What is the main cause of Alzheimer’s disease?
Alzheimer’s disease affects the brain, particularly the areas that control memory and emotion. In the early stages of the disease, which is considered the ‘preclinical’ stage, people experience memory loss, behavioral changes, and difficulty with thinking and communication. Alzheimer‘s is considered a long-term condition, so while the symptoms may appear for many years, they are often a precursor to the final stage, which is the ‘presumptive’ stage.
Alzheimer’s disease belongs to a category of diseases known as ‘central nervous system diseases, ‘ including Parkinson’s disease and multiple sclerosis.
Not all dementias lead to dementia, but when a person has dementia the condition is associated with ‘neurodegeneration’.
Why are Alzheimer’s disease and dementia different from dementia?
There are many different kinds of dementia, including Alzheimer’s disease and vascular dementia. However, we can distinguish dementia from Alzheimer’s disease, because Alzheimer’s disease is a type of dementia.
Dementia refers to a range of disorders that affect thinking and behavior and a person’s ability to perform everyday activities. However, people with dementia also have Alzheimer’s disease as a diagnosis.
Alzheimer’s disease is the most common type of dementia and accounts for 60% of dementia cases in the UK.
If you’ve had a stroke, you might be considered to have vascular dementia. However, dementia can also arise as a result of dementia.
A diagnosis of dementia is often made when someone has the following symptoms for a year or more: memory loss of one of the four main areas (or four main functions) of thinking and behavior; behavioral changes; a decline in capacity for managing daily activities (for example difficulty thinking or engaging in conversation); loss of the capacity to think and decide; significant impairment of physical function (for example difficulties moving around or getting out of bed); and changes in mental functioning.
A dementia diagnosis is made by a GP, who will examine your general health and discuss the symptoms of dementia.
During a dementia diagnosis, the GP will usually ask you questions that will help determine your thinking and behavioral capacity and the accuracy of your memory.
Your memory and thinking
A psychiatrist may ask you to remember what you did in the past three days and compare that memory with your current ability.
The psychiatrist will also assess your mental processing abilities. It is a relatively simple mental test in which you have to remember numbers. For example, you need to remember how many objects are on a grid and then count the number of items on each grid.
Mental processing is a complex process that involves the use of the parts of your brain that deal with memory, attention, and learning.
What is Alzheimer’s disease?
Alzheimer’s disease is the most common cause of dementia, accounting for 60% of dementia cases in the UK.
Alzheimer’s disease causes a complex process called neurodegeneration. The brain changes and degenerates into a condition that is often referred to as ‘neurodegeneration’.
So, you could see a pattern of memory loss, behavior changes, and emotional decline.
There is no single factor or diagnosis for Alzheimer’s disease, but we are likely to diagnose Alzheimer’s disease when:
a person’s thinking and memory are markedly impaired (we see evidence of the underlying brain changes); or
they’ve had Alzheimer’s disease for at least two years.
Alzheimer’s disease can develop gradually or quickly. If it progresses rapidly, it may be called ‘early Alzheimer’s disease, ‘vascular dementia, or ‘allostatic dementia’.
The best way to diagnose Alzheimer’s disease is to test your memory. You will probably have to take several tests before a diagnosis is made, which include:
- verbal memory
- total memory recall
- vocal memory capacity (this includes remembering how to spell, spell different words and recite phrases from books and films)
- verbal intelligence (this involves a range of tests of mental processing, including memory recall and speaking and writing), and
- cognitive behavior test.
These are often carried out in people who are under the age of 65 and have not been diagnosed with a neurodegenerative disease, such as dementia.
A doctor may refer you for a mental function test to assess your general mental and cognitive functioning. You can ask to have these tests carried out at a hospital.
Depression and depression
Alzheimer’s disease and depression are sometimes confused and are often diagnosed together as they share some symptoms.
You should not be worried or concerned if you have depression and some of your cognitive functions are impaired, as that is normal for depression.
However, if you have a mild cognitive impairment, you may need to be diagnosed with dementia.
A diagnosis of depression is made by a doctor who asks you questions about your mental health history.
The doctor will ask about your mood, your symptoms, how often you feel depressed, your current feelings, mood, and emotional states. The doctor will also ask you to respond to statements with a yes, no, or maybe.
If you have depression and some of your cognitive functions are impaired, you will probably have to be referred for a mental health diagnosis.
A doctor will make the diagnosis of depression when the person has either one or more of the following symptoms:
- problems with mood, sleep, and eating
- problems with attention or concentration
- problems with memory and thinking
- Problems with thinking are especially important, as a possible sign of Alzheimer’s disease. However, you need to be aware that the definition of cognitive impairment is very complex.
- Problems with thinking are necessary but not sufficient to diagnose dementia. It is possible to have some thinking problems but not dementia.
So, a certain combination of symptoms or problems with cognition might be a sign of dementia but not depression.
A person’s overall mental functioning and cognitive function will help to assess the severity of their cognitive impairment. It is a necessary but not sufficient condition to diagnose Alzheimer’s disease and depression.
Diagnosing Alzheimer’s disease and depression
Your doctor will ask you about:
- history of depression
- depression and its current and previous treatments
- any history of dementia
- memory problems
Your doctor will ask you to undergo a medical and psychiatric evaluation.
At this stage, your doctor will decide whether to diagnose depression or Alzheimer’s disease.
If the diagnosis of depression is given, it may be helpful to get a physical to rule out other possible medical causes.
In some cases, your doctor may also request a brain scan or a lumbar puncture, which is a spinal tap, to rule out Alzheimer’s disease.
While you wait for the results of the diagnostic tests, your doctor may prescribe a medication to treat depression.
Taking medication for depression and other types of mental disorders is not a treatment for Alzheimer’s disease.
This is why it is important to see a doctor for the diagnosis of depression.
Post-traumatic stress disorder (PTSD)
Some people may think that Alzheimer’s disease and PTSD are very similar, but they are not. Alzheimer’s is a neurodegenerative disease, which causes memory loss and a progressive decline in the ability to carry out everyday tasks.
PTSD is a mental health condition triggered by a terrifying event. It is triggered by a real or perceived threat that causes severe and persistent fear.
Many people experience PTSD following exposure to a life-threatening event, such as military combat, natural disasters, terrorist attacks, and other traumas.
Because psychological trauma often leads to physical changes in the brain, PTSD can be a contributing factor to dementia.
While other types of memory loss may impact the risk of dementia, PTSD is a cause.
It is important to note that only 5-10 percent of people diagnosed with Alzheimer’s or mild cognitive impairment have PTSD.
If you have PTSD, it is a good idea to discuss your symptoms and treatment with your doctor.
PTSD and the progression of Alzheimer’s disease
Alzheimer’s disease and PTSD can both cause depression and cognitive impairment. Alzheimer’s disease and PTSD can both cause depression and cognitive impairment.
PTSD can often be a cause of depression which often co-occurs with depression, and symptoms can worsen together. It is commonly mistaken for depression or bipolar disorder, as it can have similar symptoms.
Some people with Alzheimer’s and post-traumatic stress disorder (PTSD) can experience a dissociative state or a disconnect between their thoughts and their actions.
Because of this, some people with PTSD may experience trouble following verbal instructions or responding to emotional stimuli, including anger and fear.
If you have both depression and PTSD, your doctor may want to consider treatment for both conditions.
Treatment for Alzheimer’s disease and PTSD
Treatments for depression and PTSD can include:
- medication
- psychotherapy
- talk therapy
- sleep treatment
- Medications to treat depression
Risk factors
Many risk factors for depression and Alzheimer’s disease overlap. These include:
- Age: Approximately 50-60 percent of people diagnosed with Alzheimer’s disease have an aagedabove 65.
- Genetics: About 50 percent of people with Alzheimer’s disease have a genetic risk for the condition.
- Personal history: People with family members with either dementia or depression may be at increased risk.
- Mental health conditions: People who have a diagnosis of PTSD or bipolar disorder are also at higher risk for the condition.
- People who have a diagnosis of PTSD or bipolar disorder are also at higher risk for the condition.
- Social isolation: Many people diagnosed with dementia and other types of dementia live with others.
- General health: Poor health and lack of exercise and vitamin D may increase the risk of developing dementia.
- Physical activity: Physical activity can improve a person’s overall mental and physical health and reduce the risk of dementia.
The following behaviors may increase the risk of dementia:
- smoking
- excessive alcohol use
- high blood pressure
- heart disease
- sedentary lifestyle
- Lifestyle changes for people with Alzheimer’s disease
Because the disease process is prolonged, it is not usually possible to make significant lifestyle changes in a short period. However, these lifestyle changes can make a big difference in the long run.
It is important to address risk factors, such as having a family history of Alzheimer’s or living in a nursing home, as soon as possible.
People who are already at risk for developing Alzheimer’s or dementia may benefit from the following:
- Aging
- Aging is associated with dementia and a higher risk for heart disease and stroke.
- Living with dementia
People diagnosed with Alzheimer’s or dementia may benefit from an extra period of supportive care.
Supportive care can include:
Physical therapy: Good physical therapy can help maintain or improve functional abilities and confidence.
- Good physical therapy can help to maintain or improve functional abilities and increase confidence. Occupational therapy: Occupational therapy can help with daily living skills and the development of daily life skills.
- Occupational therapy can help with daily living skills and the development of daily life skills. Speech-language pathology: People with dementia who need support for swallowing, speaking, and everyday tasks may benefit from a speech-language pathologist.
- People with dementia who need support for swallowing, speaking, and everyday tasks may benefit from a speech-language pathologist. Physical therapy: People with dementia who need help with mobility and daily activities may benefit from physical therapy.
Anyone who is considering having surgery should always talk to a doctor before undergoing any procedure.
Early diagnosis and treatment
If a person suspects that they have Alzheimer’s disease, they should see a doctor as soon as possible.
Dementia cannot be cured, but many drugs can improve the symptoms and help people live longer.
Drugs currently approved to treat Alzheimer’s disease include:
- alpha-amyloid suppression agents (statins)
- manipulator molecules (Namenda)
- BAN2401
- Respiratory failure and death
A substantial number of deaths from Alzheimer’s disease are due to problems associated with living with the condition, including pneumonia, stroke, infection, or falls.
About half of people with Alzheimer’s disease experience a significant loss of function or the ability to perform normal activities, such as getting out of bed or going to the bathroom.
Nursing homes are generally the main place where people with Alzheimer’s or dementia live. However, some people with dementia are unable to live in a nursing home.
The U.S. Department of Health and Human Services (HHS) recommends community-based long-term care to those who are at risk of Alzheimer’s.
For example, people may live at home with their spouse or a relative who can help them with their daily activities and treatments.
Even in a nursing home, some people will have to get out of bed to go to the bathroom and eat.
New research indicates that patients with moderate to severe Alzheimer’s disease may benefit from staying in the hospital for one night, three times a week.
Another study found that the use of a semi-private room where people can still see and talk with other people improved the overall quality of life for people with Alzheimer’s disease.
