What causes Alzheimer’s disease?
Scientists do not fully understand what causes Alzheimer’s disease, or AD. There probably is not one single cause, but several factors that affect each person differently. Age is the most important known risk factor for AD. The number of people with the disease doubles every five years beyond age 65. Family history is another risk factor. Scientists believe that genetics may play a role in many AD cases.
Scientists are studying education, diet, and environment to learn what role they might play in the development of this disease. They are finding increasing evidence that some of the risk factors for heart disease and stroke -- such as high blood pressure, high cholesterol and low levels of the vitamin folate -- may predispose people to AD. Evidence for physical, mental and social activities as protective factors against AD is also increasing.
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What are the symptoms of Alzheimer’s disease?
AD begins slowly. At first, the only symptom may be mild forgetfulness. In this stage, people may have trouble remembering recent events, activities or the names of familiar people or things. They may not be able to solve simple math problems. Such difficulties may be a bother, but usually they are not serious enough to cause alarm.
However, as the disease goes on, symptoms are more easily noticed and become serious enough to cause people with AD or their family members to seek medical help. For example, people in the middle stages of AD may forget how to do simple tasks, like brushing their teeth or combing their hair. They can no longer think clearly. They begin to have problems speaking, understanding, reading or writing. Later on, people with AD may become anxious or aggressive, or wander away from home. Eventually, patients need total care.
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How is Alzheimer’s disease diagnosed?
An early, accurate diagnosis of AD helps patients and their families plan for the future. It gives them time to discuss care while the patient can still take part in making decisions. Early diagnosis also offers the best chance to treat the symptoms of the disease.
Today, the only definite way to diagnose AD is to find out whether there are plaques and tangles in brain tissue. To look at brain tissue, however, doctors must wait until they do an autopsy, which is an examination of the body done after a person dies. Therefore, doctors can only make a diagnosis of “possible” or “probable” AD while the person is still alive.
At specialized centers, doctors can diagnose AD correctly up to 90 percent of the time. Doctors use several tools to diagnose “probable” AD, including:
- Questions about the person’s general health, past medical problems, and the history of any difficulties the person has carrying out daily activities
- Tests of memory, problem solving, attention, counting and language
- Medical tests, such as tests of blood, urine or spinal fluid
- Brain scans
Some of these test results help the doctor find other possible causes of the person’s symptoms. For example, thyroid problems, drug reactions, depression, brain tumors and blood vessel disease in the brain can cause AD-like symptoms. Some of these other conditions can be treated successfully.
Recently, scientists have focused on a type of memory change called mild cognitive impairment (MCI), which is different from both AD and normal age-related memory change. People with MCI have ongoing memory problems, but they do not have other losses like confusion, attention problems and difficulty with language.
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How is Alzheimer’s disease treated?
AD is a slow disease, starting with mild memory problems and ending with severe brain damage. The course the disease takes and how fast changes occur vary from person to person. On average, AD patients live from 8 to 10 years after they are diagnosed, though the disease can last for as many as 20 years.
No treatment can stop AD. However, for some people in the early and middle stages of the disease, the drugs tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon) or galantamine (Reminyl) may help prevent some symptoms from becoming worse for a limited time. Another drug, memantine (Namenda), has been approved for treatment of moderate to severe AD. Also, some medicines may help control behavioral symptoms of AD such as sleeplessness, agitation, wandering, anxiety and depression. Treating these symptoms often makes patients more comfortable and makes their care easier for caregivers.
Developing new treatments for AD is an active area of research. Scientists are testing a number of drugs to see if they prevent AD, slow the disease or help reduce symptoms.
There is evidence that inflammation in the brain may contribute to AD damage. Some scientists believe that drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) might help slow the progression of AD, although recent studies of two of these drugs, rofecoxib (Vioxx) and naproxen (Aleve), have shown that they did not delay the progression of AD in people who already have the disease. Now, scientists are studying the NSAIDs celecoxib (Celebrex) and naproxen to find out if they can slow the onset of the disease.
Research has shown that vitamin E slows the progress of some consequences of AD by about 7 months. Scientists now are studying vitamin E to learn whether it can prevent or delay AD in patients with MCI. Recent research suggests that ginkgo biloba may be of some help in treating AD symptoms. There is no evidence that ginkgo will cure or prevent AD. Scientists now are trying to find out whether ginkgo biloba can delay or prevent dementia in older people.
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What can I do now to prevent or slow the effects of Alzheimer’s disease?
First, manage your numbers -- your blood pressure, cholesterol, blood sugar and body weight -- to stay healthy as you age. Feed your brain with nutrients by eating foods high in vitamins E and C, taking a multivitamin that includes folic acid, and including salmon, mackerel and other foods high in omega-3 fatty acids in your diet. Also, exercise both your body and brain. Work out, take a class, converse with others, read, play cards or work on crossword puzzles.
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Is it true that “a world without Alzheimer’s disease” can become a reality?
Almost everything we know about AD we’ve learned in the past 15 years, and scientists are making great strides in better treatments and preventions that one day may lead to a cure. The joint efforts of government agencies, research centers and pharmaceutical companies have uncovered many secrets of the disease, and AD can now be diagnosed with 90 percent accuracy. So, yes, there is progress, hope and great momentum toward ending AD.
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What can I do to help fight Alzheimer’s disease?
There are many ways the average citizen can help in the fight against AD. Join an Alzheimer’s Association Memory Walk™ or spend a few hours at your local chapter. Lobby your legislators to increase federal funding for Alzheimer’s to $1 billion each year, and talk to them about supporting local Alzheimer’s initiatives. You can also donate money to the Alzheimer’s Association to advance research and enhance support -- and to make Alzheimer’s a part of our past, not our future.
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