Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. People with the late-onset type may experience symptoms in their mid-60s. On the other hand, early-onset Alzheimer’s occurs between a person’s 30s and mid-60s, which is also very rare.

 

The disease is named after Dr Alois Alzheimer. In 1906, Dr Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behaviour. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibres (now called neurofibrillary, or tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.

This damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As neurons die, additional parts of the brain are affected. By the final stage of Alzheimer’s, the damage is widespread, and brain tissue has shrunk significantly.

Risk factors

Experts haven’t determined a single cause of Alzheimer’s disease but they have identified certain risk factors, including:

Age: Most people who develop Alzheimer’s disease are 65 years of age or older.
Family history: If you have an immediate family member who has developed the condition, you’re more likely to get it.
Genetics: Certain genes have been linked to Alzheimer’s disease.

Having one or more of these risk factors doesn’t mean that you’ll develop Alzheimer’s disease. It simply raises your risk level.

Symptoms of Alzheimer’s disease

Everyone has episodes of forgetfulness from time to time. But people with Alzheimer’s disease display certain ongoing behaviours and symptoms that worsen over time. These can include:

• Memory loss affecting daily activities, such as an ability to keep 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 judgment.
• Decreased personal hygiene.
• Mood and personality changes.
• Withdrawal from friends, family, and community.

Alzheimer’s Test

There’s no definitive test for Alzheimer’s disease. However, the doctor will likely do several tests to determine your diagnosis. These can be mental, physical, neurological, and imaging tests.

The doctor may start with a mental status test. This can help them assess short-term memory, long-term memory, and orientation to place and time. For example, they may ask:

• What day it is
• Who the president is
• To remember and recall a short list of words.

Next, they will likely conduct a physical exam. For example, they may check blood pressure, assess heart rate, and take the temperature of the patient. In some cases, they may collect urine or blood samples for testing in a laboratory.

The physician may also conduct a neurological exam to rule out other possible diagnoses, such as an acute medical issue, an infection, or a stroke. During this exam, they will check reflexes, muscle tone, and speech.

Brain-imaging studies may also be carried out. These studies, which will create pictures of the brain can include:

Magnetic resonance imaging (MRI): 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.

Positron emission tomography (PET) scan: PET scan images can help your doctor detect plaque buildup. Plaque is a protein substance related to Alzheimer’s symptoms.

Other tests the physician may include blood tests to check for genes that may indicate a higher risk of Alzheimer’s disease.

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Medication

There’s no known cure for Alzheimer’s disease. However, the doctor can recommend medications and other treatments to help ease the symptoms and delay the progression of the disease for as long as possible.

To moderate Alzheimer’s, the doctor may prescribe medications such as donepezil (Aricept) or rivastigmine (Exelon). These drugs can help maintain high levels of acetylcholine in your brain. This is a type of neurotransmitter that can help aid memory.

To treat moderate to severe Alzheimer’s, a physician may prescribe donepezil (Aricept) or memantine (Namenda). Memantine can help block the effects of excess glutamate. Glutamate is a brain chemical that’s released in higher amounts in Alzheimer’s disease and damages brain cells.

The physician may also recommend antidepressants, antianxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms include:

• Depression.
• Restlessness.
• Aggression.
• Agitation.
• Hallucinations

Prevention

Just as there’s no known cure for Alzheimer’s, there are no foolproof preventive measures. However, researchers are focusing on overall healthy lifestyle habits as ways of preventing cognitive decline.

The following measures may help:

• Quit smoking.
• Exercise regularly.
• Try cognitive training exercises.
• Eat a plant-based diet.
• Maintain an active social life.

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