Alzheimer's is a disease that robs people of their memory. At first, people have a hard time remembering recent events, though they might easily recall things that happened years ago.
The exact causes of Alzheimer’s disease aren’t fully understood. But at a basic level, brain proteins fail to function normally, which disrupts the work of brain cells (neurons) and triggers a series of toxic events. Neurons are damaged, lose connections to each other and eventually die.
Scientists believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.
Less than 1% of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease. These rare occurrences usually result in disease onset in middle age.
The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly.
Researchers trying to understand the cause of Alzheimer’s disease are focused on the role of two proteins:
Plaques - Beta-amyloid is a fragment of a larger protein. When these fragments cluster together, they appear to have a toxic effect on neurons and to disrupt cell-to-cell communication. These clusters form larger deposits called amyloid plaques, which also include other cellular debris.
Tangles - Tau proteins play a part in a neuron’s internal support and transport system to carry nutrients and other essential materials. In Alzheimer’s disease, tau proteins change shape and organize themselves into structures called neurofibrillary tangles. The tangles disrupt the transport system and are toxic to cells.
Everyone has episodes of forgetfulness from time to time. But people with Alzheimer’s disease display certain ongoing behaviors and symptoms that worsen over time. These can include:
Memory loss affecting daily activities, such as keeping appointments
Trouble with familiar tasks, such as using a microwave
Difficulties with problem-solving
Trouble with speech or writing
Becoming disoriented about times or places
Decreased personal hygiene
Mood and personality changes
Withdrawal from friends, family, and community
Your doctor may start with a mental status test. This can help them assess your:
Orientation to place and time
For example, they may ask you:
What day it is
Who the president is
To remember and recall a short list of words
Next, they’ll likely conduct a physical exam. For example, they may:
Check your blood pressure
Assess your heart rate
Take your temperature
Request urine or blood tests, in some cases
Your doctor may also conduct a neurological exam to rule out other possible diagnoses, such as acute medical issues like infection or stroke. During this exam, they will check your:
Your doctor may also order brain imaging studies. These studies, which will create pictures of your brain, can include:
Magnetic resonance imaging (MRI) scan. MRIs can help pick up key markers, such as inflammation, bleeding, and structural issues.
Computed tomography (CT) scan. CT scans take X-ray images, which can help your doctor look for abnormal characteristics in your brain.
Other tests your doctor may do include blood tests to check for genes that may indicate you have a higher risk of Alzheimer’s disease.
There’s no known cure for Alzheimer’s disease. However, your doctor can recommend medications and other treatments to help ease your symptoms and delay the progression of the disease for as long as possible.
Your doctor may also recommend antidepressants, anti-anxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms vary based on the progression of the disease, and can include:
Difficulty sleeping at night
Along with your doctor, a team of healthcare professionals can help you maintain your quality of life at all stages along the Alzheimer’s journey. A care team for Alzheimer’s may include a:
Physical therapist, to help with staying active
Dietician, to maintain a balanced, nutritious diet
Pharmacist, to help with monitoring medications
Mental health professional, who may work with the person with Alzheimer’s as well as their caregivers
Social worker, to help with accessing resources and support
Respite care center, to provide short-term care for someone with Alzheimer’s when their caregivers are temporarily unavailable
Hospice care center, to manage symptoms in a comfortable and supportive setting at the end of life