Alzheimer’s points to the neurodegenerative disease that is termed after the German physician, Dr. Alois Alzheimer. Around 1906, the medical practitioner paid attention to a 51-year-old female patient. The woman had manifested an atypical mental illness symptomized in loss of memory, difficulty in language, and erratic behaviour. After her death, the German physician examined her brain and discovered that the presenting symptoms were caused by a combination of abnormal masses (amyloid plaques) and tangled bundles of fibre (neurofibrillary).
With his discovery, the German physician named the two basic features which, together with the lack of connections between the brain cells, are used to describe Alzheimer’s Disease (AD) today.
Prevalence of Alzheimer’s Disease
Alzheimer’s is one of the many forms of Dementia, a common term for a multiplicity of neurodegenerative conditions. The conditions manifest in the deterioration of cognitive abilities related to thought-processing. As a result, thinking and memory functions are negatively affected and the person with the syndrome presents discrepancies in behaviour and in carrying out daily activities. Paradoxically, Alzheimer’s is also indicated as a cause of dementia.
Alzheimer’s disease is listed top among the forms of dementia. The World Health Organisation (WHO) reports that around 50 million people live with some form of dementia. Among these, about two-thirds have Alzheimer’s. As reported by the World Alzheimer’s Report 2018, trends analysis on dementia predicts that a massive 152 million people in the globe will be living with some form of dementia by 2030. By deduction, we would forecast that a large majority of these will suffer the symptoms of dementia.
The World Alzheimer’s Report mentioned earlier also reports that a new case of AD adds to the current global statistics every 3 seconds. As a result, the disease has replaced cancer at the top of the list of killer diseases in some parts of the world. Globally, Alzheimer’s is ranked 7th with other dementia conditions. In America, Alzheimer’s claims more lives than breast and prostate cancers put together. In England and Wales, AD is the number one killer disease!
We would understand why some experts with an interest in Alzheimer’s disease have predicted that the disease will be declared a global epidemic in the future if these numbers keep going up.
The preceding statistics and facts leave anyone with several questions: What are the features of Alzheimer’s disease? Is everyone at risk? Do patients of AD stand a chance for a cure? Is the disease preventable?
Symptoms and Diagnosis of AD
The features of AD can be approached from a dual perspective. The first focuses on brain imaging that reveals the abnormal masses (plaques and tangles) described by the German physician, Alzheimer. The second approach focuses on the cognitive and bio-physiological symptoms of the disease.
The plaques and tangles
The presence of abnormal structures in the brain, commonly referred to as plaques and tangles, reveal the presence of Alzheimer’s disease in a patient. These are associated with the death of brain cells. The plagues are a build-up of beta-amyloid proteins that deposit between the nerve cells. The tangles manifest as twisted fibres and are also a type of protein known as tau which deposits within brain cells. The combination of these two proteins creates a malicious condition by blocking communication between the nerve cells of the brain. This impedes the survival of the cells, crucial for normal cognitive and bio-physical body process.
Brain imaging studies have consistently revealed that most people develop plaques and tangles with age. Prospective Alzheimer’s patients, however, develop the masses in bigger volumes and in a consistent pattern. Additionally, the presence of these masses in the brain of a prospective Alzheimer’s patient is first noticed in the most crucial areas of the brain – those responsible for learning and thought processes – before spreading to other brain lobes.
The brain cells destroyed by the plaques and tangles are responsible for the consequent symptoms of AD. They include memory loss, behaviour change, and difficulty accomplishing normal daily activities. Beyond these general symptoms, AD has a range of other manifesting features.
Manifesting symptoms of AD
It is suggested that Alzheimer’s begins to develop up to a decade before the characterising signs manifest. Following the extensive and consistent destruction of brain cells, an Alzheimer’s patient shows a range of cognitive and behavioural symptoms as listed:
- Struggle to remember recently gained information. This is the most common of the early signs of Alzheimer’s.
- The AD patient exhibits a general slowness in the thought process. They also manifest a blank memory with specific information such as names of places and persons they have always interacted with. These features are identified as acute, beyond the normal deterioration of brain functions with ageing.
- AD patients cannot trace their steps in finding something they have misplaced or may search for something they are holding in their hands.
- Disorientation and incapacity to find and move easily in places the person is familiar with.
- Moodiness and inconsistent behaviour that is not explained by external forces, but is instead associated with Alzheimer’s related depression.
- Unfounded suspicion around family members and familiar persons including their caregivers.
- Inability to visually recognise people and things that are familiar.
- The person is generally withdrawn and has no social life.
- Uncoordinated motor skills such as cumbersome walking and clumsy use of equipment. The person may scribble rather than write legibly.
- Difficulty speaking and ingesting food.
- The person cannot make plans beyond the present and even then, the plan or decision at hand may be easily forgotten and abandoned.
- A poor judgement that may cause them to argue about something that doesn’t seem logical to others.
Risk factors for Alzheimer’s Disease
Risk factors predispose you to the primary brain degeneration process and later to the secondary cognitive and bio-physiological signs. Experts suggest that in most cases, multiple risk factors work together to cause Alzheimer’s. Some of these factors are beyond our control, while others can be prevented. We discuss the 5 major risk factors for the development of AD.
Advancement in age tops the list of causes for AD. This implies that as we age, we ran a greater risk of developing the brain-related condition. It is, however, important to note that age is not an automatic cause and Alzheimer’s is not a normal part of the ageing process.
Persons with 65 years and above make the greatest percentage of those with AD. The risk of manifesting the signs of Alzheimer’s doubles every lustrum after the age of 65.
Science proposes that hereditary factors play either a risk or a determining role in causing AD. In the first case, risk genes augment the probability of developing AD, while in the latter case, deterministic genes cause Alzheimer’s.
The core explanation for genetically acquired risk for AD is in the inheritance of the Apolipoprotein E (APOE) gene. 3 autosomal dominant genes are, instead, associated with a deterministic role in the disease’s development: the Amyloid Precursor Protein (APP), Presenilin1 (PSEN1), and Presenilin2 (PSEN2).
It is encouraging to note that only less than 1% of persons with AD can blame their struggle with the disease on genetics.
While genetics may make part of family history, other risk factors related to the family have nothing to do with genetics. This may include family lifestyle and general living environments that expose family members to similar experiences.
If you have a family member with AD, your risk of developing the disease increases by 30%. This may explain why people with family members who are patients of AD often wonder if testing for genetic predisposition can lessen the risk for the disease. And while the test might reveal you have a greater predisposition for Alzheimer’s, the most you can do is use the information to improve your lifestyle, but not eliminate the risk. Nonetheless, having a family member with Alzheimer’s is no guarantee you will also develop the disease.
It’s obvious that lifestyle choices majorly contribute to disease prevention and management. Among lifestyle choices that feature as risk factors for many diseases are lack of exercise, a poor diet, and heavy alcohol and cigarette consumption among others. These lifestyle factors are also listed as predisposing conditions for Alzheimer’s disease. In addition, persons suffering from heart diseases, high blood pressure, diabetes, high cholesterol, and obesity are also at a higher risk for AD.
Head injuries from accidents, falls, sport blows or explosions cause the brain to violently jolt inside the skull and are responsible for Traumatic Brain Injuries (TBI). These negatively affect the cognitive abilities related to learning and the thought process.
Persons with TBI are at greater risk of developing AD. Research also suggests that these individuals may have an earlier onset for the disease, way before the 65th year.
Treatment and Prevention
As with other neurodegenerative conditions, Alzheimer’s disease has no known cure. Following proper medical testing and diagnosis, patients can be put on medication to help manage the symptoms.
Memantine and Cholinesterase inhibitors are the two most commonly used drugs in the management of AD. The medications preserve the neurotransmitter that is threatened by the plagues and tangles and enhance communication between brain cells. The drugs also help with AD-related depression.
Away from medical solutions, caregivers can help in the management of Alzheimer’s symptoms by creating a safe and supportive environment for AD patients. Here are some specific actions that carers can take to help Alzheimer’s patients cope better with their condition:
- Place equipment in the same position to avoid confusing the AD patient. These may include house keys, clocks, phones, or even personal hygiene objects such as combs and brushes.
- Always help the AD patient with their medication. Auto medicating may place them at the risk of overdose or consuming the medication out of the recommended times.
- Use tracking devices with gadgets that belong to AD patients to help you trace them in case they should be lost.
- Stick to scheduled doctor visits and to prescribed drug dosages.
- As much as possible, keep pathways clear and avoid excessive furniture in spaces where patients frequent. Extra furniture may obstruct their movement more than already affected by the disease.
- Remove mirrors if an AD patient gets confused with their or other images reflected on the mirror.
- Ensure that the patient has an ID on them always.
- Find ways of keeping the patient’s brain active. This could mean working crossword puzzles, playing cards, or simply engaging them in moderate conversations.
Prevention is majorly related to pre-empting the risk factors discussed earlier. Preventive measures for Alzheimer’s disease include: steering clear of smoking and the excessive consumption of alcohol, avoiding a sedentary life and consistently engaging in exercise, eating a healthy diet, and not making lifestyle choices that provoke the onset of cardiovascular diseases (consumption of sugars and saturated fats, stressful situations among others).
A Ray of Hope
The foregoing facts on AD suggest that the disease is a health threat to the global population. For this reason, researchers have given preferential focus on the killer disease to understand whether its prevalence can be controlled. Researchers are also trying to understand if persons suffering from Alzheimer’s can be helped to better cope with the symptoms. The discovery of any determining processes for the development of AD that is still undiscovered would mean a better understanding of the disease and, hence, new treatments.
Even though not conclusive, recent discoveries in biomedical research have offered a ray of hope by suggesting that newly discovered drugs can significantly slow down the development of the plagues and tangles and, therefore, the cognitive and bio-physiological symptoms of Alzheimer’s disease.
If at any point you or your loved ones should manifest AD-like symptoms, seeking the help and opinion of a medical physician should be a priority. Even though the neurodegenerative disease is not reversible, taking action for early diagnosis is key in ensuring the disease is managed. Opportune treatment of the symptoms gives the patient a better quality of life.