Alzheimer’s is a neurodegenerative disease and firstly identified by Aloysius Alzheimer at 1906.
Aloysius Alzheimer had observed the pathology and symptoms by using Amyloid markers in the lab studies.
The question “What is Alzheimer’s?” should be answered by starting to explain Dementia. Dementia is a term for cognitive decline caused by neurodegenerative or other types of diseases which also includes Alzheimer’s.
To clarify; not all Dementia patients are Alzheimer’s, but all Alzheimer’ patients have Dementia. About 70% of Dementia patients have Alzheimer’s.
What causes Alzheimer’s?
The facts causing Alzheimer’s are not certainly known but we can point to some insights by using the results of researches and statistics. Alzheimer’s is characterized with blocking the electrochemical flow between neurons because of abnormal increase in 2 types of proteins called Amyloid and Tau. As a result, the patients suffer from progressive and irreversible cognitive decline. We will explain the symptoms caused by cognitive decline within the following sections.
After understanding the effect of Amyloid and Tau, the medical researches are mostly focused on the mechanisms to remove these proteins. But despite of promising researches, a certain molecule to prevent or reverse Alzheimer’s could not be found. However there are drugs aiming to reduce the symptoms.
What are the causes of the increase on Amyloid and Tau level?
Instead of a direct relationship, a gene called Apoe4 increases the risk to have Alzheimer’s. It is not correct that everyone having apoe4 will have Alzheimer’s but according to the statistics, increased risk is clear. If parents have this gene, the heritage probability of their child is 50% – which is a dramatical risk increase.
Age is the biggest risk factor for Alzheimer’s disease. After 65, the risk will increase 2 times for every 5 years. It is very uncommon to see Alzheimer’s before 65 (1 for every 20 patients).
3. Down Syndrome
According to researches, people who have Down Syndrome also have the gene which causes Amyloid plaques. As a result they have an increased risk for Alzheimer’s.
4. Head Injuries
There is a statistically meaningful relationship between serious head injuries and Alzheimer’s, but there is a need for more studies to clarify the subtypes and effects of injuries that may be related with Alzheimer’s.
5. Cardiovascular Problems
Some researches indicate that a cardiovascular damaging lifestyle is also a risk for developing Alzheimer’s. To reduce the risk, you should pay attention to the following precautions:
- Stop smoking
- Keep your ideal weight
- Control diabetes
- Balance your blood pressure
- Balance your cholesterol
6. Hearing Impairment
The relationship between hearing impairment and Alzheimer’s has found in some studies.
7. Long Term Depression
There is a strong consensus on the fact that long term loneliness and depression may trigger Alzheimer’s.
What Are the Symptoms of Alzheimer’s?
Alzheimer’s is a progressive disease that causes cognitive decline. The cognitive symptoms can vary at each disease stage. Every patient can have different symptoms and the severity of the symptoms can also vary, but the most common symptoms can be grouped as following:
- Depression, anxiety, discomfort
- Mild forgetfulness (shopping lists, dates)
- Inability to learn new things instead of remembering the past
- Forgetting words, misusing of words or describing the words such as “that thing” or “the thing used for writing” rather than saying the exact word.
- Having trouble of financial and daily planning
- Inability to find the way
- Inability of doing daily routines without the help of the relatives
- Speech impairment
- Forgetting the names of grandchildren and relatives
- Behavior disorders (Aggression, hiding the things to inappropriate places
- Disregarding personal hygiene
- Lack of interest to their hobbies and social network
At the latest stages, patients are mostly dependent to their caregivers (and mostly to bed). They are usually unresponsive to their environment and unable to speak.
How Alzheimer’s is Diagnosed?
There is no easy way to diagnose Alzheimer’s and in some cases it may take years. In this period, patients and the relatives may come across a lot of psychological and social difficulties. Sometimes the symptoms can be considered as if they are related with other health problems and sometimes the symptoms can not be observed under medical tests.
Especially Major Depression has the most similar cognitive symptoms with Alzheimer’s. But the distinctive feature of Alzheimer’s are:
- progressive cognitive decline
- severe symptoms for a long term
Diagnosis of Alzheimer’s can only be certain after autopsy. Except this, clarifying the diagnosis is only possible by eliminating the possibility of other diseases that can cause the clinical symptoms. The following tests can be asked for this purpose:
- Mental Status Examination (Moca, Mini Mental Test etc..)
- Neuropsychological Tests (To examine the neurodegenerative condition, psychological condition and awareness)
- Lab Tests (Blood tests such as B12 or Thyroid hormones can be asked for excluding other conditions that can cause cognitive problems)
- MRI (To understand if there is any other problem in the brain or not)
- CT and Pet Scan (To eliminate other diseases)
If possibility of having any other disease is not found, Alzheimer’s can be diagnosed by clinical follow-up. Especially in early stages, Mental Status Examination Tests and simple Clock Drawing Test can provide high accuracy for Dementia. Cognity is a mobile app that provides free remote Clock Drawing Test and you can also get Mental Status Examination with a more detailed cognitive report for early stage risk scoring. By simply following up the instructions described in the app, take a photo of your hand-drawing clock and Cognity’s Artificial Intelligence will score your risk by analyzing the photo.
You can also find a more detailed article about diagnosing Alzheimer’s and Dementia by clicking here.
What Are the Benefits of Early Stage Diagnosis?
We emphasized the fact that it is not possible to reverse or stop Alzheimer’s. So exactly what benefits can you expect with early stage diagnosis?
1.Relieving the Symptoms
Although it is not possible to reverse or stop the disease, you can improve your loved one’s life quality by relieving the symptoms. It is very critical to know how to live with Dementia for caregivers.
Currently there are 5 FDA-approved molecules for Alzheimer’s medicine. These are Donepezil, Galantamine, Rivastigmine, Memantine, Donepezil & Mementine combination. Donepezil (Aricept) is recommended for all stages Galantamine (Razadyne) and Rivastigmine (Exelon) are suggested for mild or moderate stages.
The medicines can relieve the symptoms in especially early and moderate stages but there can also be side effects such as confusion, vomiting, lost of appetite, drowsiness, motion problems and headache. So, staying under control of a neurologist is very important to manage the doze and judge the balance between benefits and sideeffects.
2. Better Planning Your Life
In early stages, the patient and caregivers can gain time to plan their life better. There are many active working patients that are diagnosed as Dementia. These people can experience big problems during their working life. Imagine that a doctor, a lawyer or an accountant has Dementia. It is very critical to diagnose the disease earlier for these people.
Alzheimer’s patients can be vulnerable against frauds. They can be an easy target for misleading sales. So, they should always be under supervision by their caregivers.
In the late stage of Alzheimer’s, the patient will need continuos and sometimes professional caregiving. You may need to find a professional caregiver or nursing service and may need a new house. Also there are social networks and Dementia centers for keeping the patients in social life. Planning these requirements need time, so early diagnosis can give you the time you need.
3.Reversible Dementia Types
Every Dementia diagnostic does not mean Alzheimer’s. Although Alzheimer’s is not reversible, there are some reversible types of Dementia. For example after an ischemic attack, Dementia patients has a possibility to reverse the cognitive impairment or partially be cured. So, even if there is a diagnosis of Dementia, it may be important for you to learn the type of Dementia.
4.Psychological Relieve of Patients
In early stages, patients can have awareness about something going wrong. But not knowing the cause of the problems can cause anxiety and depression. After diagnosis, even if you don’t give a detailed explanation, you can explain the patient that she/he has a disease and need to take medication. Having this information can take their confusion and anxiety.
5.Consciousness of Relatives
When a person has Dementia without a diagnosis, the relatives and their network can be angry against them because of unusual behaviours. After diagnosis, all the behaviours will be related with the disease and this will make other people more sensible to the patient.
6.Psychology of Relatives
If you are a caregiver or relative, your psychology will effect the patient’s condition directly. You can feel devastated when you know about the disease, but don’t forget that if your psychology is not stable, you can’t be able to help your loved one.
7.Questioning Other Health Problems
Alzheimer’s and Demantia can cause symptoms in a wide spectrum. For example, Syncope is not a rare symptom for Dementia but there are a lot of diseases that cause Syncope. The patient and relatives can have fear and anxiety for these type of symptoms. If the patient have Dementia diagnosis, the doctors approach to these symptoms will be different. Sometimes you can prevent unnecessary medical tests and screenings.
The relatives can feel very sad after diagnosis. But if they know about the progress, they can plan more quality time with their loved ones. These are invaluable times for patients and relatives, so thanks to an early diagnosis, you can have more time together.
Under What Conditions Should I See the Doctor?
In section 3, we empasized the symptoms of Alzheimer’s. If you have these kind of symptoms, it will be ideal to see a doctor. But in early stages, the symptoms may not be observed under medical tests, so whenever you have progressive cognitive problems, you should visit a neurologist periodically.
Sometimes we can’t find time to visit a doctor or don’t belive to have the disease. Because of this, a warning mechanism can provide you a lot of benefits. An Artificial Intelligence based mobile app Cognity provide remote risk analysis for Alzheimer’s and Dementia. You can calculate your risk easily at home and the app will warn you if you need to visit a doctor urgently. Because the symptoms are not very clear in early stages, you can also take periodical test with the app remotely to stay under control if you can’t find the time to visit a doctor.
It is very important to get periodical tests for the people aged 65 and above and also have Dementia story in their families.