Last week we discussed dementia as an umbrella term that describes a set of symptoms including impaired memory, judgment, and reasoning. Today, we will focus on the most common type of dementia – Alzheimer’s Disease (AD). This disease was first identified in 1906 when Dr. Alois Alzheimer examined the brain of a woman who had died of a mental illness that had included symptoms of memory loss, language problems, and unpredictable behavior. He noticed changes in the brain tissue that today we call plaques and tangles. Plaques are abnormal clumps of a certain type of protein that are found in the spaces between the brain cells. Tangles occur inside the brain cells when a different type of protein becomes twisted and sticks together. These plaques and tangles ultimately lead to cell death and, as cells die, the affected areas of the brain begin to shrink.
In about 5% of all people with AD, the onset of the disease occurs between the ages of 30 and 60, and is referred to as early-onset Alzheimer’s. Most cases of early-onset AD result from genetic factors, and scientists are still studying the relationship between certain types of genes and the development of AD.
AD is not a normal part of aging, but most commonly occurs in people over age 65. This type of AD is called late-onset. Increasing age is the greatest risk factor for AD and, after age 65, the risk of developing AD doubles every five years (www.alz.org).
The Alzheimer’s Association has identified ten warning signs of dementia. They include:
- Memory changes that disrupt daily life
- Challenges in planning or solving problems
- Difficulty completing familiar tasks at home, work, or leisure
- Confusion with time or place
- Trouble understanding visual images and spatial relationships
- New problems with words in speaking or writing
- Misplacing items and losing the ability to retrace steps
- Decreased or poor judgment
- Withdrawal from work or social activities
- Changes in mood and personality
For specific examples of these warning signs and how to distinguish them from normal behavior, visit the Alzheimer’s Association website.
There is no single test to diagnose AD and a thorough medical evaluation will help rule out other possible causes of dementia symptoms. Women are more likely to develop AD than men, and life expectancy depends upon an individual’s age at diagnosis and general state of health. Younger and healthier individuals may live as long as 20 years. AD is a progressive disease, and individuals eventually move from the early stages of mild forgetfulness to demonstrating increasing levels of cognitive deficiency such as poor concentration, the inability to perform complex tasks, loss of personal memories, and general confusion. Some affected individuals may demonstrate wandering behavior, sleep disturbances, hallucinations (such as seeing or hearing things that aren’t really there), delusions (false beliefs such as someone is stealing from them or a spouse is being unfaithful), repetitive behaviors (such as picking at or rubbing something) and/or periods of agitation. Care needs increase gradually as cognition declines, and physical assistance with dressing, eating, and toileting will be required. Eventually, during the latest stages of the disease, physical functioning is affected and difficulties with walking, sitting, swallowing, and general movement occur. During the course of AD, symptoms may be treated with medications and environmental/behavioral interventions.
Unfortunately, there is no cure for AD at this time. The Harrisburg area Walk to End Alzheimer’s seeks to change this fact by raising funds for research, the care and support of those with the disease and their families, and through increasing public awareness. Last year’s event included over 1,100 walkers and raised over $145,800. Join us this year on City Island on September 20th.
Karen Kaslow, RN