There is admittedly so much that we do not know about Alzheimer’s disease and what really causes this brain degenerative disease, that we unlearn life’s simplest tasks, forgetting in as much as we see, hear, taste or even smell. There is no cure yet, but having a closer look behind so many milestones, we see how much has been put into research. Knowing more about this serious senior health challenge is possibly one of the best things to keep the wheel rolling, and somehow we can work from the known to the unknown, and the nondescript. In 1906, Alzheimer’s disease is first described by Dr. Alois Alzheimer in his patient known only as Auguste D. The patient experienced memory loss, paranoia, and psychological changes. Dr. Alzheimer noted in the autopsy that there was shrinkage in and around nerve cells in her brain, the invention of the electron microscope in1931 by Marx Knoll and Ernst Ruska allowing up to 1 million times magnification of the brain cells made it easier to study the brain cells. But nothing made Alzheimer’s disease more printable than when former President of the United States Ronald Reagan announced that he had been diagnosed with Alzheimer’s disease. This led to greater awareness about the disease but so many people are yet to come to terms with this common yet unknown disease. Alzheimer’s 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. Alzheimer’s is the most common cause of dementia among older adults.

What exactly is Alzheimer’s disease?

Alzheimer’s disease is a progressive disorder that causes brain cells to waste away (degenerate) and dies. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently. The early signs of the disease may be forgetting recent events or conversations. As the disease progresses, a person with Alzheimer’s disease will develop severe memory impairment and lose the ability to carry out everyday tasks.

 Signs and early symptoms of Alzheimer’s disease

  1. Memory loss that disrupts daily life-One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking for the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

  1. Challenges in planning or solving problems-Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
  2. Difficulty completing familiar tasks -People with Alzheimer’s often finds it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.

  1. Confusion with time or place-People living with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

  1. Trouble understanding visual images and spatial relationships-For some people, having vision problems is a sign of Alzheimer’s. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.
  2. New problems with words in speaking or writing-People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves.
  3. Misplacing things and losing the ability to retrace steps-A person living with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

  1. Decreased or poor judgment-Individuals may experience changes in judgment or decision-making- For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.
  2. Changes in mood and personality-Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone.

Causes and risk factors for Alzheimer’s disease

Researchers believe there is not a single cause of Alzheimer’s disease. The disease likely develops from multiple factors, such as genetics, lifestyle and environment. Scientists have identified factors that increase the risk of Alzheimer’s. While some risk factors — age, family history and heredity — can’t be changed, emerging evidence suggests there may be other factors we can influence.

  1. Age-The greatest known risk factor for Alzheimer’s is increasing age, but Alzheimer’s is not a normal part of aging. While age increases risk, it is not a direct cause of Alzheimer’s.

  1. Family History-. Those who have a parent, brother or sister with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness. When diseases tend to run in families, either heredity (genetics), environmental factors, or both, may play a role.
  2. Genetics (heredity)-Scientists know genes are involved in Alzheimer’s. Two categories of genes influence whether a person develops a disease: risk genes and deterministic genes. Alzheimer’s genes have been found in both categories. It is estimated that less than 1 percent of Alzheimer’s cases are caused by deterministic genes (genes that cause a disease, rather than increase the risk of developing a disease).

  1. Other risk factors-While age, family history and heredity are all risk factors we can’t change, research is beginning to reveal clues about other risk factors we may be able to influence through general lifestyle and wellness choices and effective management of other health conditions.

Such risk factors that we can control include;

  • Head injury-: There is a link between head injury and future risk of dementia.
  • Heart-head connection-Some of the strongest evidence links brain health to heart health. This connection makes sense, because the brain is nourished by one of the body’s richest networks of blood vessels, and the heart is responsible for pumping blood through these blood vessels to the brain. The risk of developing Alzheimer’s or vascular dementia appears to be increased by many conditions that damage the heart and blood vessels. These include heart disease, diabetes, stroke, high blood pressure and high cholesterol.

Case management and treatment

There is no cure for Alzheimer’s disease, but available medications temporarily slow the worsening of dementia symptoms and help with behavioral problems that may appear during the course of the disease.

The four current medications approved for Alzheimer’s disease have shown modest effects in preserving brain function. They may help lessen or stabilize the symptom of Alzheimer’s disease for a period of time. Due to the side effects of these drugs – especially the gastrointestinal effects — doctors and patients should talk about their use before prescribing them. Also, these drugs should be stopped when dementia reaches advanced stages.

  1. Cholinesterase inhibitors-The cholinesterase inhibitors are all approved to treat the symptoms of mild to moderate Alzheimer’s disease (AD).

  1. NMDA antagonist- It blocks the neurotransmitter glutamate from activating NMDA receptors on nerve cells, keeping the cells healthier. This medication works differently than the cholinesterase inhibitor.
  2. Monoclonal antibodies (under research)- All currently approved medications target Alzheimer’s disease after it develops. Scientists are currently researching ways to stop or slow the progress of Alzheimer’s disease before it starts.

Some of the drugs in late-stage investigation are called monoclonal antibodies. These drugs target the amyloid protein that builds up in brain cells. They work by attaching to the amyloid proteins as they float in the brain and remove them, before they form into the plaques and tangles that interfere with the brain’s ability to properly function.

Alzheimer’s disease gets worse over time and is ultimately fatal. Persons with Alzheimer’s disease live, on average, four to eight years after diagnosis. Some patients can live as long as 20 years after diagnosis. The course of the disease varies from person to person. The best thing is that research is full throttle to find a possible cure to prevent Alzheimer’s disease before progression. There are so many things that you can do yourself like maintaining a healthy weight and avoiding unnecessary head trauma and smoking.

 I hope we find a cure, until then, stay well and healthy.