The reason why one hears most often about Alzheimer's Disease is that it comprises an estimated 50-70% of all dementia cases. Alzheimer's falls into the category of a progressive disease--meaning that even early symptoms mean that one is on the road to a death sentence. While billions are being spent on research globally, there is not yet an effective long-term treatment or cure...but progress is being made from multiple angles.
Alzheimer's is characterized by amyloid plaques and tangles in the brain, also called neurofibrillary tangles. These are caused by abnormal protein deposits in the brain. I am not going to go into the detailed neurological jargon that defines the minutia underlying the disease and its progression. Suffice it to say that these amyloids compromise the ability of cells to function by binding with brain cells and synapses. The plaque happens when amyloids merge with other insolubles in the brain and grow. Neurofibrillary tangles, or tau, are the result of phosphate threads in the cell binding with the tau, resulting in tangles (much like when something gets in your hair and causes tangles).
For the benefit of those who are not scientists, science students, or science enthusiasts, this concludes the technical introduction to Alzheimer's and how it happens [cheers heard in the background]. Instead, I will focus on practical matters, such as signs and symptoms, some of the potential systemic causes, and a bit on the prognosis for Alzheimer's Disease moving forward.
Signs & Symptoms
Unfortunately, Alzheimer's Disease is progressive and will get worse over time.😢 It takes a medical expert to differentiate the signs and symptoms of the various stages of the disease; however, there are warning signs and symptoms that may indicate that an individual has Alzheimer's. Before I elaborate on them, a few notes are in order:
Some of the symptoms could be caused by other factors, such as new medications, stress, fatigue, alcohol, depression, and so forth.
These symptoms are nothing more than indicators that one may want to consult a doctor to determine if Alzheimer's is a cause of the symptoms.
DO NOT try to self-diagnose -- this is no place for amateurs to make guesses!
Some of the signs and symptoms heralding the onset of Alzheimer's include:
short-term memory loss that affects your daily life
unusual apathy, depression, and irritability
inability to remember information and asking the same question repeatedly
trouble with daily tasks
loss of cognitive skills such as critical thinking, planning, organization, or other tasks that were normally completed without difficulty.
confusion about scheduled events and disorientation
oral and written communication deficits (finding the right words, giving wrong names to things)
vision difficulties (beyond normal changes in vision one might see with regular checkups)
losing/misplacing items
social introversion, loss of interest, increased alone activities (TV, sleeping, etc.)
inability to correctly handle money
trouble maintaining hygiene/grooming
sudden bouts of anxiety, fear, or suspicion
newly-emerging motor deficits (handling familiar objects)
less energy or motivation in doing things
The Mild stage of Alzheimer's can last from about 2-4 years. As the disease progresses, so does the severity and pronouncement of symptoms. The next level of Alzheimer's--the middle or moderate stage, can last from 2-10 years. This stage includes:
persistent memory loss--including family and close friends
speech that rambles/repeats
nonsensical reasoning
confusion about scheduled events and disorientation
wandering or getting lost in previously familiar places
significant sleep disturbances
significant changes in mood and behavior
uninhibited behavior, delusions, and aggression
significant effects on mobility--coordination, slowness, tremors, rigidity
inappropriate dress for weather or situation
The final--late or severe stage--typically lasts 1-3 years. It is at this stage that one typically finds the need for 24/7 support because the person suffering from Alzheimer's is no longer able to care for themselves or maintain safety. This final stage includes:
inability to remember
inability to communicate or understand information
confusion about both past and present
likely immobility
eating, swallowing, incontinence problems
extreme changes in behavior and mood swings
delirium and hallucinations
loss of weight, seizures, dermal infections, susceptibility to other illnesses
Risk Factors
While there is no magic genetic formula, blood test, or other factor to predict who will succumb to Alzheimer's Disease, there are some things that may increase one's risk. You know how some people admonish us to eat right, exercise, and live a good life? Well...they are not that far off, actually! Common external factors that increase the risk of getting Alzheimer's include:
Down's Syndrome
severe head trauma (TBI, CTE)
high cholesterol in the blood
diabetes
smoking
alcoholism
obesity
heart disease
poor diet
stroke
The risk of Alzheimer's also increases with age. Although rare cases my occur as early as 30 years old, early onset is considered to being the 50's and most age-related risks grow exponentially after age 60-65...but old age is not a guarantee of contracting Alzheimer's, and one can live a fruitful and active life into their 90's.
Caregiving & Prognosis
One of the most difficult decisions that family members will have to make is the point at which the family will no longer be able to provide the necessary care for victims of Alzheimer's Disease. The most effective way to assess the need for care giving is to consult with experts when the onset of Alzheimer's has been verified by medical professionals. Not to be morbid, but having a plan for shifting to visiting, full-time, or residential care giving is as important to a family as having a will, insurance, and final disposition plans for any member of the family. Alzheimer's will, at least for the foreseeable future, result in death in 3-10 years after onset.
Unfortunately, even with ongoing research--and some successes--the prognosis for those afflicted with Alzheimer's disease is quite poor. There is no cure for Alzheimer's and the symptoms and dementia will intensify with time until the patient succumbs to this awful disease. If symptoms present when a person is in their 60's or 70's, they may expect to live for another 7-10 years on average; when onset occurs in one's 90's, the average life expectancy in 3 years...or less. For those in their 50's, they may live as long as another 20 years. With the many variables involved in onset and progression, these numbers are only estimates. As with other diseases or conditions, every individual's case is unique to them.
Information derived from: Earlstein, F. (2016). Dementia Facts & Information. NRB Publishing: Nevada.
For more resources and references on Alzheimer's Disease, see the following:
Dementia Resource Links: https://www.drcarlforkner.com/dementia-friendly
Dementia News & Research: https://www.drcarlforkner.com/dementia-memory-news
For & About Caregivers: https://www.drcarlforkner.com/caregivers