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Alzheimer’s disease is a disease that damages and ultimately destroys brain cells, leading to:
The condition can also lead to:
When these changes get severe enough to get in the way of day-to-day life, they are known as dementia. Alzheimer’s disease is the most common cause of dementia, accounting for 3 to 4 out of every 5 people with dementia—but it is not the only cause.
Other conditions that cause dementia include:
When a person has more than one of these conditions, it is called mixed dementia. Dementia can also be caused by:
Many types of dementia cannot be cured, although some have treatments that can alleviate symptoms or slow the progression of the disease. Alzheimer’s disease affects more than 5 million Americans, about half of who don’t know they have the condition. Other types of dementia are harder to estimate, but may affect an additional 1.3 to 3.5 million people in the United States.
Alzheimer’s disease and other dementia are not a normal part of aging. The exact cause of Alzheimer’s disease is not known, although scientists believe it is caused by a mix of:
Once Alzheimer’s disease begins, it kills brain cells secondary to altered biochemistry, which results in multiple proteins within the neurons “misfolding” and disrupting the intracellular mechanical support of the cell and the cell membrane itself. As a result, there is a loss of neurons, neuronal connections (referred to as synapses) and the entire brain shrinks The brains in people with Alzheimer’s disease also develop:
Other types of dementia have different causes. For example:
Age is the greatest risk factor for Alzheimer’s disease and many other types of dementia. Dementia is not a normal part of aging, but it does become much more common after age 65.
Some of the known risk factors for dementia include:
• Genes. You may be more likely to get Alzheimer’s disease or certain other types of dementia if one of your parents or siblings has it. Huntington’s disease and one rare strain of Alzheimer’s disease are dominant genetic disorders, which means that if one of your parents has the gene for the disease, you have a fifty-fifty chance of inheriting the gene, and if you inherit the gene you will almost definitely have the disease.
• Sex. Women are at slightly higher risk than men for Alzheimer’s disease. This is especially true in women who take hormone treatment for a long time after menopause.
• Head trauma. Injuries that affect your brain can raise your risk of Alzheimer’s disease and vascular dementia The effects of chronic head trauma in professional football players has recently been described and diagnosed as chronic traumatic encephalitis (CTE) and is the basis of a lawsuit against the National Football League (NFL).
• Poor health. If you have unhealthy eating or exercise habits can increase your risk of Alzheimer’s disease and vascular dementia. Health problems like high blood pressure, high cholesterol, and diabetes can also increase your risk.
• Mild cognitive impairment. Sometimes a slight decline in memory is an early sign of problems to come.
• Down syndrome. People with Down syndrome often develop plaques and tangles like those seen in Alzheimer’s disease.
• Alcohol abuse. Drinking to excess can lead to Wernicke-Korsakoff syndrome and other types of dementia.
The good news? Studies have also shown that keeping your mind active and interacting with other people may help reduce your risk of Alzheimer’s disease. So factors that may help protect you from dementia may include:
• An interesting job that engages your mind
• A college education, especially a graduate degree
• An active social life
• Playing a musical instrument
• Other challenging hobbies
• Playing chess, bridge, or other games
Dementia can be difficult to diagnose, because there are many factors that could cause the same symptoms. Alzheimer’s disease, in particular, can only be confirmed for certain by an autopsy—so any diagnosis while you are alive is based on your doctor’s best judgment. Researchers are searching for tests to identify patients at risk of developing AD before the disease commences. These biochemical tests are targeting the suspected “mis-folded” plaques of proteins (beta-amyloid and tau proteins) in the cerebrospinal fluid, or CSF, which can be obtained from a spinal tap. Your doctor or a mental health professional will also test your memory and thinking skills, and possibly give you a neuropsychological exam. Do not expect a quick diagnosis.
To start, your doctor will start by asking you questions about:
• Your symptoms
• Your family history
• Your day-to-day life, such as whether you’ve stopped doing any activities you used to do
Your doctor will also review your medical history and give you a physical examination. During the physical exam, your doctor will probably test:
• Your reflexes
• Your balance and coordination
• Your vision
• Your hearing
• Your strength and muscle tone
• Your ability to get up from a chair and walk across the room
Dementia symptoms may vary, depending on the type of dementia you have. In general, symptoms of Alzheimer’s disease and other dementias may include:
Early warning signs may include:
Over time, Alzheimer’s disease may lead to:
These symptoms may be different if you have a different type of dementia. For instance:
The long-term outcome depends on the type of dementia you have. Sometimes dementia has a specific cause and goes away when that cause is treated. But some types of dementia are unstoppable and deadly. Others may be slowed with treatment, though are not curable. The average life expectancy for people with Alzheimer’s disease is 8 to 10 years after symptoms start, but some live with Alzheimer’s disease for as long as 20 years.
Lifespans with other types of dementia can vary widely. People with Huntington’s disease typically survive for 15 to 25 years after diagnosis, while 9 out of 10 people diagnosed with Creutzfeldt-Jacob disease die within a year.
Life with dementia and Alzheimer’s disease can be a challenge, and it often worsens over time. But there are things you can do to help keep up your quality of life:
At present, there are no guidelines for routine screening for dementia. If you are concerned about memory problems, doctors have a variety of questionnaires they can use to assess you for dementia symptoms. There are also at-home tests you can use, though no self-test can take the place of a thorough exam by a doctor.
If you are concerned about inheriting a condition that causes dementia, or about passing one on to your children, genetic testing is available for the genes that cause Huntington’s disease and some types of Alzheimer’s disease and frontotemporal dementia.
Some types of dementia can’t be prevented. But there are things you can do to reduce your overall risk of dementia. The main thing you can do? Keep your mind and your body active.
Keeping your mind engaged in challenging work or activities, such as games or puzzles, playing a musical instrument, or interacting with other people, has been shown to reduce your risk for Alzheimer’s disease.
Taking good care of your heart can also reduce your risk of Alzheimer’s disease and frontotemporal dementia. This includes:
You can also avoid other controllable risk factors for dementia, such as:
Sometimes, dementia has a clear cause, such as a hormone imbalance or a side effect of a medication. In these cases, dementia usually resolves on its own once the underlying cause is removed. Unfortunately, many types of dementia have no cure, at least not yet. Treatment for dementia focuses on slowing disease progress when possible, and keeping symptoms under control. Namenda (memantine) affects the way your brain sends and receives messages, by regulating the chemical messenger glutamate. Namenda may slow down Alzheimer’s disease and some other types of dementia, especially when combined with another type of medicine called a cholinesterase inhibitor.
Cholinesterase inhibitors help control symptoms by improving communication between your brain cells. Cholinesterase inhibitors include:
Unfortunately, cholinesterase inhibitors don’t work for everyone, but they can help some patients with:
Your doctor may also prescribe other treatments to help with specific symptoms, such as trouble sleeping.
Treatment may also include occupational therapy to help you adapt to living with dementia, and lifestyle changes such as exercise, nutrition, and changes to the home environment to reduce risks and simplify everyday life.
Relaxation techniques such as music therapy, aromatherapy, or massage can help relieve problems such as frustration and anxiety in people with dementia and Alzheimer’s.
Some herbs and supplements may help as well, but they should be used with caution:
Always talk with your doctor about any herbal treatment or supplement you are considering.
Living with dementia can be difficult and stressful, but there are things you can do to help yourself or a loved one with dementia.
To help yourself cope emotionally:
To help keep your independence despite day-to-day issues:
If you are caring for a loved one with dementia, it’s important to take care of yourself as well. Caregiver burnout is a very real problem, and much more common than you might think. Don’t be afraid to ask for help when you need it, and find a caregiver support group in your area. Hiring help may not be the same as being there yourself, but a nurse or home aide can give you the relief you need to be at your best when you are there.
If you have problems remembering things, or other symptoms that might be caused by dementia, see a doctor. If you see these symptoms in a loved one, encourage him or her to see a doctor. If necessary, help make the appointment and take your loved one there.
When you go to see your doctor, it’s good to have a list of the questions you’d like to have answered. Take a moment to write down some of the things you want to know. Your questions for your doctor might include some of these:
Other useful resources to help you learn about Alzheimer’s can be found at:
Alzheimer’s Association 24/7 Helpline: 800-272-3900
Support for caregivers
Early symptoms checklist
National Institute on Aging Alzheimer’s Disease Education and Referral Center
Alzheimers.gov caregiver support
How to Reduce Stress and Boost Your Immune System While Social Distancing
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