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Facts about Alzheimer’s Disease

Prepared by the Alzheimer's Association

How is it pronounced correctly?

(AHLZ-hi-merz)

What is it?

Alzheimer’s disease is a disorder that destroys brain cells. It is the leading cause of dementia. As it progresses, people afflicted with the disease experience bodily failures and inability to care for themselves.

What is dementia?

Dementia is a condition that involves gradual memory loss, decline in the ability to perform routine tasks, disorientation, difficulty in learning, loss of language skills, impairment of judgment, and personality changes.

What is the rate of progression of Alzheimer’s?

It varies from person to person. The time from the onset of symptoms until death ranges from three to twenty years. The average duration is about eight years.

Who discovered the disease?

German physician Dr. Alois Alzheimer first described the disease in 1906 by observing the autopsy of a woman with dementia. The autopsy revealed two kinds of abnormal structures in the brain: amyloid plaques and neurofibrillary tangles.

Who is at the biggest risk for developing Alzheimer’s?

The greatest risk is aging. Other risks include a family history of the disease, both generational and cross-generational (i.e., sibling with the disease).

Ten percent of people 65 and older have the disease, and nearly 50% of people 85 and older have the disease.

How is Alzheimer’s disease diagnosed?

There is no single test to detect the disease. Currently, the ability to detect the abnormal structures in the brain of a living person does not exist. However, a diagnosis is made based on a thorough evaluation of symptoms and an assessment of an individual’s health.

Various tests including, but not limited to, physical examination, medical history review, and laboratory tests such as blood or urine samples or brain imaging scans are ways to assess the disease. Also, a physician asks for family input on observed behavioral changes.

What are the symptoms of the disease?

Alzheimer’s is divided into four stages, each characterized by characteristics and behaviors unique to each category.

A. Stage 1- Forgetfulness Stage

  • Recent memory loss begins to affect job performance
  • Vague complaints
  • Less tolerant
  • Angry
  • Less energy
  • No initiative
  • Slow to react and learn
  • Forgets what he/she just was told
  • Loss of spontaneity, spark, or zest for life
  • Mood/personality changes, keeps to his/herself
  • Poor judgment
  • Takes longer with routine chores
  • Trouble handling money

Examples: forgets which bills are paid, phone numbers, and grocery lists; difficulty driving, following recipes, and maintaining checkbooks; loses things; or arrives at wrong time/place or constantly rechecks calendar

B. Stage 2- Confused Stage

  • Needs assistance to manage
  • Can’t calculate, understand, plan, concentrate, or decide
  • Slow to react or overreacts
  • Can’t cope with failure
  • Self-absorbed
  • Increasing memory loss and confusion
  • Shorter attention span

Examples: not performing activities of daily living (bathing, cooking), giving money to strangers

C. Stage 3- Disorientated Stage

  • Obviously disabled
  • Lethargic
  • Disorientated to time and place
  • Uncertain how to react
  • Poor recent memory
  • Inappropriate behavior problems
  • Problems recognizing close friends/family
  • Repetitive statements and/or movements
  • Restless, especially late afternoon and night
  • Occasional muscle twitches or jerking
  • Perceptual motor problems
  • Problems organizing thoughts and/or thinking logically
  • Problems with reading, writing, and numbers
  • Suspicious, irritable, fidgety, teary, or silly
  • May see or hear things that aren’t there
  • Delusions
  • Needs full-time supervision

Examples: can’t remember visits immediately after they leave, tapping, sleeps often and awakes frequently at night to “go to work”, troubles getting into a chair, can’t find the right words, forget to dress/undress in proper place, high appetite for junk food, forgets when last meal occurred

D. Stage 4- Dependent Stage

  • Can’t recognize self or family
  • Needs assistance with simple task
  • Appears apathetic
  • Perception is distorted
  • Physical disabilities
  • Seizures
  • Skin breakdown
  • Greater immobility
  • Loss of coordination
  • Inability to feed oneself or swallow
  • Infections
  • Loss of bowel/bladder control
  • Loses weight even with adequate diet
  • Can’t communicate with words
  • Little capacity for self care
  • Maybe put everything in mouth or touch everything

Examples: looks in mirror and talks to own image, needs help bathing, dressing, eating, or using the bathroom; may groan, scream, or make grunting sounds

How does one react appropriately to an Alzheimer’s disease victim at each stage?

Stage 1

  • Try to understand the person’s anger and confusion
  • Offer support in times of frustration
  • Begin to simplify and organize daily routines
  • Structure the home environment for safety

Stage 2

  • Be prepared to offer supervision
  • Provide help, but treat as an adult
  • Give one-step directions
  • Limit choices
  • Set routines
  • Remind and repeat gently
  • Encourage strengths
  • Accept withdrawal

Stage 3

  • Devise and use memory aids
  • Offer reassurance
  • Approach slowly
  • Explain before doing a task
  • Decipher meanings
  • Relate to feelings, not words
  • Use touch to communicate

Stage 4

  • Assist with daily needs
  • Remember that behavior is not intentional
  • Understand that the disease is affecting the patient
  • Ask for support in practical and emotional matters
  • Look to the community for resources/respite care
  • Nursing home may need to be considered

Can Alzheimer’s be confused with other conditions?

The disease can be mistaken for depression, adverse drug reactions, and nutritional deficiencies. These are treatable conditions that may cause memory problems or other dementia symptoms.

What treatments are available?

  1. tacrine (Cognex)
  2. donepezil (Aricept)
  3. rivastigmine (Exelon)
  4. galantamine (Reminyl)

These U.S. Food and Drug Administration approved drugs are the most commonly used drugs to treat Alzheimer’s disease. About half of these people taking these medications show modest and temporary improvement in memory and thinking skills.

Vitamin E is also frequently prescribed because it may inhibit molecular activity contributing to brain cell damage.

What is respite care?

Short-term relief given to individuals who care for loved ones. By providing companionship to a client, caregivers can take a break and have time for themselves. Caregivers Community Network provides exactly that.

Is there an alternative to medication?

The Alzheimer’s Association offers a broad range of programs and services for people with the disease, as well as their families and caregivers. A 24-hour information and referral line links families who need assistance with nearby chapters.

For information, please call (800)-272-3900, or visit the Alzheimer’s Association website at http://www.alz.org, or send an email to info@alz.org