What is Alzheimer's disease?

According to the National Institute of Neurological Disorders and Stroke, Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die. The disease often results in the following behaviors:

• Impaired memory, thinking, and behavior

• Confusion

• Restlessness

• Personality and behavior changes

• Impaired judgment

• Impaired communication

• Inability to follow directions

• Language deterioration

• Impaired thought processes that involve visual and spatial awareness

• Emotional apathy

How is Alzheimer's different from other forms of dementia?

Alzheimer's disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy. Brains affected by Alzheimer's disease often show presence of the following:

• Fiber tangles within nerve cells (neurofibrillary tangles)

• Clusters of degenerating nerve endings (neuritic plaques)

Another characteristic of Alzheimer's disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and somatostatin.

Alzheimer’s Disease Causes

Scientists do not fully understand what causes the disease, although age, personal health, family history, genetics and abnormal protein deposits in the brain are believed to contribute.

The National Institute on Aging says that suspected causes often include the following:

• Age and family history

• Certain genes

• Abnormal protein deposits in the brain

• Other risk and environmental factors

• Immune system problems

Alzheimer’s Warning Signs

The first, most common warning sign of Alzheimer’s disease is changes in short-term memory that may disrupt daily life, such as forgetting words or names, or how to get to a familiar location. Familiar tasks, like cooking or paying bills, may become challenging.

According to the Alzheimer's Association, the following are the most common symptoms of Alzheimer's disease. However, each individual may experience symptoms differently. Symptoms may include:

• Memory loss that affects job skills, especially short-term memory loss

• Difficulty performing familiar tasks

• Problems with language

• Disorientation to time and place

• Poor or decreased judgment

• Problems with abstract thinking

• Misplacing things

• Changes in mood or behavior

• Changes in personality

• Loss of initiative

• Loss of ability to recognize who people are, even people well known to the individual, such as his or her child or spouse, when the disease progresses to a severe stage

Alzheimer’s Disease Diagnosis

There is no single test for diagnosing Alzheimer’s. Specialists can rule out other similar conditions and diagnosis Alzheimer’s disease with about 95 percent accuracy. The only way to confirm the disease is through autopsy.

Examination and evaluation are essential in determining whether the dementia is the result of a treatable illness. In addition to a complete medical history and extensive neurological motor and sensory exam, diagnostic procedures for Alzheimer's disease may include the following:

• Mental status test. This is a brief and simple test of memory and some other common cognitive or thinking skills; it is usually part of a complete neurological exam

• Neuropsychological testing

• Blood tests

• Lumbar puncture (spinal tap). A procedure performed by inserting a hollow needle into the lower back (lumbar spine)

• Urinalysis. Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein

• Chest X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film

• Electroencephalogram (EEG). A procedure that records the brain's continuous electrical activity by means of electrodes attached to the scalp

• Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

• Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body

• Genetic testing. Some genetic testing is available, especially in some research settings. Because there is no cure or effective treatment for Alzheimer's, the decision to undergo genetic testing is one that requires careful consideration and counseling with a specialist in genetics.

Alzheimer’s Disease Treatment

At this time, there is no cure for Alzheimer’s. The disease progresses as nerve cells in the brain are damaged and can no longer function normally, and there is no way to reverse this deterioration.

Physical exercise and social activity are most important in managing Alzheimer’s disease, as are proper nutrition, health maintenance, and a calm and well-structured environment. Medications can sometimes help with cognitive and behavioral symptoms.

Specific treatment for Alzheimer's disease will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

At this time, there is no cure for Alzheimer's, no way of slowing down the progression of this disease, and no treatment available to reverse the deterioration of Alzheimer's disease. New research findings give reason for hope, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time.

There are some medications available to assist in managing some of the most troubling symptoms of Alzheimer's disease, including the following:

• Depression

• Behavioral disturbance

• Sleeplessness

In managing the disease, physical exercise and social activity are important, as are proper nutrition, health maintenance, and a calm and well-structured environment.