Alzheimer’s disease is a progressive disorder that causes the brain to shrink and causes brain cells to die. It is a neurodegenerative disorder and causes gradual memory loss, thinking impairment, and behavioral changes. In this post we discuss Alzheimer’s Disease including what it is, what are the symptoms of Alzheimer’s Disease, what causes Alzheimer’s Disease, risk factors of Alzheimer’s Disease, is Alzheimer’s Disease genetic, how Alzheimer’s Disease is diagnosed, and where to find help and resources.
The early signs of Alzheimer’s may include forgetting recent conversations or events, but as the disease progresses there is severe memory impairment and lack of ability to do everyday tasks.
This slowly developing disease commonly affects older adults, and most of them get a diagnosis in their 60s.
- Alzheimer’s disease is the most common type of Dementia.
- It is a progressive brain disease beginning with mild memory loss and potentially leading to losing the ability to carry on a conversation or respond to the environment.
- Alzheimer’s disease involves the parts of the brain that control memory, thought, and language.
- In 2020, up to 5.8 million Americans were living with Alzheimer’s disease; this number is expected to nearly triple to 14 million people by 2060
The symptoms of Alzheimer’s worsen with time, but the rate of progress is quite variable.
At first, the symptoms are mild, and the person can function independently.
But as the disease progresses, the patients become severely challenged.
They may become agitated and frustrated quickly.
The disease progression causes them to become dependent on caregivers over time and need physical, emotional, and psychosocial support.
What Causes Alzheimer’s Disease?
The cause of Alzheimer’s Disease is unknown to scientists.
Likely there can be many factors causing it, a combination of changes in the brain related to aging, environmental, genetic and lifestyle factors.
On investigation, an Alzheimer’s brain may show many changes.
The most prominent change includes the buildup of abnormal proteins called amyloid plaques and neurofibrillary tangles that damage the brain’s inter-neuronal networks.
As the brain cells deteriorate, there is also a gradual decrease in neurochemical transmitters (such as acetylcholine), further damaging the established pathways.
These and many other changes may causes Alzheimer’s Disease symptoms.
What are the Symptoms of Alzheimer’s Disease?
The most common symptoms of Alzheimer’s Disease include memory loss and difficulty in learning new information.
With advancing age, our mental ability begins to slow down, and we have trouble remembering important things. However, don’t ignore memory loss if it disrupts daily activities. Family members and close friends may notice these symptoms.
If you detect symptoms of Alzheimer’s Disease, discuss them with your health care provider.
Although symptoms vary depending on the stage of the disease, common symptoms of Alzheimer’s Disease may include:
- Difficulty learning new information
- Memory loss disrupting daily activities, for example, getting lost in previously known places
- Repetition of questions
- Difficulty in managing money matters and paying bills
- Poor judgment
- Changes in mood and behavior patterns
- Misplacing items
- Unable to retrace steps
- Difficulty completing familiar tasks
- Disorientation of time and place
- Poor hygiene care
- Social withdrawal
Risk Factors for Developing Alzheimer’s Disease
Although the causes of Alzheimer’s isn’t fully understood, risk factors probably include a combination of:
- Age: Changes to the brain as we age, like blood vessel damage and inflammation may harm our neurons and affect some brain cells.
- Heredity – your Genetics: Both types of Alzheimer’s disease (early onset and the more common late onset) can be related to genetics.
- Environmental, health and lifestyle factors can play a role, for example stroke, heart disease, diabetes, high blood pressure, exposure to pollutants and obesity.
Is Alzheimer’s Disease Genetic?
Many people who have a family member with Alzheimer’s ask – is Alzheimer’s Disease genetic?
A person’s chance of having the disease may be higher if specific genes pass down from a biological parent. However, if you have a parent with Alzheimer’s Disease, it does not always mean that you will develop it.
Genes are passed down from your biological parents. Genes carry information that defines your traits. For example, eye color and height. In addition, genes play a role in keeping your body’s cells healthy.
If there are problems with your genes, even if there are small changes, it can cause some diseases like Alzheimer’s Disease.
Genetic mutations are permanent changes in one or more specific genes. These genetic mutations may cause some diseases. If someone inherits a genetic mutation that causes a particular disease, then they may get that disease. Some examples of inherited disorders include cystic fibrosis, sickle cell anemia, and some cases of early-onset Alzheimer’s.
Alzheimer’s Disease and Genetic Risk
There are two types of Alzheimer’s Disease. These include early-onset and late-onset Alzheimer’s, and they both have a genetic component.
Early-Onset Alzheimer’s Disease – Is Alzheimer’s Disease Genetic?
Early-onset Alzheimer’s tend to affect people between the ages of 30 years old and mid-60s. This type of Alzheimer’s disease is relatively uncommon and includes less than 10% of the total people affected by Alzheimer’s Disease. Inherited genes cause some of the early-onset cases. The three gene mutations associated with early-onset include:
- Amyloid precursor protein (APP) ( on chromosome 21)
- Presenilin 1 (PSEN1) (on chromosome 14)
- Presenilin 2 (PSEN2) (on chromosome 1)
Mutations in one of these three genes result in the production of abnormal proteins, and these abnormal proteins associated with Alzheimer’s.
If one of your biological parents has a genetic mutation for one of these three genes, you have a 50/50 chance of inheriting that same mutation.
If you do inherit that mutation, you have a strong probability of developing early-onset Alzheimer’s.
For other cases of early-onset, research shows that involvement of other genetic components. Research is ongoing to identify additional genetic risks.
Late-Onset Alzheimer’s Disease – Is Alzheimer’s Disease Genetic?
Most people with Alzheimer’s have the late-onset form and symptoms usually are noticed in their mid-60s and later.
Researchers have not found one specific gene that directly causes late-onset Alzheimer’s.
However, having a genetic variant of the apolipoprotein E (APOE) gene on chromosome 19 increases a person’s risk.
This APOE gene is involved in making a protein that helps carry cholesterol and other types of fat in the bloodstream.
The APOE gene has several different forms or alleles. Each person inherits two alleles, one from each biological parent.
- APOE ε2 is pretty rare and may provide some protection against Alzheimer’s. If Alzheimer’s occurs in a person with this APOE ε2, it usually develops later in life.
- APOE ε3 plays a neutral role in Alzheimer’s Disease(it doesn’t increase or decrease the risk) and is the most common allele.
- APOE ε4 increases the risk for Alzheimer’s and also usually associated with an earlier age of disease onset. Therefore, having one or two APOE ε4 alleles increases the risk of developing Alzheimer’s disease. However, keep in mind that if someone inherits an APOE ε4 allele, that does not mean they will definitely develop Alzheimer’s Disease. Meaning, some people with an APOE ε4 allele never get Alzheimer’s, and some with Alzheimer’s don’t have any APOE ε4 alleles.
Genetic Testing for Alzheimer’s Disease
There is a blood test that identifies which APOE alleles someone has, but it cannot predict whether that person will develop Alzheimer’s Disease.
Physicians use genetic testing to help diagnose early-onset Alzheimer’s. It may also be used to test someone with a strong family history of Alzheimer’s.
Keep in mind that genetic testing can only tell you what risk factor genes someone has; it cannot determine your likelihood of developing the disease.
The Alzheimer’s Association does not recommend genetic testing for Alzheimer’s for the general population. Instead, for those concerned about Alzheimer’s or memory changes, the Association encourages you to have a discussion with you physician.
How is Alzheimer’s Disease Diagnosed?
Alzheimer’s disease cannot be diagnosed with the help of a single test.
Instead, a series of different tests are carried out so one is diagnosed accurately.
Usually, providers use the methods below to get an accurate picture of the disease.
Initially, a physician takes a good medical history.
The doctor reviews the history of the patient along with the cognitive and behavioral changes.
After reviewing signs and symptoms, they rule out other possible causes before someone is diagnosed with Alzheimer’s.
Involving family members in the discussion is a good idea if the patient is unable to communicate effectively with the physician.
Friends or family members can often describe the changes more accurately as they have seen the changes in behavior firsthand.
Assessment of Mental Status
The doctor conducts different tests to confirm suspicions. These tests mainly include assessment of:
- Memory, both long and short term
- Problem-solving abilities
- Attention span
- The orientation of time and surroundings
- Visuospatial Abilities
The mental status results of such tests are subjective and the patient’s level of education possibly influencing results.
Laboratory tests include ruling out disorders that may cause similar symptoms such as thyroid hormone levels, vitamin B12, and niacin levels. Hypothyroidism and the deficiency of some vitamins can also produce Alzheimer-like symptoms. So, it is essential to rule them out before diagnosing Alzheimer’s Disease.
Alzheimer’s results from progressive loss of brain cells, which may show up in different ways on a brain scan.
However, these scans alone are not enough to make an Alzheimer’s diagnosis because there is overlap in normal age-related brain changes and abnormal change.
Imaging techniques may include:
MRI Scan (Magnetic Resonance Imaging):
MRI scans use strong magnetic fields with radio waves to produce a detailed outline of the brain.
CT Scan (Computed Tomography):
Cross-sectional images of the brain are obtained with the help of a CT scan.
PET Scan (Positron Emission Tomography):
Advanced PET scans can now detect amyloid plaques’ deposition in the brain, which is a hallmark of Alzheimer’s Disease.
5 Other Things to Consider with Alzheimer’s Disease
1. Consider Advance Care Planning
Advance care planning is putting your health care preferences in writing so if you become unable to speak for yourself, your family and health providers know what health care you would want.
Most commonly, people write their wishes in a legal document, like an advance directive.
This is especially important for someone who has a progressive memory loss disease like Alzheimer’s because it is likely they may not be able to make their own health decisions as the disease advances.
Discussions about end-of-life care decisions can be stressful and sensitive for the caregiver and care receiver.
For more information about advance care planning and suggestions on preparing for these sensitive discussions, please read our post Sensitive Discussions About End of Life Care
2. Be Aware of Caregiver Stress
Caregivers face the possibility of caregiver burnout and fatigue.
It is helpful to understand how stress may impact you, how to manage stress and to recognize the potential harms of stress on your body.
For more information about stress and it’s impact on your health, please read our post What is Stress?
3. Caregiver Self-Care
Self-care is critical for caregivers to help stay physically and emotionally healthy.
Self-care is essential to ensuring you stay healthy so you can continue providing care to others without burning out from stress.
Research shows the physical and emotional benefits of eating healthy, exercising, getting enough sleep, and staying hydrated.
Regular visits to your doctor, mindfulness and relaxation can also be very beneficial.
For more information about caregiver self care, please read our post Self-Care Tips For Caregivers.
4. Where to Find Help and Resources
Caring for a loved one with Alzheimer’s disease can get complicated and demanding.
There may be resources available in your community that could help you or your loved one.
There may be low or no-cost meal delivery programs, visiting nurses, or respite care programs available in your community.
These programs can be beneficial to your loved one and alleviate some of your stress.
For an in-depth list of community resources, read our post Senior Resources- Guide for Caregivers.
5. The Alzheimer’s Association
The Alzheimer’s Association is an excellent place to find information and resources about Alzheimer’s Disease and all Dementias.
They provide disease specific information and also much information for caregivers, including an online community and virtual support groups. Additionally, the Alzheimer’s Association has a help line telephone number: (800) 272-3900 available 24/7.
Caring for someone with Alzheimer’s Disease can be extremely challenging, especially as the disease advances. Understanding the disease progression and how to manage your loved one is critical through this journey. Having more information about the symptoms of Alzheimer’s Disease, causes, risk factors, how Alzheimer’s is diagnosed and is Alzheimer’s disease genetic will help you better understand the disease. Recognizing caregiver stress and implementing self-care will help your physical and emotional well-being. Looking into the available resources in your community can benefit you and your loved one.