Alzheimer's disease (patient information)
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What is Alzheimer's disease?
Alzheimer's disease is a brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. Memory problems are one of the first signs of Alzheimer's. People may have trouble remembering things that happened recently or names of people they know. Over time, symptoms will most often get worse, and problems can include getting lost, repeating questions, and taking longer than normal to finish daily tasks. As the disease progresses, people may have trouble learning new things, recognizing family and friends, and communicating. Eventually, they need total care.
Alzheimer's disease is the most common cause of dementia among older people. Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a person's daily life and activities. Other causes of dementia include blood-vessel disease in the brain (called vascular dementia), Parkinson's disease, frontotemporal dementia, and Lewy body disease.
There are two types of AD -- early onset and late onset.
- In early onset AD, symptoms first appear before age 60. Early onset AD is much less common than late onset. However, it tends to progress rapidly. Early onset disease can run in families. Several genes have been identified.
- Late onset AD, the most common form of the disease, develops in people age 60 and older. Late onset AD may run in some families, but the role of genes is less clear.
What are the symptoms of Alzheimer's disease?
Dementia symptoms include difficulty with many areas of mental function, including:
- Language
- Memory
- Perception
- Emotional behavior or personality
- Cognitive skills (such as calculation, abstract thinking, or judgment
Dementia usually first appears as forgetfulness.
Mild cognitive impairment is the stage between normal forgetfulness due to aging, and the development of AD. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops AD.
Symptoms of Mild cognitive impairment include:
- Forgetting recent events or conversations
- Difficulty performing more than one task at a time
- Difficulty solving problems
- Taking longer to perform more difficult activities
The early symptoms of AD can include:
- Language problems, such as trouble finding the name of familiar objects
- Misplacing items
- Getting lost on familiar routes
- Personality changes and loss of social skills
- Losing interest in things previously enjoyed, flat mood
- Difficulty performing tasks that take some thought, but used to come easily, such as balancing a checkbook, playing complex games (such as bridge), and learning new information or routines
As the AD becomes worse, symptoms are more obvious and interfere with your ability to take care of yourself. Symptoms can include:
- Forgetting details about current events
- Forgetting events in your own life history, losing awareness of who you are
- Change in sleep patterns, often waking up at night
- Difficulty reading or writing
- Poor judgment and loss of ability to recognize danger
- Using the wrong word, mispronouncing words, speaking in confusing sentences
- Withdrawing from social contact
- Having hallucinations, arguments, striking out, and violent behavior
- Having delusions, depression, agitation
- Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, and driving
People with severe AD can no longer:
- Understand language
- Recognize family members
- Perform basic activities of daily living, such as eating, dressing, and bathing
Other symptoms that may occur with AD:
- Incontinence
- Swallowing problems
What are the causes of Alzheimer's disease?
Who is at risk for Alzheimer's disease?
Age and family history are risk factors for AD.
- As you get older, your risk of developing AD goes up. However, developing Alzheimer's disease is not a part of normal aging.
- Having a close blood relative, such as a brother, sister, or parent who developed AD increases your risk.
- Having certain combination of genes for proteins that appear to be abnormal in Alzheimer's disease also increases your risk.
Other risk factors that are not as well proven include:
- Longstanding high blood pressure
- History of head trauma
- Female gender
How to know you have Alzheimer's disease?
When to seek urgent medical care
Call your health care provider if someone close to you experiences symptoms of senile dementia/Alzheimer's type.
Call your health care provider if a person with this disorder experiences a sudden change in mental status. (A rapid change may indicate other illness.)
Discuss the situation with your health care provider if you are caring for a person with this disorder and the condition deteriorates to the point where you can no longer care for the person in your home.
Treatment options
Diseases with similar symptoms
Where to find medical care for Alzheimer's disease
Directions to Hospitals Treating Alzheimer's disease
Prevention of Alzheimer's disease
Although there is no proven way to prevent AD, there are some practices that may be worth incorporating into your daily routine, particularly if you have a family history of dementia. Talk to your doctor about any of these approaches, especially those that involve taking a medication or supplement.
- Consume a low-fat diet.
- Eat cold-water fish (like tuna, salmon, and mackerel) rich in omega-3 fatty acids, at least 2 to 3 times per week.
- Reduce your intake of linoleic acid found in margarine, butter, and dairy products.
- Increase antioxidants like carotenoids, vitamin E, and vitamin C by eating plenty of darkly colored fruits and vegetables.
- Maintain a normal blood pressure.
- Stay mentally and socially active throughout your life.
- Consider taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin), sulindac (Clinoril), or indomethacin (Indocin). Statin drugs, a class of medications normally used for high cholesterol, may help lower your risk of AD. Talk to your doctor about the pros and cons of using these medications for prevention.
In addition, early testing of a vaccine against AD is underway.
What to expect (Outlook/Prognosis)
How quickly AD gets worse is different for each person. If AD develops quickly, it is more likely to worsen quickly.
Patients with AD often die earlier than normal, although a patient may live anywhere from 3 - 20 years after diagnosis.
The final phase of the disease may last from a few months to several years. During that time, the patient becomes immobile and totally disabled.
Death usually occurs from an infection or a failure of other body systems.
Possible Complications
- Loss of ability to function or care for self
- Bedsores, muscle contractures (loss of ability to move joints because of loss of muscle function), infection (particularly urinary tract infections and pneumonia), and other complications related to immobility during end stages of AD
- Falls and broken bones
- Loss of ability to interact
- Malnutrition and dehydration
- Failure of body systems
- Harmful or violent behavior toward self or others
- Abuse by an over-stressed caregiver