Distinctly different from the mild forgetfulness normally observed in older people, Alzheimer's disease is a degenerative disease of the brain from which, at this time, there is no recovery. The disease slowly and irreversibly attacks nerve cells in all parts of the cortex of the brain, as well as some surrounding structures. Alzheimer's disease affects a person's memory, language, motor skills, sensory function, abstract thinking (judgment, making plans, etc.), and eventually even affects the ability to recognize loved ones, friends, and once-familiar objects. The combination of all these changes has devastating effects on the person's relationships, social life, and occupational life (including work, school, shopping, hygiene, finances, etc.).

An estimated 4.5 million Americans have Alzheimer's disease. While Alzheimer's disease is certainly not the foregone result of "getting old," unless a cure for the disease is found that number is expected to triple in the next 20 years as more people live into their 80's and 90's.

Symptoms of Alzheimer's

Finding out that you or someone you care about has been diagnosed with Alzheimer's can be devastating. You may not know what to do, what to expect, or where to turn for help. Understanding the symptoms is important. Alzheimer's is not a disease characterized by memory impairment alone. Typically, a combination of symptoms defines the illness.

• Memory impairment is the most common and one of the defining symptoms of Alzheimer's disease. In the early stages of the disease, the person may forget small things, like a doctor's appointment or name of the mailman. Sadly, this impairment progresses to forgetting to finish tasks (like turning off the stove and water), and eventually to even forgetting relatives' names. When forgetfulness is a problem, Alzheimer's patients sometimes become paranoid, and, for example, may believe that people are stealing from them. Remember that everyone forgets occasionally and that common forgetting does not mean that you have Alzheimer's disease.



• Language difficulties are also consistent in Alzheimer's patients. At first, the person may just have difficulty in finding the right word, but as with the other symptoms, the difficulty gets worse. A person in later stages may have problems with speaking and understanding language. The ability to repeat words is well preserved but naming, speaking, and comprehension deteriorates as the disease progresses.



• Abstract thinking is also affected as Alzheimer's disease progresses. Abstract thinking deals with activities that involve a multi-step process and that require reasoning and judgment. Planning and organizing can become increasingly difficult and eventually, impossible. Activities once taken for granted (such as balancing the checkbook and reading) can become very difficult. A caregiver must be willing to understand what effect this loss of independence can have on the person and be willing to help in the completion of these duties in a subtle and tactful (and not overbearing) manner.



• Personality changes which may occur are often the most difficult symptom for loved ones to handle. A previously calm, caring spouse may become irritable, stubborn, and depressed without warning. Before Alzheimer's disease is diagnosed, the spouse of the person may see these changes as problems in their relationship and may become totally fearful or awe-struck by the change in the person. These changes are not the person's fault and do not indicate any change in feeling toward a spouse or loved one.



• Disorientation and confusion are also common -- a person will not know the date, time, or even where he or she lives. The person with Alzheimer's disease may wander aimlessly and not be able to find their way home.

These symptoms may start off mild and progressively worsen. In the final stage of Alzheimer's disease, the person is incapable of caring for himself or herself, talking with others, or paying attention.

Causes of Alzheimer's Disease

As researchers work hard to find the cause of Alzheimer's disease, several theories have been developed that, while neither proven nor disproven, may shed light on why some people develop the disease. A few popular theories include:

Chemical Theories

While the cause of Alzheimer's disease is still not known, it is understood that two significant abnormalities occur in the brains of those afflicted by the illness: twisted nerve cell fibers, known as neurofibrillary tangles, and a sticky protein called beta amyloid.

Neurofibrillary Tangles

The tangled fibers are the damaged remains of microtubules, the support structure that permits the flow of nutrients through the nerve cells.

Beta Amyloid

A high concentration of placques of a protein known as beta amyloid forms patches called neuritic placques outside the nerve cells and grossly obstructs the normal function of neurotransmitters which are the chemical messengers in the brain.

Genetic Theory

Researchers have found some people have a genetic predisposition to Alzheimer's disease. Recently, several different genes have been discovered that may possess a link to Alzheimer's disease. More research needs to be to determine why some people have this predisposition and others develop the disease with no family history. Some studies suggest that the genetic factor may need to combine with some other environmental factor to produce the illness.

Autoimmune Theory

Sometimes, the immune system turns against the person's body. Some researchers think the immune system may turn against the brain and cause damage to it that results in the symptoms of Alzheimer's disease.

Slow Virus Theory

Some diseases are caused by viruses. It is possible that a virus could attack the brain and cause changes that result in the symptoms of Alzheimer's disease.

Blood Vessel Theory

This theory suggests that there is a break in the blood-brain barrier. This barrier is a thin membrane that keeps toxic substances and foreign bodies from entering the brain. If the barrier were to break, it is possible that these toxic substances could enter and cause damage to the brain resulting in the symptoms of Alzheimer's disease. Note that this theory differs from hardening of the arteries in the brain and stroke.

Treatment For Alzheimer's Disease

Alzheimer's disease is an irreversible and progressive illness. This means there is not yet a cure for the disease and that it will get worse over time. Therapy can provide significant help, for the person with Alzheimer's, as well as for their close family members whose lives are also markedly impacted by the effects of the disease. Medications are also useful in managing the patient's symptoms of Alzheimer's.

A person with Alzheimer's disease will live an average of eight years and as many as 20 years or more from the onset of symptoms. From the time of diagnosis, people with Alzheimer's disease survive about half as long as those of similar age without dementia. Average survival time is affected by age at diagnosis and severity of other medical conditions.

For much of the course of their illness, a person with Alzheimer's can still partake in many activities with family and friends, especially if others are kept aware of the person's limitations. Many people retain the ability to demonstrably give and receive love throughout their illness.

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