Alzheimer's (ALTZ-heye-mers) disease may also be called "AD". Alzheimer's disease is a long-term brain problem that slowly gets worse over time. It is a type of dementia (de-MEN-shah), which is a gradual loss of thinking ability. With AD, brain cells die and do not come back. There are also fewer amounts of the normal chemicals in the brain. These chemicals carry messages back and forth between the nerve cells throughout the body. This causes problems with how you think, behave, and remember things.
The disease usually starts at about age 65 to 70 years, but can start earlier. In its later stages, you will need 24-hour care for feeding, personal care, and bathroom needs. AD usually lasts from 2 to 10 years, but some people may live 20 years or more with the disease. There is no cure for Alzheimer's disease.
What may cause Alzheimer's disease? It is not known for sure what causes AD. The risk of getting AD increases with age, but AD is not a normal part of aging. AD is likely caused by more than one factor. Scientists are continuing to study possible causes of AD. People who have one or more of the following may have a greater risk of getting AD:
Family history: Genetic (inherited) factors are something that you are born with. Scientists believe that more than half of the people with AD inherited it. Women seem to get AD more than men do. Some genetic problems that affect the following may increase your risk for AD:
ApoE protein: A protein called ApoE, which normally carries cholesterol in the blood, may cause AD. Everyone has ApoE, but one type of ApoE seems to protect a person from getting AD. Another type of ApoE seems to make it more likely to get the disease. Scientists are learning more about ApoE and other genetic factors that increase your chance of getting AD.
Cholesterol: Scientists are also studying how having high cholesterol increases your risk of getting AD. Brain cells affected by Alzheimer's often have high levels of a protein. This causes plaques and tangles in the brain.
Metals: Scientists have found metals like aluminum and zinc in the brain tissue of people with AD. They are studying these metals to see if they caused the AD. They are also looking to see if the metals build up in the brain because of the disease.
Viruses: Scientists have found changes in the brain tissue of people with AD. They are studying viruses (a type of germ) to see if they cause changes in brain tissue that might cause AD.
Other health problems: Having had a head injury or a heart attack in the past may increase your risk of AD. Smoking, depression, and diabetes may also increase your risk of getting AD.
What are the signs and symptoms of Alzheimer's disease?
Mild AD signs and symptoms: The mild symptoms of AD may last from one to three years. The earliest signs and symptoms of AD may be minor and ignored as "normal" signs of growing old. The following are signs and symptoms of mild AD.
Memory loss is the most common symptom. You may be able to remember what happened years ago, but may not remember things from yesterday. You may be confused about what month or season it is. You may forget to brush your teeth or comb your hair. You may not remember the names of common things or people. You may feel like you have to make up stories to hide your forgetfulness.
It may be hard to work on your checkbook or to take care of your house. You may find it hard to make decisions that were once easy. You may not be as interested in doing things. You may feel depressed, angry, or confused about the changes you notice. Walking may become harder for you.
Moderate AD signs and symptoms:
You may have problems choosing what clothes to wear or doing simple jobs. Feeding yourself, brushing your teeth, or shaving may be hard. Taking care of your body may no longer seem important. You may not know people familiar to you. Things that happen may seem to be happening for the first time. You may become loud, violent, and hard to control. Sleeping, wandering off, and pacing may cause problems because you are confused.
You may seem anxious, restless, and agitated at night. This is often called "sundowners syndrome". It may be hard to find words to say what you mean. Talking in normal sentences may give you problems. Your speech may be hard to understand. You may quickly change topics when you are talking.
You may seem depressed or worried. You may be happy at unusual times. You may put things in strange places and not remember where you put them. You may be unable to make choices and decisions. It may be hard to reason or solve problems. You may be unable to plan and follow through with activities.
You may find it hard to control your emotions. Sometimes you may act like a child because you cannot control your anger. You may not be able to wait to get what you want. You may get more tired because everything takes more effort and energy. You may think that something is true even though it is not. You may see things that are not actually there. Sometimes you may not be able to control urination (going to the bathroom).
Severe AD signs and symptoms: As AD gets worse over time, you may completely lose your memory and speech. Groups of your muscles may stop working, including those used for urinating and having a bowel movement (BM). It may be very hard to walk. Your behavior may change and you may become very angry and out of control. You may be aggressive and destroy things. With time, you will not be able to care for yourself and will need someone to take care of you.
How does my caregiver find out if I have Alzheimer's disease? It can be hard to diagnose AD because other health problems can cause AD-like symptoms. They include blood vessel disease in the brain, brain tumors, thyroid disease, depression, and drug reactions. Some of these other problems can be treated. Your caregiver may need to do one or more of the following to find the cause of your symptoms.
A complete medical history and examination.
A review of medicine, alcohol, and tobacco use.
Medical tests such as blood, urine, or spinal fluid tests.
Neuropsychological tests to check memory, problem solving, attention, counting, and language skills.
Special tests to take pictures of the brain, which may include one or more of the following.
CT scan:
This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.
You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
MRI: MRI stands for magnetic resonance imaging. This test uses magnetic fields, radio waves, and computers to take 3-D (three dimensional) pictures of your brain.
PET scan: PET stands for positron emission tomography. A PET scan records the activity of chemicals in your brain.
What may be done to treat Alzheimer's disease? Because there is no known cure for AD, treatment includes keeping a good quality of life, for as long as possible. Scientists are currently studying the best way to treat AD. Ask your caregiver for more information about the most current treatment available. Your treatment may also include the following:
Caregiver appointments: You should see your caregiver regularly. Your caregiver will check to see how you are doing. Your caregiver will treat other illnesses if they happen. Caregivers can also help to support you and those caring for you at home. Those caring for you may need help handling physical, emotional, and financial stressors.
Counseling: Counseling for you and those caring for you at home may be helpful. Counseling can teach ways to cope with Alzheimer's disease. It may be done one-on-one with a caregiver or may include family members or other persons with AD. Counseling may include the following:
Cognitive therapy helps to make you aware of how you see things and helps you to see them in a more positive way.
Behavioral modification teaches you how to change your behavior (actions).
Stimulation therapy helps keep your mind active. Caregivers may use music, art, or animals (pets) in this type of therapy.
Medicine: Your caregiver may give you one or more of the following kinds of medicines to treat AD and the problems it may cause.
Cholinesterase inhibitors: Cholinesterase inhibitors are a group of medicines that help increase the amount of normal chemicals in your brain. They may help you think better and may make it easier to do every day activities. They work best in the early to middle stages of Alzheimer's disease.
NMDA receptor antagonist: This medicine may help decrease the number of dead brain cells. It may be used in the moderate to severe stages of Alzheimer's disease.
Antidepressants: This medicine may be given if your Alzheimer's disease causes you to feel sad or depressed. It may take a little while before this medicine starts to work.
Antianxiety medicine: This type of medicine may help you feel less nervous and restless in the later stages of Alzheimer's disease. It may also help you sleep better.
Incontinence medicine: You may need this type of medicine to help you have more bladder control. Incontinence means loss of control over urinating and having bowel movements. This problem may happen in the later stages of Alzheimer's disease.
Anticonvulsants: This medicine may be used if you are easily angered, and are very restless.
Antipsychotics: This medicine may be used to control delusions (false fixed beliefs), hallucinations (seeing or hearing things that are not there) or violent behaviors (actions).
Other remedies: "Miracle drugs" to treat or cure diseases like Alzheimers are talked about, but they have not been proven to work. Many of these are herbs and claim to be "all natural" but this does not mean they are safe. Some have harmful side effects, or cause problems with other medicines you may be taking. It is very important to talk to your caregiver before using any new medicines, vitamins, or herbs.
Wellness hints: Exercise, good nutrition, and social activity are important. Work with your caregivers to keep active for as long as possible.
Where can I go for support? Accepting that you or a loved one has AD is hard. You and those close to you may feel angry, depressed, or frightened. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join an AD support group. This is a group of people who are living with AD. This group may help you work through your feelings. For more information, contact the following organization.
Alzheimer's Association 225 N.Michigan Ave, FL 17 Chicago, IL 60601-7633 Phone: 1-800-272-3900 Web Address: http://www.alz.org
Alzheimer's Disease Education and Referral Center P.O. Box 8250 Silver Spring, MD 20907 P.O. Box 8250 Silver Spring, MD 20907 Phone: 1-800-4384380 Web Address: http://www.alzheimers.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
