Alzheimer's Disease

Alzheimer’s disease (AD) is one of the leading causes of dementia among adults (typically) over 65 years of age. In 2006 this degenerative disease affected over 26.2 million sufferers worldwide, and that number is projected to affect 1 in 85 people globally by 2050 (Wikipedia.org). AD disrupts it’s victims lives biologically (physical deterioration of the brain), psychologically (severe and permanent memory loss), and socially as they becoming fully dependent on their caregivers. By understanding the stages of AD, possible causes, and prevention we can recognize the symptoms early and help those with AD live their best life.
There are 5 stages of Alzheimer’s disease. The first is preclinical Alzheimer’s disease. In this stage there are no physical or cognitive symptoms. Friends and family members of those affected notice to changes. This stage can last months, years, even decades (mayoclinic.com).

Mild cognitive impairment (MCI) due to Alzheimer’s disease is the second stage.  Changes in the brain at this stage are not significant enough to affect work or social interactions. During this time those with MCI may have difficulty recalling information that was once remembered easily. This includes placement of keys, conversations, or recent appointments. They may have difficulty judging the amount of time it takes to complete a task or following the sequence of steps that were once second nature. Also, the ability to make decisions is problematic (mayoclinic.com).

The third stage of Alzheimer’s disease is mild dementia due to AD. This is the time AD is most often diagnosed when it becomes clear to friends and family members that their loved one is having difficulty with memory and thinking (mayoclinic.com). In this stage patients with AD may experience:

• Memory loss of recent events – difficulty remembering events that have happened recently asking the same question over and over

• Difficulty with problem-solving, complex tasks, and sound judgments – inability or difficulty planning family events, or balancing a check book

• Marked changes in personality – the patient becomes increasingly withdrawn, displaying uncharacteristic anger or aggression, shortened attention span, and depression

• Difficulty organizing and expressing thoughts – no longer able to articulate conversation, unable to express ideas or emotions as they could in the past

• Getting lost or misplacing belongings – decreased ability to find one’s way around, the home may become a foreign place they have never been, unable to locate items of necessity

In the fourth stage of this degenerative disease (moderate dementia due to AD) people become more and more confused with everyday life, and completing activities of daily living (ADLs). ADLs include getting dressed, bathing, eating, brushing teeth, etc. They may:

• Show increasingly poor judgment , deepening confusion – patients may lose track of the day, week or season, wandering action begins, inability to be left the their own devices

• Confuse family members with one another or strangers

• Severe memory loss -  forgetting significant lifecycle milestones like the birth of a child, or marriage, the inability to recall their phone number or address, repeating favorite stories to fill in the gaps

• Assistance with ADLs – choosing clothing, bathing, grooming, and other self-care, incontinence

• Radical personality and behavioral changes – distrust, hallucinations, frequent agitation, and un-provoked aggression including hitting, pinching, screaming, and hyper-sensitivity to light, sound and touch (mayoclinic.com).

The fifth and final stage of Alzheimer’s disease is severe dementia due to AD. It is in this stage that most patients lose the ability to communicate coherently, they require daily assistance with ADLs, and experience a severe decline in physical abilities (mayoclinic.com). “A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions (mayoclinic.com).”
The progression of AD can be slow and steady (lasting up to 25 years) or acute. The typical life expectancy after diagnosis is 7 – 10 years. People with AD do not die because of the disease but because of the side-affects. If a person is no longer mobile and spends most of the day in bed, pneumonia may be the cause of death because of impaired swallowing of food or fluids, or aspiration. On the other hand, if the person with AD is still mobile and falls resulting in broken bones or development of urinary tract infections are common causes of death.

The cause and progression of Alzheimer’s disease is not well understood. Research indicates that the disease is caused by a buildup of plaques on tangles in the brain. Studies have also shown that there are several factors that may contribute to the development of Alzheimer’s. Recent "studies have resulted in the discovery of an association between a decline in learning and memory, and a deficit in excitatory amino acid (EAA) neurotransmission, together with important roles for the cholinergic system in attentional processing and as a modulator of EAA neurotransmission" (jnnp.bmj.com). The herpes simplex virus type 1, and age-related myelin breakdown in the brain caused by the release of iron are possible causes as well (Wikipedia.org).

There is no cure or scientifically proven prevention for Alzheimer’s disease. Any studies of practices to prevent or delay the onset of AD have proven inconclusive. There are some studies, however, that suggest a correlation between the risk of AD and a person’s diet, cardiovascular risk (hypertension, diabetes, and smoking), pharmaceutical intervention, and the prevalence of intellectual social activities. Long-term use of non-steroidal anti-inflammatory drug (NSAIDs) is related with a reduced chance of developing AD. The elements of a Mediterranean diet (fruits, vegetables, wheat, olive oil, and fish) may reduce the risk of AD.

This chilling degenerative disease shows no signs of slowing down. It is one of the most feared diagnoses, next to cancer. To forget yourself, all of your life experiences, and deteriorate into infancy is the worst way to die. By understanding the stages of AD, possible causes, and prevention we can recognize the symptoms early and help those with AD live their best life.