Categories Brain & Spine

Alzheimer’s: Symptoms, Stages, Diagnosis & Treatment

Alzheimer’s disease is a progressive neurologic disorder that causes the brain to shrink and brain cells to die. This is a progressive form of dementia. This disease begins with mild memory loss and possibly leads to loss of memory and the ability to carry on a conversation and respond to the environment.   

Alzheimer’s is a type of dementia that mainly affects memory, thinking, and behavior. This disease accounts for 60-80% of dementia cases. Certain medications can improve or slow the progression of symptoms. There is no treatment for Alzheimer’s disease.   

Signs and Symptoms of Alzheimer’s disease:  

Alzheimer’s disease is a condition in which symptoms develop gradually over years and become severe. This condition mainly affects multiple brain functions. A minor memory problem is the first sign of Alzheimer’s disease.  

Brain changes associated with Alzheimer’s disease can lead to growing trouble with:  

  • Memory:  

Usually, it is observed that everyone has occasional memory lapses but memory loss associated with Alzheimer’s disease continues and worsens, thus affecting the ability to function. People may observe the patient to  

  1. Repeat statements and questions over and over  
  2. Forget conversation and not remember them later  
  3. Misplace belongings 
  4. Get lost in familiar places  
  5. Forget the names of family members and objects  

 

  • Thinking and reasoning:  

This disease causes difficulty in concentrating and thinking. With this disease, multitasking becomes difficult. Also, multitasking becomes a problem for managing finances, balancing checkbooks, and paying bills on time. A person affected by Alzheimer’s is most often unable to recognize and deal with numbers.   

  • Making judgments and decisions:  

Alzheimer’s disease causes a decline in the capability of one to make reasonable decisions and judgments.   

  • Planning and performing familiar tasks:  

Routine activities that involve sequential steps such as planning, and cooking a meal becomes a struggle as this disease progresses. Alzheimer’s affected person usually finds the difficult to execute, and plan basic tasks such as dressing and bathing.   

  • Change in personality and behavior:  

Neurological changes which are caused by this disease affect moods and behaviors. Problems include depression, social withdrawal, mood swings, irritability and aggressiveness, change in sleep habits, and loss of inhibitions.   

Who is affected by Alzheimer’s disease?  

Alzheimer’s disease is common in people over the age of 65. The risk of Alzheimer’s disease increases with age, affecting approx. 1 in 14 people over the age of 65 and 1 in every 6 people above the age of 80. Younger people also get Alzheimer’s disease but it is less common.   

Causes of Alzheimer’s disease:  

At a basic level, brain proteins fail to function normally and disrupt the work of brain cells I.e., neurons, and trigger a series of toxic events. This results in damaged neurons and they also lose connections to each other and die.   

The cause of Alzheimer’s disease is focused on the role of two proteins:  

  • Plaques: Beta-amyloid is a fragment of a large protein. When these segments join together, they appear to have a toxic effect on neurons and disrupt cell-to-cell communication. These groups later form larger deposits called amyloid plaques, which also have cellular debris.   
  • Tangles: Tau proteins have an important role in a neuron’s internal support and transport system. They are responsible for carrying nutrients and other essential materials. In this disease, the protein changes shape and arranges itself in a structure called neurofibrillary tangles. This disrupts the transport system and is toxic to cells.   

Diagnosing Alzheimer’s disease:  

One of the ways to diagnose Alzheimer’s disease is to examine the brain tissue after death. Doctors can use other tests and examinations to access mental abilities, diagnose dementia and also rule out other conditions. The doctor will also have a look at the medical history.   

Patients must also talk about their symptoms, family medical history, past, and current medical conditions, ongoing medications, diet, alcohol intake, and other lifestyle habits.   

Doctors may also recommend several tests to determine if you have Alzheimer’s disease.   

Alzheimer’s Tests:  

There are no specific tests for Alzheimer’s disease. However, mental, physical, neurological, and imaging tests help doctors reach a diagnosis. Your doctor may begin with mental status tests which help in assessing short- and long-term memory along with the orientation to place and time.   

After this, the doctor will conduct a physical exam to find out the heart rate, temperature, etc. Your specialist may also conduct a neurological exam to rule out other possible diagnoses, such as infection or stroke. This exam will help in determining reflexes, muscle tone, and speech.   

Imaging diagnostic scans:  

Magnetic Resonance Imaging (MRI) scan: This helps pick up key markers such as inflammation, bleeding, and structural issues.   

Computed tomography (CT) Scan: This takes a series of X-Ray images which helps in looking for abnormal characteristics in the brain.   

Alzheimer’s Stages:  

Alzheimer’s is a progressive disease in which symptoms gradually increase with time. There are seven main stages of Alzheimer’s disease:  

Stages 1-3 are defined as pre-dementia and mild cognitive impairment:  

Stage 1: in this stage, no symptoms develop. If you have a family history of Alzheimer’s and develop no symptoms, you must consult a doctor to know about strategies.   

Stage 2: In this stage, one will develop symptoms such as forgetfulness.   

Stage 3: In this stage, mild physical and cognitive impairments appear I.e., such as reduced memory and concentration. In this stage, learning new skills will become harder. These changes will be noticeable to family or friends.   

Stages 4-7 are defined as Dementia stages:  

Stage 4: In this stage, Alzheimer’s is diagnosed but it is still considered mild. Here you can commonly notice memory loss and will have difficulty managing everyday tasks.   

Stage 5: During this stage, moderate to severe symptoms will be observed. It is important to ensure that daily needs are being met.   

Stage 6: in this stage, a person affected with Alzheimer’s disease will need help in performing basic tasks such as eating, dressing, etc.   

Stage 7: This is the most severe stage of Alzheimer’s disease. There is a progressive loss of speech and facial expression.   

How is Alzheimer’s disease treated?  

Although there is no cure for Alzheimer’s disease, medical management can help in improving the quality of life for people affected with Alzheimer’s disease. The doctor may recommend certain medications and treatment procedures to ease your symptoms and help in delaying the progression of the disease. Treatment addresses different areas:  

  • Helps patients in maintaining brain health  
  • Managing behavioral symptoms  
  • Slowing or delaying the symptoms of the disease   

There are other supports as well which are available to help people with Alzheimer’s disease. Psychological treatments such as cognitive stimulation therapy must be recommended to help support memory, problem-solving skills, and language ability.   

Doctors also recommend some medication, for early to moderate Alzheimer’s, your doctor may prescribe medications such as donepezil or rivastigmine. These help in maintaining high levels of acetylcholine. A medicine named aducanumab is also recommended for patients diagnosed with early Alzheimer’s disease. This helps in reducing the protein plaques which build up in the brain.   

For treating moderate to late-stage Alzheimer’s disease, specialists may prescribe donepezil. This helps in blocking the effect of excess glutamate.   

In addition to medicines, lifestyle changes also help in managing the condition. By incorporating some small steps such as simplifying tasks, limiting confusion, getting proper rest, using relaxation techniques, and also creating a calming environment.  

Cognitive Simulation Therapy (CST): 

Cognitive Simulation Therapy is a treatment for people with mild-to-moderate dementia. These are based on theoretical concepts of reality orientation and cognitive simulation. In this, series of themed activities are involved which typically run twice a week over a 7-week period. These sessions mainly aim to actively stimulate and engage people with dementia, while providing an optimal learning environment.  

Preventing Alzheimer’s disease:  

As you know, there is no known cure for Alzheimer’s disease. By addressing some health-promoting lifestyle habits, you can prevent Alzheimer’s. These include:  

  • Quit smoking: quitting smoking will provide you with great health benefits immediately and in the long term.   
  • Regular exercise: exercising regularly will keep you active and will also reduce the risk of many conditions such as cardiovascular disease and diabetes. You must also try some cognitive training exercises to keep your brain active.  
  • Eat properly: eating a balanced diet will help you stay healthy and fit.   
  • Maintain an active social life: patients affected with Alzheimer’s must maintain an active social life. They must often meet their friends and neighbors and must engage in the hobby of their choice. 

Summary:   

Individuals affected with Alzheimer’s disease can live for several years after symptoms develop. Alzheimer’s disease is a life-limiting illness and is also a neurodegenerative condition. A buildup of plaques and tangles in the brain, along with cell death causes memory loss and cognitive decline. There is no specific cure but some medications will help you in easing the condition. Living a healthy lifestyle can prevent Alzheimer’s disease and improve the quality of life.   

mrinalini signature updated logo