Alzheimer’s and Brain Awareness Month
Alzheimer’s is a brain disorder that causes irreversible damage to the nerve cells in the brain. It begins with mild memory loss and progresses to the inability to respond to the environment, carry on a conversation, and carry out daily activities. The risk of getting Alzheimer’s increases with age and usually affects individuals aged 60 or older. It is the 7th leading cause of death among US adults and the 6th leading cause of death among 65 years or older in 2022.
Alzheimer’s disease is the most common cause of dementia. Dementia is a general term for symptoms that are caused by specific diseases. The other main types of dementia are frontotemporal dementia, vascular dementia, mixed dementia, and Lewy body dementia. All kinds of dementia are progressive conditions which means they worsen over time.
RISK FACTORS
When risk factors are present, there is a high chance for Alzheimer’s disease to develop. The biggest known risk factor is age. The risk of having Alzheimer’s disease increases as a person grows older, particularly at age 65 and beyond. Some genes increase the risk of Alzheimer’s disease and other dementias. The APOE (apolipoprotein E) gene is the strongest gene known. This can be inherited from one of each biological parent. However, some people with this allele never develop into the said disease. In comparison to men, women are more likely to develop Alzheimer’s disease.
Other medical conditions identified as risk factors are high blood pressure, heart disease, stroke, concussion or other traumatic brain injury, depression, and mild cognitive impairment.
Research shows potentially modifiable risk factors that can prevent or delay the case of dementia. Eating well, being physically active, and engaging in social activities can help reduce the risk of dementia and improve brain health. Avoiding excessive alcohol consumption and smoking can lower your risk of developing dementia and other medical conditions. The following is a list of modifiable risks.
1. Obesity
Obesity increases the probability of developing Alzheimer’s. It has been linked to a smaller brain volume, cognitive defects, and impaired long-term potentiation and synaptic plasticity.
2. Hypertension
Older people with hypertension or high blood pressure are at higher risk of developing Alzheimer’s. The treatment for hypertension is known as an effective preventive medication for dementia.
3. Diabetes
There is a strong relationship between poorly controlled blood sugar and Alzheimer’s. Due to this connection, others have called Alzheimer’s “type 3 diabetes” or “diabetes of the brain”.
4. Physical Inactivity
Adults should aim for 75 minutes of vigorous aerobic activity each week or 150 minutes of moderate aerobic activity. Aerobic activities include jogging, dancing, swimming, and cycling.
5. Smoking
Smoking not only increases the risk of dementia but also other medical conditions such as lung cancer and stroke. Stopping smoking reduces a person’s risk of developing dementia.
6. Excessive alcohol consumption
Excessive alcohol consumption can cause mental and behavioral disasters and non-communicable diseases. Drinking more than 21 units of alcohol weekly can increase the risk of dementia.
7. Depression
Depression increases the risk of developing dementia but not everyone with depression will eventually have dementia. Other studies reveal that depression is also a symptom of dementia. However, there is no clear indicator as to what extent depression can affect dementia and vice versa.
7. Less education
Studies show that there is a link between formal education and reduced risk of Alzheimer’s. People with higher childhood education levels and lifelong educational attainment were less likely to have dementia.
8. Infrequent social contact
Maintaining social contact can reduce the risk of developing dementia. Social contacts, such as community groups and clubs, can promote beneficial behaviors and cognitive reserve.
9. Air Pollution
Research revealed that air pollution is linked to the development of dementia over time. Air pollution from wildfires and agriculture were the strongest links between pollution and dementia.
10. Untreated Vision Loss
Some eye conditions such as diabetic retinopathy or cataracts can increase a person’s risk of developing dementia. On the other hand, other conditions such as age-related macular degeneration or glaucoma do not increase the risk of dementia.
11. Hearing Impairment
People aged 40 to 65 with hearing impairment have an increased risk of dementia. Hearing impairment can also be an early symptom of it. In a report, hearing aids can reduce cognitive decline in older adults. It can also be used to lower the risk of dementia.
12. Head Injury
Older adults with a history of moderate traumatic brain injury were at greater risk of developing Alzheimer’s than those who had no history of head injury. Generally, head injuries are caused by vehicular accidents, falls, military exposures, violent assaults, and boxing.
13. Elevated LDL levels
Excess cholesterol in the brain is associated with an increase in amyloid β and tau. These two proteins increase the risk of developing dementia, such as Alzheimer’s disease.
SIGNS AND SYMPTOMS OF ALZHEIMERS
There is no common symptom for all people with Alzheimer’s since it may vary from person to person. People with Alzheimer’s may find it difficult to recognize these symptoms and will associate it as part of aging. However, these memory problems are serious and cause major changes in the brain. The following are some of the signs that a person has Alzheimer’s disease:
Memory loss that disrupts daily life
Misplacing things and losing the ability to retrace steps
Trouble understanding visual images and spatial relationship
Difficulty completing familiar tasks
Withdrawal from work or social activities
STAGES OF ALZHEIMER’S
Alzheimer’s is a continuum and worsens over time. A person with Alzheimer’s lives four to eight years after diagnosis but may live as long as 20 years on average.
Mild Alzheimer’s disease
People are often diagnosed at this stage where they experience greater memory loss and other difficulties in their cognitive skills. It interferes with some daily activities such as taking longer to complete normal daily tasks, wandering and getting lost, repeating questions, trouble handling money, and behavior and personality changes.
Moderate Alzheimer’s disease
Alzheimer’s interferes with many of the daily activities caused by damage in the areas of the brain that control conscious thoughts, reasoning, language, and sensory processing. Their confusion and memory loss worsens making them unable to recognize their family or friends. People at this stage also experience delusions, hallucinations, paranoia, and behave impulsively.
Severe Alzheimer’s disease
People at this stage will experience symptoms that interfere with most of their everyday activities and become completely dependent on others for care. In this later stage of Alzheimer’s disease, a person may be in bed most or all of the time. Their plaques and tangles spread through the brain, and their brain tissues shrink significantly.
DIAGNOSIS AND TREATMENT
Doctors can use different methods to determine whether a person has Alzheimer’s. It may be by standard medical tests, brain scans, asking the person and their family member about their medical history and overall health, a cognitive skills test, collecting cerebrospinal fluid to measure the level of proteins, and tests to determine other mental health conditions.
It is important to talk with a doctor to identify the main cause of the symptoms and to know if it is treatable. If the symptoms are diagnosed as Alzheimer’s, it is encouraged to start treatments early since it can help families plan for the future and preserve daily functioning for a while. Moreover, early treatment can allow them to participate in clinical trials for new treatments. Early diagnosis provides medical benefits, emotional and social benefits, and cost savings.
There is no cure for Alzheimer’s disease but getting treatments can manage behavioral symptoms, help people maintain the health of their brain, and slow down the symptoms of the disease. Treatment depends on the cause and progression of the disease. Prescription drugs approved by the US Food and Drug Administration best work for people in the early or middle stage of Alzheimer’s by temporarily slowing the disease from getting worse.
According to the Alzheimer’s Association, donanemab (Kisunla™) and lecanemab (Lequembi®) are the two treatments for Alzheimer’s which demonstrate that cognitive and functional decline can be reduced by removing beta-amyloid. It is best to talk with a doctor about what treatment is the most effective for those with Alzheimer’s.
SUPPORT AND CARE
The demands of caring for someone with Alzheimer’s require emotional, physical, and financial costs. The first step is being well-informed about Alzheimer’s disease by joining programs that provide strategies for dealing with it. It is crucial to have a strong support network and good coping skills to handle the stress and challenges of caring for a person with Alzheimer’s. Support groups are an avenue to share experiences, receive comfort, express concerns, and learn tips from others.
This year, the theme for Alzheimer’s and Brain Awareness Month is “Take Charge of Your Brain Health”. Wear and share purple this June to raise awareness of Alzheimer's and other dementias. Use #ENDALZ to share your story.
Read more about mental health in older adults from Ca Care Association.
