Alzheimer's Disease

What Is Alzheimer’s Disease?

Alzheimer's disease (AD) is a type of dementia. It is a neurodegenerative disorder that affects a person's thinking, memory, and behavior and gets worse over time. Alzheimer's makes up about 60-80 percent of all dementia cases.

What are the types of Alzheimer’s disease?

There are two distinct types of Alzheimer's disease:

Typical Alzheimer's disease

This type of AD includes episodic memory loss. Because it usually occurs after the age of 65, it is often called late-onset AD.

Atypical Alzheimer's disease

Atypical AD more often occurs before the age of 65, but can also occur after age 65.

This type of AD includes:

• Logopenic variant AD.
• Posterior cortical atrophy.
• Primary progressive aphasia (PPA).

Other types of Alzheimer's

Less common forms of AD include:

• Behavioral-variant AD.
• Corticobasal syndrome.
• Executive variant AD.

What are the stages of late-onset Alzheimer’s disease?

There are stages of progression in typical Alzheimer's. However, the disease doesn't always progress in a predictable way. Each person may experience different symptoms.

Mild cognitive impairment

At first, a person with mild memory loss or mild cognitive impairment (MCI) will still be able to perform most activities of daily living on their own. Some people with MCI may develop dementia, but some with not. If hallmark brain changes are present on an MRI, MCI can be an early stage of Alzheimer's.

Early-stage (mild)

In the early stages of Alzheimer's, you can usually function on your own.

During early-stage Alzheimer's, you may:

• Forget what you just read.
• Get lost in a familiar place.
• Have problems doing routine tasks.
• Have trouble managing time.
• Have trouble remembering names or words.
• Lose or misplace objects.

Middle-stage (moderate)

The middle stage of Alzheimer's can last for years. The symptoms become more noticeable and include:

• Changes in personality.
• Changes in sleep patterns.
• Compulsive behavior like pacing, tapping, or hand-wringing.
• Forgetting basic information like your address.
• Forgetting events or things that happened in the past.
• Getting easily frustrated or angry.
• Incontinence.
• Withdrawing from friends and family.

Late-stage (severe)

In the final stage of Alzheimer's, you will probably need 24/7 care.

You may:

• Be susceptible to urinary tract and respiratory infections.
• Lose awareness of your surroundings.
• Lose mobility.
• Lose the ability to communicate.
• Not recognize loved ones.

How common is Alzheimer’s disease?

The typical form of late-onset Alzheimer’s disease is common, but it’s not a normal part of aging. It's the sixth leading cause of death among adults age 65 and older in the U.S. and is the most common type of dementia.

The Alzheimer’s Association estimates that Alzheimer’s disease affects approximately 1 out of 9 adults over age 65. Early-onset Alzheimer’s disease is less common.

What causes Alzheimer’s disease?

Experts believe that a build-up of amyloid and tau proteins in the brain causes Alzheimer's. These proteins form plaques around brain cells, which can disrupt normal cell activity and lead to cell death.

This process begins many years before symptoms appear. It's unclear why some people get Alzheimer's and some don't. It may be a mix of genetic, lifestyle, and environmental factors.

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What Are the Signs and Symptoms of Alzheimer’s Disease?

As people age, it’s normal to wonder if they are showing early symptoms of Alzheimer’s disease when they misplace their keys or forget what they need from the grocery store after they arrive.

Sometimes it's hard to distinguish between normal forgetfulness and a sign of something more serious.

Here are some signs of early-stage Alzheimer's:

• Becoming quickly agitated.
• Forgetting important dates and events.
• Having trouble following directions.
• Losing track of the day of the week or season of the year.
• Personality changes.
• Poor hygiene.
• Poor judgment.
• Problems with routine tasks such as using the microwave.
• Putting things in odd places, such as putting your keys in the freezer.
• Struggling to come up with the right word.
• Trouble following a conversation.
• Vision problems that lead to balance issues or problems driving.
• Withdrawing from social activities.

When should I see a doctor about my Alzheimer’s disease symptoms?

If you have symptoms of Alzheimer’s or any type of dementia, you should schedule an appointment with your doctor right away. Your doctor may refer you to a neurologist who specializes in diagnosing and managing different types of dementia.

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How Do You Diagnose Alzheimer’s Disease?

It's crucial to have an expert diagnosis for any type of dementia.

Diagnosing Alzheimer’s is complex because symptoms may be similar to other types of dementia. Sometimes, a person will have more than one type of dementia at a time (mixed dementia).

To diagnose Alzheimer’s, your doctor will perform physical and neurological examinations and review your symptoms and medical history. Your doctor may also order tests to confirm your diagnosis or rule out other problems.

What to expect during your visit

During your visit, your doctor will:

• Ask you about your symptoms.
• Order tests.
• Perform a physical and neurological exam.
• Review your medical history.

Tests to diagnose Alzheimer’s disease

There's no conclusive test to diagnose Alzheimer’s disease. However, your doctor may order tests to provide information or rule out other problems, including:

• Blood tests — Checks for abnormalities and rules out other conditions.
• Cerebral spinal fluid analysis (spinal tap or lumbar puncture) — Involves inserting a needle into your lower back to collect a sample of cerebrospinal fluid (CSF) for analysis in a lab.
• Magnetic resonance imaging (MRI) — Creates images of your brain using contrast dye to look for damaged or abnormal areas.
• Neurological examination — A noninvasive test to check your reflexes, balance, movement, memory, and ability to think.
• Neuropsychological examination — Checks your ability to think, reason, and remember.

Alzheimer’s disease prognosis

There's no cure for Alzheimer's. Alzheimer’s is a progressive disease that gets worse over time and may eventually cause a loss of independence. Your prognosis after Alzheimer’s diagnosis depends on how quickly your condition progresses, your overall health, and other factors.

What is the life expectancy of someone with Alzheimer’s disease?

Usually, people live about four to eight years after an Alzheimer’s diagnosis. But there are many factors that affect life expectancy, and sometimes people with Alzheimer's can live as long as 20 years after diagnosis.

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How Do You Treat Alzheimer’s Disease?

There is no cure for Alzheimer's. However, doctors can treat symptoms and sometimes slow the progression of the disease.

Doctors may recommend Alzheimer’s treatments including:

Lifestyle changes for Alzheimer’s disease

Lifestyle changes may help to improve some Alzheimer’s symptoms.

Your doctor may recommend:

• Increasing daytime exercise to improve sleep at night.
• Avoiding long naps.
• Staying away from caffeine and alcohol.
• Going to physical therapy to help with movement and balance problems.

Medication for Alzheimer’s disease

Talking with your doctor is the first step in learning if medication is the right Alzheimer’s treatment for you. Although medication can help manage Alzheimer’s symptoms or even slow the progression of the disease, no medication can reverse the damage that has already occurred.

Types of medication that a doctor may prescribe for someone living with Alzheimer's may include:

• Drugs that slow the progression of the disease — Several FDA-approved medications are available to slow Alzheimer’s progression. They work by clearing amyloid protein buildups or reducing nerve cell damage in the brain. Your doctor will let you know which medication or combination of medications may be right for you.
• Drugs that treat cognitive symptoms — Cholinesterase inhibitors support communication between nerve cells in the brain. They may help manage the symptoms of Alzheimer's.
• Drugs that treat other symptoms of Alzheimer's — Other medications may be used to treat anxiety, agitation, or sleep problems.

Clinical trials for Alzheimer’s

Although today’s medications can’t cure Alzheimer’s, researchers are studying how various drugs may be able to treat the root cause — not just slow the progress of the disease. Some drugs used to treat other diseases and conditions, such as cancer and high blood pressure, show promise in fighting Alzheimer's.

You may be eligible to participate in clinical research to help doctors better understand Alzheimer’s and develop new therapies to treat the condition. Your doctor will let you know if you may be eligible to participate in a clinical trial.

Caregiver tips for managing behavioral symptoms

Many people have Alzheimer's symptoms that can include anxiety and restlessness. They may not be able to communicate well, making it challenging for caregivers to meet their physical and emotional needs.

Techniques that may be helpful for caregivers include:

• Being patient and flexible.
• Calling your loved one by name.
• Not taking negative behavior personally.
• Holding your loved one’s hand while you talk.
• Maintaining a calm setting.
• Making eye contact.
• Not arguing or pointing out that your loved one’s memories aren't correct.
• Redirecting your loved one’s attention if necessary.
• Sticking to a routine.
• Using gentle touch instead of verbal communication.

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