Dementia Alzheimer’s Type

Alzheimer’s disease is the most common cause of dementia, accounting for 60-80% of all dementia cases. This progressive brain condition gradually damages memory, thinking, and the ability to perform everyday tasks, affecting millions of older adults worldwide.

Table of contents

• What Is Alzheimer’s Type Dementia?
• Signs and Symptoms
• What Causes the Disease
• How It Is Diagnosed
• Treatment Options
• Living With the Condition

What Is Alzheimer’s Type Dementia?

Alzheimer’s disease is a brain condition that slowly damages your memory, thinking, learning and organizing skills. It is the most common type of dementia—a general term used to describe a range of brain diseases that get worse over time^[1]. About 6.9 million people in the United States age 65 and older live with Alzheimer’s disease, and more than 70% are age 75 and older^[6].

Alzheimer’s is a neurodegenerative disease, which means it damages and destroys cells in your brain over time^[15]. The disease is caused by the buildup of proteins in the brain. These proteins form amyloid plaques and neurofibrillary tangles, which cause brain cells to die and the brain to shrink^[6]. Eventually, people with Alzheimer’s lose some of their brain functions, including memory and language.

It’s important to understand that dementia is not a normal part of aging. While some memory changes are normal as a person ages, Alzheimer’s disease interferes with your ability to function in daily life^[7]. The disease is progressive, meaning symptoms get worse over time.

Signs and Symptoms

Memory loss is the key symptom of Alzheimer’s disease. Early in the disease, people may have trouble remembering recent events or conversations^[6]. Over time, memory gets worse and other symptoms occur. At first, someone with the disease may be aware of having trouble remembering things and thinking clearly. As signs and symptoms get worse, a family member or friend may be more likely to notice the issues.

Alzheimer’s disease can affect several areas of mental function. Memory issues from Alzheimer’s are different and more serious than occasionally forgetting where you left your phone. People with Alzheimer’s might forget faces or names, important facts, or where they are, even in familiar places like at home^[15].

The disease can make it hard to reason and make decisions. Someone with Alzheimer’s might seem confused or take an unusually long time to make a choice. This can affect their ability to decide what to do next, follow a recipe, or make plans^[15].

Language problems are also common. Alzheimer’s disease can make it hard for you to speak, read or understand language. You may communicate less than you used to, mix up words, or say the wrong word^[15].

Mood and personality changes are another important symptom. You might notice that a person with Alzheimer’s acts more suspicious, even around people they’ve known for years. They may experience mood swings, feel increased worry or fear, or show more aggressive behavior than usual^[15].

Spatial understanding problems may develop as well. People with Alzheimer’s may have a hard time understanding how close objects around them are or feel less coordinated than usual. This can include bumping into furniture, having trouble picking something up, or struggling to do delicate hand motions like tying shoes^[15].

The symptoms of Alzheimer’s disease are divided into stages based on severity. In the mild stage, people may wander and get lost, or repeat questions. In the moderate stage, they may have problems recognizing friends and family or show impulsive behavior. In the severe stage, people with Alzheimer’s cannot communicate^[3].

What Causes the Disease

The exact cause of Alzheimer’s disease is not fully understood, but many factors play a role. The disease is caused by an abnormal buildup of proteins in the brain. These proteins are called amyloid-beta and tau^[15].

Abnormal deposits of these proteins form amyloid plaques and tau tangles throughout the brain. This causes brain cells to stop working properly, lose connections with other brain cells, and eventually die^[3]. As more neurons die, affected regions of the brain begin to shrink.

Many factors can increase your risk of developing Alzheimer’s disease. Age is the most important risk factor—the disease is much more common in people older than 65^[5]. About 5% to 8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age^[7].

Having a close relative, like a parent or sibling, with Alzheimer’s disease increases a person’s chance of developing it^[5]. However, there are many things you can do to reduce your risk, such as being physically active and controlling your blood pressure.

Other conditions that damage blood vessels can also increase risk. These include diabetes, high blood pressure, and high cholesterol^[5]. Things that increase the risk of developing dementia also include being overweight, smoking, drinking too much alcohol, being physically inactive, being socially isolated, and depression^[9].

A small percentage of cases are caused by specific gene changes passed down in families. This form is called familial Alzheimer’s disease and makes up less than 1% of all cases. Most people who have early-onset Alzheimer’s (symptoms appearing before age 65) have this familial form^[8].

How It Is Diagnosed

An important part of diagnosing Alzheimer’s disease includes being able to explain your symptoms. It may help to get input from a close family member or friend about your symptoms and their impact on your daily life^[12].

Tests of memory and thinking skills help diagnose Alzheimer’s disease. Blood and imaging tests can rule out other potential causes of your symptoms. They also can check for proteins in the brain that are linked to Alzheimer’s disease^[12].

Diagnosing Alzheimer’s disease would likely include several types of tests. Healthcare professionals will review your medical history and conduct a physical exam. They will ask about your symptoms, including when they started and how they affect your daily life.

Mental status testing assesses memory, thinking, and simple problem-solving abilities. These tests help doctors understand how well your brain is working. A neurological exam checks reflexes, coordination, muscle tone and strength, eye movement, speech, and sensation^[12].

Brain imaging tests are important for diagnosis. An MRI or CT scan can show if there are other problems in the brain, such as tumors, strokes, or bleeding. These tests also can show patterns of brain shrinkage that suggest Alzheimer’s^[12].

Recently, biomarker tests have become important for diagnosis. Biomarkers are substances in the body that indicate the presence of disease. Blood biomarker tests can tell if someone is likely to have amyloid in the brain. Other biomarker tests include specific types of PET scans of the brain or analysis of cerebrospinal fluid—the fluid that surrounds the brain and spinal cord^[12].

Healthcare professionals can now diagnose Alzheimer’s disease during life with more certainty than in the past. They do this by using a combination of tests that may include tests for biomarkers^[12].

Treatment Options

There is currently no cure for Alzheimer’s disease. However, several prescription drugs are approved to help either manage the symptoms of or treat the disease^[11]. Medicines may improve symptoms or slow the decline in thinking. Programs and services can also help support people with the disease and their caregivers^[6].

Medications fall into two main categories: drugs that change disease progression in people living with early Alzheimer’s disease, and drugs that may temporarily help with symptoms^[14].

Cholinesterase inhibitors are prescribed for mild to moderate Alzheimer’s symptoms. These medicines include galantamine, rivastigmine, and donepezil. They prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking^[11]. Common side effects include nausea, diarrhea, and dizziness.

Another medication called memantine is used for moderate or severe Alzheimer’s disease. The main benefit of this medication is to help slow the rate of functional decline. Its more common side effects can include constipation and some fatigue^[17].

Newer treatments address the underlying biology of the disease. Lecanemab and donanemab are immunotherapy drugs approved for the treatment of early Alzheimer’s. These drugs target the protein beta-amyloid to help reduce amyloid plaques in the brain^[11]. Clinical studies showed that these drugs slowed the rate of cognitive decline among some study participants over 18 months and reduced the levels of amyloid in the brain. Before prescribing these medications, doctors may order PET scans or an analysis of cerebrospinal fluid to check whether amyloid deposits are present in the brain^[11].

Non-drug treatments are also important. Cognitive stimulation therapy involves taking part in group activities and exercises designed to improve memory and problem-solving skills. Cognitive rehabilitation involves working with a trained professional to achieve a personal goal, such as learning to use a mobile phone^[13].

Reminiscence work involves talking about things and events from your past, usually using props such as photos, favorite possessions, or music. These approaches can improve mood and wellbeing^[13].

Sometimes people with Alzheimer’s develop behavioral symptoms such as increased worry, wandering, or aggression. If coping strategies do not work, doctors may prescribe medications to help manage these symptoms. Antidepressants may be given to treat depression, anxiety, or irritability. Low doses of antipsychotics may be considered to help address delusional thinking or aggression^[13].

Living With the Condition

Living with Alzheimer’s disease presents unique challenges, but there are steps you can take to help now and in the future. Many people with early-stage dementia continue to manage their everyday activities, but it’s important to look ahead and adopt new strategies early^[23].

To make everyday tasks easier, write down to-do lists, appointments, and events in a notebook or calendar. Set up automated bill payments and consider asking someone you trust to help manage your finances. Use a weekly pillbox or medication dispenser to manage your medications^[21].

Following a regular schedule can help. Try to keep a routine, such as bathing, dressing, and eating at the same time each day. Plan activities that you enjoy and try to do them at the same time each day^[20].

Participating in activities you enjoy and getting exercise may help you feel better, stay social, maintain a healthy weight, and have regular sleep habits. Try to be physically active for at least 30 minutes on most or all days of the week. Aim for a mix of exercise types—walking, dancing, lifting weights, and stretching^[21].

Sleep problems are common with dementia. Follow a regular schedule by going to sleep and getting up at the same time each day. Develop a relaxing bedtime routine with lowered lights, cool temperature, and no electronic screens. Avoid caffeine and naps late in the day^[21].

Taking care of yourself emotionally is also important. Living a healthy life with Alzheimer’s involves examining your physical, emotional, psychological, social, and spiritual health. Things you once did easily will become increasingly difficult, but coping skills will help you handle day-to-day challenges and maximize your independence^[25].

For caregivers and family members, understanding behavioral changes is crucial. Many people find the changes in behavior caused by Alzheimer’s to be the most challenging effect of the disease. These behaviors may be how someone is communicating their feelings. Sometimes these behaviors happen when a person is finding their environment confusing or when they’re being asked to do something they don’t want to do^[27].

Caregivers should try to be tactful and patient, help the person find answers themselves, look for underlying themes in repeated questions, and offer general reassurance^[27]. Providing plenty of activity and exposure to daylight, maintaining a daily routine including daily walks, and giving the person something to occupy their hands can all help manage restlessness and sleep disturbances.

Planning for the future is essential. This includes legal and financial planning, such as setting up a lasting power of attorney, planning for care costs, and making decisions about future care^[20]. Building a care team early can help ensure that support is available as the disease progresses.