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Ask a healthy senior what they fear most about getting older, and you'll likely here “Alzheimer's” or “dementia.” First, you lose your mind. Then you lose your body. Alzheimer's is a terminal disease with no cure.
In This Article:
Alzheimer's and the Dementia Family ↓
Alzheimer's Stages ↓
Causes of Alzheimer's ↓
Symptoms of Alzheimer's Disease ↓
Caring for Alzheimer's Seniors ↓
Alzheimer's Disease Prevention ↓
Treatment for Alzheimer's ↓
Women and Alzheimer's ↓
The word dementia is not a disease itself but rather a “descriptive term for a collection of symptoms that can be caused by a number of disorders affecting the brain,” says the Stanford School of Medicine.
Alzheimer's disease is the most common form of dementia. Other diseases in the dementia family include Parkinson's, vascular dementia, mixed dementia, dementia with Lewy bodies, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus.
The main results of dementia-related diseases are damaged brain cells or damaged connections between brain cells, which lead to memory loss and one or more the following conditions, according to the Alzheimer's Association:
People with Alzheimer's eventually exhibit all of these conditions.
In 1901, a 51-year-old woman, Auguste D., became a patient of German physician Alois Alzheimer (1864-1915). At the Hospital for the Mentally Ill and Epileptics in Frankfurt, Alzheimer studied dementia and nervous disorders.
Doctors had known about dementia for centuries but attributed it simply to old age.
But Auguste D's case was different because she was relatively young. Her symptoms included “reduced comprehension and memory, aphasia, disorientation, unpredictable behavior, paranoia, auditory hallucinations and pronounced psychosocial impairment,” says an article in the medical journal, The Lancet.
The following is taken from Alzheimer's case history file for Auguste D:
“During physical examination she cooperates and is not anxious. She suddenly says Just now a child called, is he there? She hears him calling…she knows Mrs. Twin. When she was brought from the isolation room to the bed she became agitated, screamed, was non-cooperative; showed great fear and repeated I will not be cut. I do not cut myself.”
After Auguste D died in 1906, Alzheimer examined her brain and case history. Her brain appeared shrunken and contained weird clumps of protein called plaques and tangled fibers inside the nerve cells—two main features of Alzheimer's.
He reported his findings of a new form of dementia to a German psychiatrist's conference, later publishing his lecture titled: “A characteristic serious disease of the cerebral cortex.”
Unfortunately, the medical community did not recognize Alzheimer's as a disease until the 1970s. Fortunately, since then focus on the disease, its causes, effects and the brain's overall functioning has exploded.
We don't know how Alzheimer's begins, but it likely initiates in the brain about a decade before the signs become noticeable. During this pre-stage, toxic changes are occurring throughout the brain.
A normal adult brain has 100 billion neurons. Each neuron has long branching extensions that form specialized connections to other neurons. These connection points are called synapses (the brain has 100 trillion of them).
Synapses allow information to flow via chemical pulses from one neuron to another. Think of it as one big highway of communication for memories, thoughts, emotions, sensations and movements.
Deposits of protein beta-amyloid accumulate outside nerve cells (neurons) forming hard plaque. At the same time, abnormal versions of the protein tau accumulate inside the neurons causing a neuron's transport microtubule to collapse.
Over time, these neurons begin to function less efficiently, eventually losing the ability to communicate with one another. As neurons die, brain tissue begins to shrink. And as the disease spreads to the outer layer of the brain (cerebral cortex), one's judgment worsens.
This is the beginning of the end for those with Alzheimer's.
Let's take a quick look at the three stages and their behaviors of Alzheimer's as described by the American Health Assistance Foundation.
Stage 1 (Mild): This stage occurs in the first 2 to 4 years. It's characterized by energy loss, mood swings, anger and frustration. Some common behaviors include getting lost, difficulty managing household affairs (bills and money management), poor judgment, losing things, repetitive questions, changes in mood and personality.
Stage 2 (Moderate): This the longest stage can last from 2 to 10 years and is where the individual clearly becomes disabled. An individual can perform simple tasks, but need help with activities that are more complex. Common behaviors include depression, loss of control, irritability, restlessness, apathy and withdrawal. More severe behaviors include paranoia and physical violence.
Stage 3 (Severe): Lasting from 1 to 3 years, in this final stage, the individual may lose the ability to speak, to recognize people, lose bodily functions and the ability to feed themselves. Memory is almost non-existent. Constant care is usually required.
Confusion is a common behavior starting in Stage 1. The person may call you by a different name, forget their address, a phone number or forget what their toothbrush is for. It's easy to get frustrated with this behavior, especially if it happens day after day.
Sundowning is late-day confusion caused by a number of factors: mental and physical exhaustion; disturbed internal body clock; reduced lighting and increased shadows; less need for sleep.
Aggression—in addition to the effects by the disease—can be caused by several other factors: poor communication, physical discomfort and their environment.
Agitation often occurs when the person is in an unpleasant environment, a new environment and their frustration trying to remember things.
Suspicion is caused by the brain perceiving things in new, sometimes unusual ways, leading them to make accusations of friends, spouses and caregivers.
Hallucinations can be terrifying for the individual or they can simply be non-threatening images from their past. Causes of hallucinations in addition to Alzheimer's include: schizophrenia, dehydration, intense pain, alcohol/drug abuse, medications and eyesight/hearing problems.
If you are an Alzheimer's caregiver, consider getting help from outside sources that provide respite care and home health care. Our database has one of the most complete listings on the web. You can also call our Alzheimer's helpline to speak to someone now.
Alzheimer's is an “irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks,” according to the National Institute on Aging.
Alzheimer's infects the senior living community like a plague. It's estimated that over 5 million Americans have Alzheimer's. And it's the sixth leading cause of death in the U.S.
Sadly, there is no cure. In fact, Alzheimer's disease is still not completely understood. While the effects on the brain are clear, the exact causes are not completely known. Scientists believe that a combination of genetic, lifestyle and environmental factors affect the brain over time.
Before we look at the causes of Alzheimer's, let's look at the disease itself.
We still don't know what starts the disease process. But we do know that damage to the brain can start 10 to 20 years before any symptoms begin.
The brain has 100 billion nerve cells that are interconnected, forming complex communication networks. Groups of cells perform special jobs like thinking and remembering. Alzheimer's kills some of these cells causing a chain reaction of brain destruction.
It's believed that two abnormal structures—plaques and tangles—are responsible for killing the brain's nerve cells.
Plaques are deposits of protein that build up in spaces between nerve cells. Tangles are fibers of a different protein that build up inside cells. Most people develop plaques and tangles as they age. But those with Alzheimer's develop greater numbers.
Scientists believe that these plaques and tangles block communication among nerve cells until the cells eventually die. This death of cells causes memory failure and personality changes.
While not a cause of Alzheimer's, age is the greatest risk factor. Most people with Alzheimer's are 65 or older. Your risk doubles every five years after 65. After age 85, your risk is 50%. It's still unknown why the risk rises so quickly with age.
Two types of genes are factors in Alzheimer's—risk genes and deterministic genes.
Risk genes increase the chances of developing the disease. But they don't guarantee you'll develop it. The APOE-e4 gene is the strongest influence and is seen in 20% to 25% of Alzheimer's cases. Those who inherit this gene from a parent have a greater risk. Inherit this gene from both parents and your risk goes up more.
Alzheimer's disease with these genes is called autosomal dominant Alzheimer's disease (ADAD) or “familial Alzheimer's disease.” People with any of these genes develop symptoms before age 60, some even in their 30s or 40s.
While not conclusive, evidence suggests your lifestyle may increase your risk for Alzheimer's. The reason: your brain health is linked to your heart health.
Each heartbeat pumps about 25% of your blood to your head. Your brain cells in turn use 20% of the food and oxygen carried by your blood.
Your risk for developing Alzheimer's is increased by conditions that damage the heart or blood vessels. Conditions such as:
These conditions are brought on by improper diet, smoking, lack of exercise, and excessive alcohol consumption.
An early adult head injury is correlated with the development of Alzheimer's disease. A head injury is one that results in the loss of consciousness for 30 minutes or more. Skull fractures and traumatic brain injuries (TBI) that result in long periods of amnesia put one at even greater risk.
Other factors thought to increase the risk are lower education levels, non-stimulating, repetitive jobs, infrequent social interactions and not regularly engaging in mental challenges like reading and playing games.
Another study has described a new condition called Mild Behavior Impairment or MBI and its symptoms. People assume that the first symptom of Alzheimer's is memory loss. However, other researchers suggest otherwise. Dr. Zahinoor Ismail, Hotchkiss Brain Institute neuropsychiatry specialist at the University of Calgary is one of them. In Alzheimer's they found 5 categories of symptoms that come before Alzheimer's memory loss. These include perception, social appropriateness, impulse control, mood and apathy. Symptoms specifically include substance abuse, hoarding, stubbornness, frustration, argumentativeness, aggression, panic episodes, disorientation and sadness. There are studies that show that if you are an older or even middle-aged adult and have a new onset of any of these symptoms of neuropsychiatry, you have more of a likelihood of declining and going into dementia or mild cognitive impairment.
If you ever saw Julianne Moore in the movie “Still Alice” you would agree that she gave a compelling Oscar worthy performance full of empathy and nuance while portraying a 50 something older adult with early Alzheimer's disease. She plays a famous linguistic professor who begins to detect trouble when she starts being at a loss for words and to get lost in her daily runs.
But the average Alzheimer's patient is more often than not well into their 60s and 70s, and the disease starts making its presence felt a lot slower than what was depicted in the movie. About an estimated eighty-one percent of people who have Alzheimer's disease are 75 or older. And the disease is estimated to go from about 5 million affected Americans in 2016 to nearly triple that in 2050.
In the US, an estimated 5.4 million Americans of all ages are estimated to have Alzheimer's disease in 2016. Out of the 5.4 million persons with Alzheimer's around 200,000 are younger than 65 years. They have what is called younger-onset Alzheimer's diseases.
Are there any early warning symptoms once can keep a look out for? Most of us know that Alzheimer's disease affects the brain and cognitive ability and memory. But there can be other surprising symptoms of Alzheimer's that can be early indicators of a higher probability of getting the disease later on or much sooner than expected.
If you are caring for an Alzheimer's senior, you are one of nearly 15 million. As a family member, spouse, or friend, you as a caregiver are an unpaid individual assisting another with activities that they can't perform on their own.
These activities range from helping your loved one dress to getting them to their medical appointments. The depth of care depends on how far their Alzheimer's has progressed.
Caring for an Alzheimer's senior is mentally stressful, physically demanding, and time-consuming no matter where you are in life. While it will never be easy, we'll show you some ways to make daily care giving a little smoother.
But first, look at these caregiver numbers.
According to the Alzheimer's Association, if you are one of the 15 million providing care to a loved one with Alzheimer's:
Communicating with your loved one will get progressively harder over time because the disease damages the part of the brain responsible for speech and for understanding written and spoken language.
Activities, says the Alzheimer's Association, should focus on the person, place, activity and approach.
Alzheimer's can affect greatly affect eating. They may forget to eat, lose the ability to use utensils, and become overwhelmed with food choices.
Bathing is difficult because it is intimate. And because the person may find it confusing or frightening.
You will face many challenges caring for an Alzheimer's senior. It may be one of the most difficult things you ever do because you're watching your loved one decline mentally and physically. And because you are taking on another job which adds stress to your life.
Simplify as much as possible by following these tips for daily living.
If you're a home care provider for someone with Alzheimer's, safety should be on the top of your list—safety for the individual and for those around him or her.
Is Your Alzheimer's Senior Safe?
The National Institute on Aging recommends asking these questions if you're concerned about leaving someone with Alzheimer's alone:
Evaluating the Environment
Pay Attention Daily
Once you've made the necessary changes to the environment, you'll still need to be vigilant every day. Even something as simple as a shower can be hazardous.
Lost and Found: Using Location Management Systems
For an added layer of safety and peace of mind, consider a system that tracks your loved one's whereabouts. There are a number of systems out there for a variety of needs and applications.
Individuals wear a small ankle or wrist transmitter that enables a local Project Lifesaver agency team to quickly track and find them. According to their website, recovery times “average 30 minutes—95% less time than standard operations.”
Costs to enroll your loved one vary by agency.
The safety of someone with Alzheimer's can never be 100% guaranteed. But as a caregiver, you can mitigate many potentially harmful situations with first a thorough survey of your home. Then with additional safety measures such as a location management system. Finally, day-to-day vigilance goes a long way to keeping your loved one and others safe.
Alzheimer's has been known as the silent serial killer of the brain's memory. The effects of Alzheimer's disease can be delayed by interacting with others and doing complex thinking. People who have a lifestyle that is mentally stimulating tend to be more protected from the decline of cognition that is related to the typical diet of the Western World. According to one study conducted in Baycrest Health Sciences in Toronto by Matthew Parrott.
In order to delay the potential killer of the brain's memory it is proven that one must be actively engaging the brain with stimulating tasks, and maintain a healthy lifestyle by eating healthy foods and exercising regularly. Switching jobs to a more stimulating one may be the right choice for someone seeking a challenge and may be the right brain food your brain has craving.
If eating better can help prevent Alzheimer's disease, would you be tempted to give up red meat, fatty foods and carbonated drinks?
According to the MIND diet, eating nutritious healthy food, that is more of green leafy vegetables, nuts, berries, beans and consuming very little or no red meat, butter, cheese, pastries and fried food can actually help you reduce the risk of Alzheimer's disease.
Eat Better to Prevent Alzheimer's
One research study states that people who followed the MIND diet decreased their risk of Alzheimer's disease by 54%. Interestingly enough, researchers found that even adults who only partially followed this diet plan were able to reduce their risk of Alzheimer's by nearly 35%.
The MIND diet (Mediterranean DASH Intervention for Neurodegenerative Delay)is the brainchild of scientists and researchers at the Rush University Medical Centre in Chicago, IL.
This plan draws upon aspects of both the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet. The Mediterranean diet is traditionally low in saturated fat but high in monounsaturated fat and those who follow this diet consume a lot of fiber in their food.
Experts predict that the number of Americans who will have Alzheimer's disease will reach 13.8 million by 2050 from the current 4.7 million. There are quite a lot of treatments and research being carried out on Alzheimer's, but results seem elusive to moderate at best. In most cases medical treatments have ranged from ineffective to very modest. But more and more experts agree that certain foods in particular seem to have a beneficial role to play in as far as prevention of the disease goes.
All kinds of so-called bad fats like trans fat and saturated fats found in most animal food products seem to cause production of plaques in our brains. In particular, trans fats seem to escalate the production of a protein called beta-amyloid that collects in plaques seen in most Alzheimer's patients.
Nutrition & Alzheimer's
Ongoing research is vital to carry out further studies and clinical trials in order to gather more vigorous data to confirm these promising trends in how a sound nutrition can help reduce our risk of getting Alzheimer's disease.
While both the MIND diet and the modified Canadian version of the MIND diet show promising results, they do differ in their recommendations, usually in dosage and portions of the different food groups.
For instance, the MIND diet allows two servings of vegetables daily whereas the Canadian version suggests five. The MIND diet suggests that eating fish once a week is enough while the Canadian version proposes that three times a week is better.
The MIND diet places more importance on eating whole grains daily but the Canadian version doesn't have a particular suggestion regarding this. The Canadian diet calls for a more generous serving of fruits daily whereas the MIND diet is all about favoring berries as it deems berries alone can lower the risk of getting Alzheimer's.
Power Nutrients – Vitamin E, B12 & Omega-3
According to Carol Greenwood, a professor at University of Toronto and an advocate of the Canadian diet, just eating the right foods by itself is not enough to promote the growth of neurons (neurogenesis) or help in growth of neural connections (synaptogenesis). Alzheimer's patients typically suffer from insufficient connectivity and poor neuron growth. But Greenwood explains that pathways that connect the neurons are definitely adversely affected due to poor nutrition and a person's nutritional levels.
To elaborate, poor eating habits and eating non-nutritional food can lead to chronic diseases like hypertension, coronary related diseases and diabetes which hinder an individual's cognitive capacities, which in turn can help set the circumstance to usher in Alzheimer's disease. The opposite is also true. A nutritious eating habit can help reduce the risk of chronic diseases which in turn means reduced risk from brain related diseases like Alzheimer's as cognitive capacities are not adversely affected.
Martha Clare Morris, one of the brains behind the MIND diet and a nutritional epidemiologist at Rush University explains that while research about nutrition, aging and preventability of brain related diseases is still at an early stage, certain nutrients have already shown that they are constructive and favorable to cognitive function.
Vitamin E is one such super vitamin, that is usually present in high quantities in whole grains, cereals, leafy vegetables, seeds, oils, nuts and is a powerful antioxidant. Vitamin E has been known to lower the risk of cognitive degeneration and promote a reduced production of beta-amyloid proteins, which is a known symptom of Alzheimer's disease.
The brain being the powerhouse that it needs to be, produces an incredible amount of energy which in turn means a lot of free radicals are rushing around and when uncontrolled can be detrimental to the brain. Vitamin E in a way catches these free radicals from becoming a threat to cognitive function.
Vitamin B12 is another great example of a vitamin whose healthy presence in organisms generally indicates reduced risk from Alzheimer's disease. Vitamin B is found in beans, nuts, green leafy vegetables, grains but also in animal fats like cheese and in meat, eggs and fish.
When we age stomach acids absorb less of the vitamin B12 that is present in the above mentioned food. It is a good idea to check one's B12 levels and eat accordingly and or take supplements as deficiency in B12 has been connected to reduced cognitive function leading to heightened risk from dementia and other brain related diseases.
Omega 3 fatty acids play an important role in transmission of neural activity and messages. Brains typically have a higher concentration of Omega-3s than other organs and cells so maintaining a sufficient level of this becomes all the more essential to help ward off dementia and Alzheimer's diseases.
Most vegetables, beans, berries, whole grains and nuts have proven to be the most beneficial for the brain. Eating moderate amounts of poultry, fish and olive oil and about one glass of wine a day has also proved to be healthy for the brain. It is best to avoid or severely restrict the consumption of cheese, fried food, fatty food, sweets, red meat and butter.
Eating healthy need not be complicated. Maintaining a nutritious well-balanced diet that focuses on vegetables and whole grains and fruits and keeping away from manufactured food and processed animal food in particular can go a long way in preventing all diseases in general and not just Alzheimer's disease.
A combination of medication and support is usually the best approach. Let's look at some non-drug options first as recommended by the Alzheimer's Association and the Mayo Clinic.
Drugs for Depression in Alzheimer's Seniors
Doctors can prescribe antidepressants for Alzheimer's seniors who have depression. Keep in mind these drugs can have side effects. The first drug prescribed may not be the best option. Sometimes it takes “experimenting” (under doctor's supervision) until the right drug is found.
Electroconvulsive Therapy (ECT)
What sounds like a scene out of a Ken Kesey novel is actually quite safe and making a comeback for treating depression. In past decades, electroconvulsive therapy was painful and led to serious side effects. Today, the procedure is relatively safe and painless and the side effects have been dramatically reduced.
The actual ECT procedure takes about 15 minutes with added time for preparation and recovery. It's performed in a hospital or as an outpatient procedure while you are under general anesthesia.
Electrode pads are placed on your head. Electric current passes through these pads to the brain producing a seizure that lasts from 30 to 60 seconds, all while you are unconscious.
Improvement in depressive symptoms is usually noticed after several treatments. It's not known exactly why this procedure works. But it is known that chemical changes occur in the brain, somehow reducing the symptoms of depression.
ECT treatments are typically given three times a week for two to four weeks, according to the Mayo Clinic.
Alzheimer's disease is one form of dementia affecting a significant number of older adults in America. Recent studies show that compared to men, Alzheimer's in women is more frequent. Across the country, 66 percent of Alzheimer patients are female. Scientists are continuously working to find the reason behind this phenomenon.
There are different opinions and studies on why women get this Alzheimer's disease more than men. However, from all points of view, nobody yet has pinpointed a clear answer to this matter. And as the population of baby boomers increases, the need to find what's behind this phenomenon also grows. Some say women live a lot longer than men making them more prone to Alzheimer's. Some say it's the hormones while others think it's in the brain.
This issue was put on a spotlight by several studies presented at the Alzheimer's Association International Conference in Washington, D.C in 2015. In the presentations, the weaknesses of women's brains were revealed
According to a study presented, women suffering from mild cognitive impairment (MCI) are bound to experience decline in memory and thinking ability. MCI affects a person's language, thinking, and memory.
Another research from the Oregon Health & Science University found out that older women who undergo several surgeries have a greater risk of having cognitive dysfunction compared to older men. The study also found that among the two genders with postoperative cognitive dysfunction, indeed women's cognitive function declined faster than men.
According to Duygu Tosun of the University of California, women's brains were found to have more amyloid plaques than men. The presence of Amyloid plaques is one of the evidence Alzheimer's disease. Amyloid plaques are sticky build up which gathers outside nerve cells. This is still the case regardless of whether the respondents have APOE E4 gene, the second risk factor for getting Alzheimer's aside from aging.
Women are more vulnerable than men when it comes to biological features, according to Katherine Lin, the MCI researcher and Ph.D. student at Duke University. She based her research on the data from Alzheimer's Disease Neuroimaging Initiative (ADNI, where they tested the cognitive capabilities of 400 adults with MCI for eight years.
From all the tests conducted and even after including the factors which contribute to the rate of decline in MCI like the education and age, Lin concluded that the cognitive abilities of women with the condition are more likely to worsen faster than men.
According to the Alzheimer's Association, 16 percent of women aged 71 years and above are diagnosed with Alzheimer's while men of the same age afflicted with the disease are only 11 percent. More and more studies are being conducted, and researchers make sure that even though there is still no evidence as to why Alzheimer's in women are more frequent than men, the advocacy for this research is bound to grow.
Based on a published article by Lin and her associates, one factor worth noticing is estrogen levels and genetics. However, results of studies about this are contradicting.
One study showed that hormones may be capable of reducing amyloid accumulation that when estrogen in women declines during menopausal years, their risk of acquiring Alzheimer's increases drastically.
Meanwhile, another research claims that if estrogen is ingested after a woman's menopause, her risk of getting Alzheimer's and MCI is also high.
Based on Lin's analysis of this phenomenon, it is best to take in estrogen before or during the first years of menopause so women can protect their brains because taking estrogen after menopause has an adverse effect on them.
Anesthesia is known as a drug injected into our body to feel no pain during surgical operations. It can cause side effects on a person's body and brain after surgery. It may affect memory and cognition for days or even weeks after the operation.
In a study conducted by Dr. Katie Schenning on postoperative cognitive dysfunction (POCD), she found that when women undergo surgery and receive anesthesia, their brains shrink and her cognitive capabilities also decline faster than men who underwent the same procedure. She found this out in her seven years of follow-ups of patients who underwent surgery.
This kind of effect for most people who undergo surgery is normal and temporary because there are patients who have a high tolerance to the general anesthesia. The case of anesthesia causing Alzheimer's in women depends on the age of the patient. If she is old enough, greater risk of long term memory loss is possible.
The Need for More Research
Until now, we undeniably still don't have a clear reason why Alzheimer's in women are more frequent than in men This remains an evolving issue for researchers continuing to study this phenomenon. There is a need to increase the number of investigators that would focus and expound on results of previous studies that relates genetics, lifestyle, hormones and biological differences as factors that may cause the high risk of Alzheimer's in women.
Maria Carrillo, chief science officer at the Alzheimer's Association, said that there is enough to support this matter by using the conclusion they came upon.
According to Carillo, Alzheimer's Association is accepting applications to fund researchers all over the world with this specific concern. To help answer queries about the difference between men and women, they will fund $5 million worth of research grants in their program called, Women's Alzheimer's Research Initiative.
We all know how devastating Alzheimer's disease is. We can relate because, in one way or another, we all know someone suffering from this. Experts researching more about Alzheimer's in women may mean that the next generation may not suffer from the same predicament.
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