Frequently Asked Questions about Alzheimer's Disease

What is Alzheimer's disease?

Alzheimer's disease (AD) is a progressive degenerative disorder that results in impaired thinking, memory, and behavior. It is characterized by a distinctive pattern of "plaques and tangles in the brain." Plaques are patches of dying nerve fibers clustered outside of the nerve cell, and tangles are minute threads of nerve fiber twisted in a double helix shape. The disease destroys brain cells and ultimately leads to death.

Because Alzheimer's is a progressive disease, victims get increasingly worse, never better. The disease is neither preventable or curable, and its causes are unknown. Although there is no known cure for Alzheimer's, there are effective ways that the victim and family can manage the environment, activities of daily living, recreation, and social relationships to allow some ease and pleasure.

Alzheimer's is not a new disease, but has been part of the human condition since prehistoric times. However, it was not clearly identified as a separate syndrome until 1906 in the laboratory of the German doctor, Alois Alzheimer. He was the first to link the characteristic "plaques and tangles" of brain cell damage with the symptoms of the disorder.

 

Is Alzheimer's senile dementia?

Alzheimer's is a form of senile dementia. Senile dementia or organic brain syndrome were the phrases in popular use about twenty years ago to describe Alzheimer's disease. "Senility" is a catch-all word that means "old" and is especially associated with memory loss in the elderly. "Dementia" is an umbrella term for disorders where the mental functions break down -- where there is confusion, disorientation, and memory loss for recent events.

 

Is Alzheimer's a mental illness

Alzheimer's is not part of the normal aging process, and therefore, is not a normal event at the end of life. However, as people age, they tend to experience changes in the speed of recall: the information is there, but, with age, it may take longer to call it up. The following examples will illustrate some of the differences between changes due to normal aging and those due to Alzheimer's, especially in the more advanced stages of the disease:

Normal Aging - May forget what she/he had for lunch.
Alzheimer's - Forgets that she/he had lunch.
Normal Aging - May not always recall names of friends and relatives, but does recognize them and can recall names later.
Alzheimer's - Doesn't recognize friends and relatives.
Normal Aging - May not remember today's date, but knows the year and time day.
Alzheimer's - Cannot remember the day of the week, season, year, or time of day.

 

Is the disease inherited?

A firm genetic link has been established in 10-15 percent of Alzheimer's cases, which are referred to as "early onset" and occur between the ages of 40 and 50. Researchers have discovered some genetic abnormalities on chromosome 21 in early-onset cases.

It is much more difficult to isolate the causes of the vast majority of cases that occur at more advanced ages. Researchers speculate that late-onset Alzheimer's may not be one disease but several. Currently, scientists all over the world are searching for other flaws in the genetic code that may be operative in late-onset Alzheimer's disease. As yet, no firm genetic link has been found. Because of this complex genetic picture, if someone in your family has had the disease, your chances of developing it yourself are only slightly higher than those in the rest of the population.

 

What causes the disease?

The cause of the steady and relentless loss of brain cells in Alzheimer's disease is unknown. Theories of the cause include a slow virus, a genetic predisposition, environmental toxins, chemical imbalance in the brain, and auto-immunity.

 

Who can get Alzheimer's?

Alzheimer's affects an estimated four million American adults. It strikes rich and poor alike, men and woman, and people of all ethnic groups. People who have exercised, eaten healthy diets, never smoked a cigarette or taken a drink are at equal risk with the rest of the population.

Alzheimer's rarely occurs before age 45 (people who have Down's Syndrome may get Alzheimer's much earlier). By age 70, the prevalence of the disease rises. Largely because people are living longer than ever before, the United States is experiencing a virtual "epidemic of Alzheimer's disease".

 

How can you tell if someone has Alzheimer's

The disease begins in a mystifying way with little things that don't add up: a forgotten word; the inability to dress properly; the tendency to blame lapses of memory on fatigue or stress, some personality changes; or a lack of motivation. Forgetfulness becomes the hallmark. People with the disease gradually forget recent experiences; fail to recognize familiar names, people and/or places; and eventually, cannot follow written or spoken instructions. These impairments in thinking and memory become progressively worse.

The Suncoast Gerontology Center AgeLine publication, The Seven Warning Signs of Alzheimer's Disease, lists the following signs:

1. Asking the same question over and over again.
2. Repeating the same story, word for word, again and again.
3. Forgetting how to cook, or how to make repairs, or how to play cards -- activities that were previously done with ease and regularity.
4. Losing one's ability to pay bills or balance one's checkbook.
5. Getting lost in familiar surroundings, or misplacing household objects.
6. Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean.
7. Relying on somebody else, such as a spouse, to make decisions or answer questions that they previously would have handled themselves.

It should be noted that if someone has several or even most of these symptoms, it does not mean that they definitely have the disease. It does mean that they should be thoroughly examined by a medical specialist trained in evaluating memory disorders, such as a neurologist or a psychiatrist, or by a comprehensive memory disorder clinic, with an entire team of experts knowledgeable about memory problems.

After onset, Alzheimer's lasts anywhere from 2 to 20 years. People with the disease eventually get so weakened that they become vulnerable to a virus infection. Pneumonia is one of the most common causes of death for Alzheimer's patients. During the course of the disease, there is no recovery of lost functions.

 

What are the diagnostic tests for Alzheimer's disease?

There is no single test that will diagnose Alzheimer's disease. However, when a physician suspects Alzheimer's and has performed several of the diagnostic tests described below, the diagnosis can be made with a high degree of accuracy. Since many dementing diseases are arrestable, reversible, or preventable, a complete medical and neurological evaluation is strongly recommended whenever an individual begins to experience significant memory problems.

Medical History Including Drug/Medication Review - to establish progressive intellectual deterioration and identify personality changes, problems with memory, and difficulty with daily activities.

Physical Examination - to rule out other causes of dementia, such as vitamin deficiency, thyroid disease, infections, circulatory disease, brain tumors, head injuries, and depression.

Mental Status Test - to rule out emotional and intellectual impairment as well as psychiatric impairment. This should include evaluation of orientation, attention, memory, judgment, thought processes, and mood.

 

Diagnostic Tests

• Chest x-ray
• Electrocardiogram (EKG)
• Stool test of blood not observable on sight
• Urinalysis
• Neurological exam
• Computerized Topography Scanning (CT Scan)
• Magnetic Resonance Imaging (MRI)
• Positive Emission Topography (PET)