Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually even the ability to carry out the simplest tasks of daily living. In most people with Alzheimer’s, symptoms first appear after age 60. Alzheimer’s disease is the most common cause of dementia among older people.
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Alzheimer's and Dementia
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2. Overview
Alzheimer’s disease is an irreversible, progressive
brain disease that slowly destroys memory and
thinking skills and, eventually even the ability to
carry out the simplest tasks of daily living. In most
people with Alzheimer’s, symptoms first appear
after age 60. Alzheimer’s disease is the most
common cause of dementia among older people.
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3. Symptoms
The cause of Alzheimer's disease is not the same in
every person, but symptoms seem to develop over
the same general stages. In most people with
Alzheimer's, symptoms first appear after age 60.
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4. Symptoms
Scientists now know that Alzheimer’s progresses
on a spectrum with three stages—an early,
preclinical stage with no symptoms; a middle stage
of mild cognitive impairment (MCI); and a final
stage of Alzheimer’s dementia. At this time,
doctors cannot predict with any certainty which
people with MCI will or will not develop
Alzheimer’s.
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5. Symptoms
As AD spreads through the brain, the number of
plaques and tangles grows, shrinkage progresses,
and more and more of the cerebral cortex is
affected. Memory loss continues and changes in
other cognitive abilities begin to emerge. The
clinical diagnosis of AD is usually made during this
stage. Signs of mild AD can include:
-- Memory loss
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6. Symptoms
-- Confusion about the location of familiar places
(getting lost begins to occur)
-- Taking longer than before to accomplish normal
daily tasks
-- Trouble handling money and paying bills
-- Poor judgment leading to bad decisions
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7. Symptoms
-- Loss of spontaneity and sense of initiative
-- Mood and personality changes, increased
anxiety and/or aggression
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8. Symptoms
In mild AD, a person may seem to be healthy but is
actually having more and more trouble making
sense of the world around him or her. The
realization that something is wrong often comes
gradually to the person and his or her family.
Accepting these signs as something other than
normal and deciding to go for diagnostic tests can
be a big hurdle for people and families. Once this
hurdle is overcome, many families are relieved to
know what is causing the problems. They also can
take comfort in the
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10. Symptoms
By this stage, AD damage has spread to the areas
of the cerebral cortex that control language,
reasoning, sensory processing, and conscious
thought. Affected regions continue to shrink,
ventricles enlarge, and signs and symptoms of the
disease become more pronounced and
widespread. Behavioral problems, such as
wandering and agitation, can occur. More intensive
supervision and care become necessary, which can
be difficult for many spouses and families. The
symptoms of this stage can include:
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11. Symptoms
-- Increasing memory loss and confusion
-- Shortened attention span
-- Inappropriate outbursts of anger
-- Problems recognizing friends and family
members
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12. Symptoms
-- Difficulty with language and problems with
reading, writing, and working with numbers
-- Difficulty organizing thoughts and thinking
logically
-- Inability to learn new things or to cope with new
or unexpected situations
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13. Symptoms
-- Restlessness, agitation, anxiety, tearfulness,
wandering—especially in the late afternoon or at
night
-- Repetitive statements or movement, occasional
muscle twitches
-- Hallucinations, delusions, suspicion or paranoia,
irritability
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14. Symptoms
-- Loss of impulse control (shown through
undressing at inappropriate times or places or
vulgar language)
-- An inability to carry out activities that involve
multiple steps in sequence, such as dressing,
making a pot of coffee, or setting the table
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15. Symptoms
Behavior is the result of complex brain processes,
all of which take place in a fraction of a second in
the healthy brain. In AD, many of those processes
are disturbed, and these disrupted
communications between neurons are the basis
for many distressing or inappropriate behaviors.
For example, a person may angrily refuse to take a
bath or get dressed because he does not
understand what his caregiver has asked him to do.
If he does understand, he may not remember how
to do it. The anger can be a
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16. Symptoms
**SEVERE AD**
In the last stage of AD, plaques and tangles are
widespread throughout the brain, most areas of
the brain have shrunk further, and ventricles have
enlarged even more. People with AD cannot
recognize family and loved ones or communicate in
any way. They are completely dependent on others
for care. Other symptoms can include:
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18. Symptoms
**SEVERE AD**
-- Lack of bladder and bowel control
Near the end, the person may be in bed much or
all of the time. The most frequent cause of death
for people with AD is aspiration pneumonia. This
type of pneumonia develops when a person is not
able to swallow properly and takes food or liquids
into the lungs instead of air.
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19. Diagnosis
A definitive diagnosis of Alzheimer’s disease can be
made only through autopsy after death, by linking
clinical measures with an examination of brain
tissue. However, doctors have several methods and
tools to help them determine fairly accurately
whether a person who is having memory problems
has “possible Alzheimer’s disease” (symptoms may
be due to another cause), “probable Alzheimer’s
disease” (no other cause for the symptoms can be
found), or some other problem.
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21. Treatment
Alzheimer's disease is complex, and it is unlikely
that any one intervention will be found to delay,
prevent, or cure it. That’s why current approaches
in treatment and research focus on several
different aspects, including helping people
maintain mental function, managing behavioral
symptoms, and slowing or delaying the symptoms
of the disease.
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22. Treatment
Four medications are approved by the U.S. Food
and Drug Administration to treat Alzheimer's.
Donepezil (Aricept®), rivastigmine (Exelon®), or
galantamine (Razadyne®) are used to treat mild to
moderate Alzheimer's (donepezil can be used for
severe Alzheimer's as well). Memantine
(Namenda®), is used to treat moderate to severe
Alzheimer's.
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23. Treatment
These drugs work by regulating neurotransmitters,
the chemicals that transmit messages between
neurons. They may help maintain thinking,
memory, and speaking skills, and may help with
certain behavioral problems. However, these drugs
don’t change the underlying disease process, are
effective for some but not all people, and may help
only for a limited time.
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24. Causes
Scientists don’t yet fully understand what causes
Alzheimer's disease, but it has become increasingly
clear that it develops because of a complex series
of events that take place in the brain over a long
period of time. It is likely that the causes include
some mix of genetic, environmental, and lifestyle
factors. Because people differ in their genetic
make-up and lifestyle, the importance of any one
of these factors in increasing or decreasing the risk
of developing Alzheimer's differs from p
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25. Causes
**Age**
One of the great mysteries of Alzheimer’s disease
is why it largely strikes older adults. Research on
how the brain changes normally with age is
shedding light on this question. For example,
scientists are learning how age-related changes in
the brain may harm neurons and contribute to
Alzheimer’s damage.
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26. Causes
**Genetics**
The more researchers learn about Alzheimer's
disease, the more they realize that genes play an
important role in its development.
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27. Causes
**Genetics**
Early-onset Alzheimer’s is a rare form of the
disease. It occurs in people age 30 to 60 and
represents less than 5 percent of all people who
have Alzheimer’s disease. Most cases of early-
onset Alzheimer’s are familial Alzheimer’s disease,
caused by changes in one of three known genes
inherited from a parent.
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28. Causes
**Genetics**
Most people with Alzheimer’s disease have “late-
onset” Alzheimer’s, which usually develops after
age 60. Many studies have linked the
apolipoprotein E (APOE) gene to late-onset
Alzheimer’s. This gene has several forms. One of
them, APOE ?4, seems to increase a person’s risk
of getting the disease. However, carrying the APOE
?4 form of the gene does not necessarily mean
that a person will develop Alzheimer’s disease, and
people carrying no APOE ?4 can also develop the
disease.
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29. Causes
**Genetics**
Most experts believe that additional genes may
influence the development of late-onset
Alzheimer’s. Scientists around the world are
searching for these genes, and have identified a
number of common genes in addition to APOE ?4
that may increase a person’s risk for late-onset
Alzheimer’s.
**Environmental/lifestyle factors**
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30. Causes
**Genetics**
Research also suggests that a host of factors
beyond basic genetics may play a role in the
development and course of Alzheimer’s disease.
There is a great deal of interest, for example, in
associations between cognitive decline and
vascular and metabolic conditions such as heart
disease, stroke, high blood pressure, diabetes, and
obesity. Understanding these relationships and
testing them in clinical trials will help us
understand whether reducing risk factors for these
conditions may help wit
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31. Prevention
Since the root cause of Alzheimer's and Dementia
is not yet known there is no scientifically proven
way to prevent Alzheimer's.
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