Alzheimer's Disease: Can It Be Prevented?

The progression of Alzheimer's disease can be heartbreaking for sufferers and families. In the early stages, patients may experience minor memory loss and confusion – known as mild cognitive decline. Patients can stop recognizing their loved ones as the disease advances and become easily agitated. With an aging U.S. population, Alzheimer's disease is currently ranked as the seventh leading cause of death. Can Alzheimer's disease be prevented? There is currently no cure for Alzheimer's. Treatment focuses on slowing progression and preserving the quality of life for both patient and caregiver. Patients live for an average of eight years from the first onset of symptoms, though Alzheimer's can progress at different rates depending upon the person. With slow progression, people have been known to live two decades with the disease.

The Difference Between Alzheimer's and Dementia

Dementia is an umbrella term for conditions that cause a decline in memory, reasoning and other thinking skills. It's caused by changes in the brain that prevent neurons (nerve cells) and their connections from working correctly. Dementia is not a normal part of aging, and researchers are currently investigating why some people develop the condition while others don't. In some cases, rare genetic variants have been linked to dementia, but that's in the minority of cases. Environment, lifestyle and overall health may also play a role. Alzheimer's disease is the most common cause of dementia and is responsible for 60 to 80% of all cases. It's associated with the abnormal buildup of proteins known as amyloid plaques and tau tangles in the brain, though scientists don't know the precise cause of these clumps forming.

Diagnosis

The early signs of Alzheimer's may not be evident to anyone except those with the disease and those closest to them. Even then, the symptoms may be confused with normal changes that come with age. Health care providers can use several different methods to diagnose the disease. They will conduct an interview with the person, take a full medical history, and may talk to family and friends about changes they have observed. Often, they will conduct a series of tests to assess cognitive skills and memory. Laboratory tests and brain imaging are also part of standard testing.

Stages of Alzheimer's Disease

Alzheimer's disease is a progressive brain disorder that causes gradual memory loss, confusion, changes in personality and loss of independence. While onset can be as early as age 30 or 40, most of the estimated six million Americans living with the disease begin exhibiting symptoms after age 65. Changes in the brain begin years before a person shows any signs of the disease. This period can last for years. Patients will have no noticeable symptoms, but brain imaging may show deposits of a protein known as amyloid beta. These deposits can block signals from moving between cells. The stages of Alzheimer's disease usually follow a progressive pattern generally classified into phases. Every patient moves through these stages at their own rate.

Mild, Early Stage or Mild Cognitive Impairment

Symptoms at this stage include mild forgetfulness that may be attributed to aging and problems with concentration. A patient may still live independently at this stage but may have problems:

• Remembering a name
• Recalling recent events
• Remembering where they put a valuable object
• Making plans
• Staying organized
• Managing money

The person may be aware of memory lapses. Their friends and family may also notice these difficulties.

Moderate, Middle Stage

This middle phase is typically the longest stage, usually lasting many years, and is often the point where a formal diagnosis is made. Symptoms include:

• Increasing trouble remembering events
• Problems learning new things
• Trouble with planning uncomplicated events, like a dinner
• Trouble remembering their own name, but not details about their own life, such as address and phone number
• Problems with reading, writing and working with numbers
• Lapses in judgment

As the disease progresses, the patient may:

• Know that some people are familiar, but do not remember their names or forget the names of a spouse or child
• Lose track of time and place
• Need help choosing the proper clothing, getting dressed, and doing daily activities, such as brushing teeth
• Become moody or withdrawn, or have personality changes, such as hallucinations, paranoia, or delusions
• Be restless, agitated, anxious, or tearful, especially in the late afternoon or at night (a condition known as "sundowning")
• Develop sleep problems
• Wander from home
• Experience physical changes

Severe, Late Stage or Severe Dementia

At this stage, a patient:

• Loses many physical abilities, including walking, sitting and swallowing
• May lose bowel and bladder control
• May be able to say some words or phrases but not have a conversation
• Needs help with all activities all the time
• Is unaware of recent experiences and of their surroundings
• Is more likely to get infections, especially pneumonia

Treatment

Treatment varies based on age, overall health, health history, symptoms and preferences. There is no cure for Alzheimer's, but some medications can slow the progress of the disease. They may work for a few months to a few years. A health care provider may also treat individual symptoms like depression, anxiety and sleep disorders. Caregivers and family members may benefit from therapy and support groups and other resources.

Can Alzheimer's Be Prevented?

Just as there is no cure, there are no clear tactics for preventing Alzheimer's disease. Most experts recommend a healthy, active lifestyle as the best way to protect your brain's health, including:

• Getting regular physical exercise
• Maintaining a healthy diet
• Engaging in social interactions with others
• Getting enough sleep
• Quitting smoking
• Limiting alcohol consumption
• Getting regular checkups

What About Brain Training?

If you spend any time on social media or use apps on your smartphone, you've likely seen advertisements for games claiming to stave off dementia. There has been much speculation about how such diversions and other brain-challenging activities like completing sudoku, crossword, and jigsaw puzzles, learning a new language, and taking adult education classes may keep your brain sharp. To date, though, no studies have definitively stated that such activities will keep you from developing dementia. Still trying out some of these tactics may have its benefits. When you regularly challenge your brain, there are indications that you may grow extra brain cells and the connections between them. Building up this reserve may delay symptoms of dementia and keep the brain sharper for longer.

Finding Help

Talk to your doctor if you have concerns about your memory or ability to think clearly. If you and your family have many questions about living with Alzheimer's disease, the Alzheimer's Association provides a wide range of resources. Other good resources include the National Institute on Aging. Watch their video.