treat the symptoms of mild to moderate Alzheimers. Donepezil, memantine, the rivastigmine patch, and a combination medication of memantine and donepezil are used to treat moderate to severe Alzheimers symptoms. All of these drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms and help with certain behavioral problems. However, these drugs dont change the underlying disease process. They are effective for some but not all people and may help only for a limited time.
Why Early Detection Can Be Difficult
Alzheimers disease usually is not diagnosed in the early stages, even in people who visit their primary care doctors with memory complaints.
- People and their families generally underreport the symptoms.
- They may confuse them with normal signs of aging.
- The symptoms may emerge so gradually that the person affected doesnt recognize them.
- The person may be aware of some symptoms but go to great lengths to conceal them.
Recognizing symptoms early is crucial because medication to control symptoms is most effective in the early stages of the disease and early diagnosis allows the individual and his or her family members to plan for the future. If you or a loved one is experiencing any of the following symptoms, contact a physician.
Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people. To learn more about clinical trials, watch this video from NIH’s National Library of Medicine.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
What Causes Alzheimers Disease
In recent years, scientists have made tremendous progress in better understanding Alzheimers and the momentum continues to grow. Still, scientists dont yet fully understand what causes Alzheimers disease in most people. In people with early-onset Alzheimers, a genetic mutation may be the cause. Late-onset Alzheimers arises from a complex series of brain changes that may occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimers may differ from person to person.
What Are The Warning Signs Of Alzheimers Disease
Watch this video play circle solid iconMemory Loss is Not a Normal Part of Aging
Alzheimers disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimers disease and related dementias.
In addition to memory problems, someone with symptoms of Alzheimers disease may experience one or more of the following:
- Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
- Trouble handling money and paying bills.
- Difficulty completing familiar tasks at home, at work or at leisure.
- Misplacing things and being unable to retrace steps to find them.
- Changes in mood, personality, or behavior.
Even if you or someone you know has several or even most of these signs, it doesnt mean its Alzheimers disease. Know the 10 warning signs .
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What Happens To The Brain In Alzheimer’s Disease
The healthy human brain contains tens of billions of neuronsspecialized cells that process and transmit information via electrical and chemical signals. They send messages between different parts of the brain, and from the brain to the muscles and organs of the body. Alzheimers disease disrupts this communication among neurons, resulting in loss of function and cell death.
Loss Of Neuronal Connections And Cell Death
In Alzheimers disease, as neurons are injured and die throughout the brain, connections between networks of neurons may break down, and many brain regions begin to shrink. By the final stages of Alzheimers, this processcalled brain atrophyis widespread, causing significant loss of brain volume.
Learn more about Alzheimer’s disease from MedlinePlus.
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How Does Alzheimer’s Disease Affect The Brain
Scientists continue to unravel the complex brain changes involved in Alzheimers disease. Changes in the brain may begin a decade or more before symptoms appear. During this very early stage of Alzheimers, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimers as well.
The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimers, damage is widespread and brain tissue has shrunk significantly.
Dementia Symptoms And Areas Of The Brain
Knowing how different types of dementia affect the brain helps explain why someone with dementia might behave in a certain way.
Dementia and the brain
Until recently, seeing changes in the brain relied on studying the brain after the person had died. But modern brain scans may show areas of reduced activity or loss of brain tissue while the person is alive. Doctors can study these brain scans while also looking at the symptoms that the person is experiencing.
The most common types of dementia each start with shrinkage of brain tissue that may be restricted to certain parts of the brain.
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Support For Families And Alzheimer’s Disease Caregivers
Caring for a person with Alzheimers can have significant physical, emotional, and financial costs. The demands of day-to-day care, changes in family roles, and decisions about placement in a care facility can be difficult. NIA supports efforts to evaluate programs, strategies, approaches, and other research to improve the quality of care and life for those living with dementia and their caregivers.
Becoming well-informed about the disease is one important long-term strategy. Programs that teach families about the various stages of Alzheimers and about ways to deal with difficult behaviors and other caregiving challenges can help.
Good coping skills, a strong support network, and respite care are other things that may help caregivers handle the stress of caring for a loved one with Alzheimers. For example, staying physically active provides physical and emotional benefits.
Some caregivers have found that joining a support group is a critical lifeline. These support groups enable caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. Many organizations sponsor in-person and online support groups, including groups for people with early-stage Alzheimers and their families.
Research On Alzheimers Continues
Alzheimers treatment can help improve the quality of life for people with the disease and slow its progress but the quest for new treatments continues worldwide.
The aim is to develop medications that target the brain changes that Alzheimers causes, but more research funding is needed to achieve that goal.
You can review the Alzheimers Associations Treatment Horizon webpage for more information about treatment of the disease.
What changes have you witnessed in a loved one going through the stages of Alzheimers? What can you tell others to help them cope through these stages? Wed like to hear your stories and suggestions in the comments below.
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Health Environmental And Lifestyle Factors
Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimers. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as conditions such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimers.
A nutritious diet, physical activity, social engagement, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimers. Researchers are testing some of these possibilities in clinical trials.
How Many Americans Have Alzheimers Disease
Estimates vary, but experts suggest that more than 6 million Americans age 65 and older may have Alzheimers. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimers disease.
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How Long Can A Person Live With Alzheimers Disease
The time from diagnosis to death varies as little as three or four years if the person is older than 80 when diagnosed, to as long as 10 or more years if the person is younger.
Alzheimers disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.
Currently, there is no cure for Alzheimers disease, though there has been significant progress in recent years in developing and testing new treatments. Several medicines have been approved by the U.S. Food and Drug Administration to treat people with Alzheimers.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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How Do People Know They Have It
The first sign of Alzheimer disease is an ongoing pattern of forgetting things. This starts to affect a person’s daily life. He or she may forget where the grocery store is or the names of family and friends. This stage may last for some time or get worse quickly, causing more severe memory loss and forgetfulness.
What Will The Doctor Do
It can be hard for a doctor to diagnose Alzheimer disease because many of its symptoms can be like those of other conditions affecting the brain. The doctor will talk to the patient, find out about any medical problems the person has, and will examine him or her.
The doctor can ask the person questions or have the person take a written test to see how well his or her memory is working. Doctors also can use medical tests to take a detailed picture of the brain. They can study these images and look for signs of Alzheimer disease.
When a person is diagnosed with Alzheimer disease, the doctor may prescribe medicine to help with memory and thinking. The doctor also might give the person medicine for other problems, such as depression . Unfortunately, the medicines that the doctors have can’t cure Alzheimer disease they just help slow it down.
Who Has Alzheimers Disease
- In 2020, as many as 5.8 million Americans were living with Alzheimers disease.1
- Younger people may get Alzheimers disease, but it is less common.
- The number of people living with the disease doubles every 5 years beyond age 65.
- This number is projected to nearly triple to 14 million people by 2060.1
- Symptoms of the disease can first appear after age 60, and the risk increases with age.
Tangles And Cell Death
In normal brain tissue, a protein called tau stabilizes microtubules. Microtubules are key parts of cell structure.
In a diseased brain, protein strands, or threads, become tangled. As a result, the brain system of transporting cell nutrients along parallel structures which can be compared to railroad tracks falls apart.
Without these critical nutrients, brain cells die.
Memory and thinking depend on the transmission of signals across 100 billion neurons in the brain.
AD interferes with this cell signal transmission. It also affects the activity of brain chemicals called neurotransmitters.
The scrambled chemistry produces flawed signaling, so the brains messages are lost. This impacts the ability to learn, remember, and communicate.
Microglia are a type of cell that initiate immune responses in the brain and spinal cord. When AD is present, microglia interpret the beta-amyloid plaque as cell injury.
The microglia go into overdrive, stimulating inflammation that further damages brain cells.
Some AD research focuses on how this inflammatory response can be reduced or controlled.
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Managing Alzheimer’s Disease Behavior
Common behavioral symptoms of Alzheimers include sleeplessness, wandering, agitation, anxiety, and aggression. Scientists are learning why these symptoms occur and are studying new treatments drug and nondrug to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimers more comfortable and makes things easier for caregivers.
Later In Alzheimer Disease
As Alzheimer disease progresses, people have trouble remembering events in the past. They start to forget the names of friends and relatives. They may require help with eating, dressing, bathing, and going to the toilet. All sense of time and place is lost: People with Alzheimer disease may even get lost on their way to the bathroom at home. Their increasing confusion puts them at risk of wandering and falling.
Disruptive or inappropriate behavior, such as wandering, agitation, irritability, hostility, and physical aggression, is common.
Information from the above sources can usually help doctors rule out delirium as the cause of symptoms dysfunctionâthe inability to acquire, retain, and use knowledge normally. Although delirium and dementia may occur together… read more ). Doing so is essential because delirium, unlike dementia, can often be reversed if promptly treated. Differences between the two include the following:
Dementia affects mainly memory, and delirium affects mainly attention.
Dementia typically begins gradually and has no definite beginning point. Delirium begins suddenly and often has a definite beginning point.
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How Is Alzheimer’s Disease Diagnosed
There is currently no single test to identify Alzheimer’s disease. The diagnosis is made only after careful clinical consultation.
The clinical diagnosis might include:
- A detailed medical history
- Lumbar puncture for cerebral spinal fluid tests
- Medical imaging
These tests will help to eliminate other conditions with similar symptoms such as nutritional deficiencies or depression. After eliminating other causes, a clinical diagnosis of Alzheimer’s disease can be made with about 80% to 90% accuracy if the symptoms and signs are appropriate. The diagnosis can only be confirmed after death by examination of the brain tissue.
It is important to have an early and accurate diagnosis to determine whether a treatable condition other than Alzheimer’s disease, is causing the symptoms. If Alzheimer’s disease is diagnosed, medical treatment and other assistance can be discussed.
Early In Alzheimer Disease
Symptoms develop gradually, so for a while, many people continue to enjoy much of what they enjoyed before developing Alzheimer disease.
Symptoms usually begin subtly. People whose disease develops while they are still employed may not do as well in their jobs. In people who are retired and not very active, the changes may not be as noticeable.
The first and most noticeable symptom may be
Forgetting recent events because forming new memories is difficult
Sometimes changes in personality
Early in the disease, people become less able to use good judgment and think abstractly. Speech patterns may change slightly. People may use simpler words, a general word or many words rather than a specific word, or use words incorrectly. They may be unable to find the right word.
People with Alzheimer disease have difficulty interpreting visual and audio cues. Thus, they may become disoriented and confused. Such disorientation may make driving a car difficult. They may get lost on their way to the store. People may be able to function socially but may behave unusually. For example, they may forget the name of a recent visitor, and their emotions may change unpredictably and rapidly.
Many people with Alzheimer disease often have insomnia. They have trouble falling or staying asleep. Some people become confused about day and night.
At some point, psychotic behavior develops in many people with Alzheimer disease.
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