What is Alzheimer's Disease?
Alzheimer's disease, also called senile dementia, is a degenerative disease of the brain for which there is no cure. Once a person starts showing signs of memory loss, inability to learn, bad judgment and poor communication, there aren't any treatments that can stop or reverse the progression of the disease. Although the exact causes of Alzheimer's are not known, it is thought that the disease develops as a result of multiple factors, including age, genetics, environment, lifestyle, and coexisting medical conditions. Alzheimer's is always fatal. It is the sixth most common cause of death in the United States. In 2013, there were 84,767 deaths from the disease.
Warning signs of Alzheimer's disease
As we age, it is not unusual to forget something occasionally or to have different behavior as we adjust to new social and physical challenges, but something more serious may be happening when our friends and family start to notice changes in our memory, behavior or abilities. The following is a list of characteristics that may be indicative of Alzheimer's disease.
Forgetfulness is one of the most common signs of Alzheimer's disease. People with Alzheimer's suffer a decline in short-term memory and they easily forget recently learned information. It is not unusual for a person suffering from the disease to ask the same questions over and over. They cannot retain new information and rely on notes and reminders from family members for things they used to handle on their own, such as following a familiar recipe or keeping track of monthly bills.
Losing track of time and place
People with Alzheimer's often get lost or have trouble driving to frequently-visited places. They may also have difficulty understanding that something will happen in the future, such as a medical appointment, and they will not plan or prepare for it. Alzheimer's patients may lose track of the passage of time, and get confused about the day of the week.
Problems speaking or writing
Vision may be impaired by cataracts or other eye problems by aging, but for some people, vision problems are a sign of Alzheimer's. They may have difficulty reading and judging distances. During conversations, people with Alzheimer's may forget what they were talking about and lose the thread of a conversation. They may also struggle finding the right word and call things by the wrong name.
Making bad decisions
People with Alzheimer's have impaired judgement and can make bad decisions. They are particularly vulnerable to scams and they may give large sums of money to telemarketers. When they realize their loss, they may accuse others of stealing. This also happens when they misplace things and are not able to find them.
Social withdrawal and lack of interest
The changes in the brain by Alzheimer's disease cause changes in personality. People with the disease may become confused, suspicious, depressed, fearful or anxious. They may become easily upset and fight with family and coworkers. The decrease in social contacts may also cause Alzheimer's patients to pay less attention to personal grooming and hygiene. The changes in personality are probably the most troubling for family members and close relatives who may resent the fact that the Alzheimer's patient does not recognize them anymore and may ask a spouse or a brother "Who are you?" several times per day.
What causes Alzheimer's disease?
The normal brain consists of neurons (brain cells) that connect and communicate at synapses, where tiny bursts of chemicals called neurotransmitters carry information from one cell to another. Alzheimer's disease disrupts the normal function of the brain through the buildup of amyloid plaques and the degeneration of the neurons by neurofibrillary tangles. Thus, the environment of the brain cells and the cells themselves are destroyed by the disease.
Beta-amyloid consists of short chains of amino acids that normally occur in the brain, but in Alzheimer's patients, these beta-amyloid chains agglomerate to create the amyloid plaques that are found in the brains of people afflicted with Alzheimer's. Amyloid plaques and neurofibrillary tangles are the two brain abnormalities that define Alzheimer's disease. The amyloid plaques destroy synapses and kill neurons, damaging the brain's communication network. Tangles destroy a vital cell transport system made of proteins. The appearance of amyloid plaques in the brain can precede the onset of behavioral symptoms by many years.
Can Alzheimer's disease be prevented?
Since the causes of the disease are not known, there is no specific medical advice for preventing Alzheimer's. Doctors generally suggest the typical advice for healthy living:
Exercise is thought to be particularly helpful because it may directly benefit brain cells by increasing the blood and oxygen flow in the brain.
Medical treatment for Alzheimer's
There are medicines that can ease some of the symptoms of Alzheimer's in some people. The drugs can slow down how quickly the disease gets worse, and they help the brain work better for longer. Three common drugs used to treat Alzheimer's are Donepezil (Aricept), Galantamine (Razadyne) and Rivastigmine (Exelon). Aricept is the only treatment approved by the FDA for all stages of Alzheimer's disease: mild, moderate, and severe. These drugs are cholinesterase inhibitors that work by slowing down the process that breaks down acetylcholine, which is a neurotransmitter that enables communication between the brain cells.
Alzheimer's disease robs people of their personality and alienates them psychologically from their family. Close relatives who become caregivers suffer trying to take care of a person who has become indifferent or belligerent. In many cases, the patient is sent to a hospice or nursing home which may be very expensive and can exhaust savings accounts and retirement funds. The financial burden and the emotional pressure can cause great grief for the family. Even when the patient has died after being sick for many years, the survivors will continue to suffer economic deprivation and they will carry the emotional scars of the experience for the rest of their lives.
President Ronald Reagan's life with Alzheimer's
Ronald Reagan left the White House in January 1989, but soon afterward, relatives and close associates started noticing signs of failing mental abilities. In 1993, tests at the Mayo Clinic revealed evidence of deterioration in his memory. By the fall of 1994, he had difficulty reading from a teleprompter, and in November, his Los Angeles office released a letter announcing his diagnosis.
Reagan deteriorated fast. He did not attend a 1996 celebration of his 85th birthday because he no longer recognized some people he had known for years. Reagan remained physically fit and he continued to take walks in parks near his home and played a weekly game of golf. After Reagan broke his hip in a fall at his home in 2001, he was virtually housebound. He died on June 5, 2004 at age 93, eleven years after his first symptoms appeared. The following is the letter that was published on November 5, 1994 announcing Reagan's diagnosis of Alzheimer's disease.
My fellow Americans,
I have recently been told that I am one of the millions of Americans who will be afflicted with Alzheimer's disease.
Upon learning this news, Nancy and I had to decide whether as private citizens we would keep this a private matter or whether we would make this news known in a public way.
In the past, Nancy suffered from breast cancer and I had cancer surgeries. We found through our open disclosures we were able to raise public awareness. We were happy that as a result many more people underwent testing. They were treated in early stages and able to return to normal, healthy lives.
So now we feel it is important to share it with you. In opening our hearts, we hope this might promote greater awareness of this condition. Perhaps it will encourage a clear understanding of the individuals and families who are affected by it.
At the moment, I feel just fine. I intend to live the remainder of the years God gives me on this earth doing the things I have always done. I will continue to share life's journey with my beloved Nancy and my family. I plan to enjoy the great outdoors and stay in touch with my friends and supporters.
Unfortunately, as Alzheimer's disease progresses, the family often bears a heavy burden. I only wish there was some way I could spare Nancy from this painful experience. When the time comes, I am confident that with your help she will face it with faith and courage.
In closing, let me thank you, the American people, for giving me the great honor of allowing me to serve as your president. When the Lord calls me home, whenever that may be, I will leave the greatest love for this country of ours and eternal optimism for its future.
I now begin the journey that will lead me into the sunset of my life. I know that for America there will always be a bright dawn ahead.
Thank you, my friends.