Medical Encyclopaedia
Check out the A to Z guide of medical conditions. Read up about the most common medical conditions, their symptoms and find out what treatment and support is available.
D
DiabetesAlzheimer's Disease (Dementia)
Introduction
Around 700,000 people in the UK have Alzheimer’s disease or another form of dementia. Dementia is a condition where the brain is progressively damaged causing problems with memory, thinking and behaviour and affecting a person's ability to carry out their daily activities. Alzheimer's disease is the commonest form of dementia and is responsible for about 60 per cent of cases. After Alzheimer's disease, the commonest form of dementia is vascular dementia,where the blood supply to the brain is impaired by a series of small strokes.
- What causes Alzheimer's disease?
- Who is most at risk?
- What are the symptoms?
- How is Alzheimer's diagnosed?
- Can Alzheimer's disease be treated?
- Can I protect myself against Alzheimer's?
What causes Alzheimer's disease?
At the moment, scientists don't really know the exact cause of Alzheimer's disease – it seems likely that there isn't a single cause, but that the disease results from a combination of factors including age, genes and lifestyle.
The symptoms of Alzheimer's disease result from changes to the brain's structure and chemistry. 'Tangles' and 'plaques' made up of fragments of protein appear in the brain, resulting in the death of brain cells.
Scientists have also found that nerve cells die and connections between nerve cells are disrupted. People with Alzheimer's disease also have lower levels of acetylcholine – a chemical transmitter which carries messages back and forth between nerve cells.
Who is most at risk?
- Age is the most important risk factor for Alzheimer's disease. Your risk of developing the illness increases as you get older. It affects one in 14 of over 65s, and one in six of those aged over 80 years, although it can affect younger people as well
- Women are slightly more likely to develop Alzheimer's disease than men even if the fact that they live longer is discounted
- Genes may be important in some cases. In a small minority of families, usually those with 'early onset' Alzheimer's disease, where the disease develops before the age of 65, Alzheimer's disease may be inherited from one generation to the next. However in most cases having a close relative with Alzheimer's disease appears to only slightly increase your risk of developing it
- There is growing evidence that some of the factors that increase the risk of heart disease and stroke may also increase the risk of Alzheimer's disease
- Research has shown that people who smoke and those who have high blood pressure, or high cholesterol levels have a higher risk of developing Alzheimer's disease
- People who suffer severe or repeated head injuries and boxers who have repeated blows to the head also seem to have an increased risk of developing dementia
- People with Down's syndrome who reach their 50s and 60s are also at higher risk of Alzheimer's disease because of their genetic make-up
What are the symptoms?
In the early stages, the symptoms involve parts of the brain that control memory, thinking and language. People with Alzheimer's disease may have problems finding the right words, have memory lapses or lose things.
Everyone has 'senior moments' now and again – misplacing keys or forgetting a name – and memory declines a little as you get older, but most people who are mildly forgetful don't have Alzheimer's disease.
People with Alzheimer's disease may struggle to remember very familiar words, forget recent conversations or events, leave things in strange places, have problems negotiating familiar routes like finding the way home from the local shops and struggle with everyday tasks like changing a plug for example. They may also experience mood swings, lose initiative and confidence in themselves and become withdrawn.
Alzheimer's disease is a progressive disease and as the brain becomes more damaged, the symptoms become more severe and begin to interfere with daily activities so that people need more support.
People have problems thinking clearly, struggle with simple tasks like dressing themselves, washing or brushing their teeth and stop recognising familiar people and places.
People with Alzheimer's disease can also become very anxious or aggressive and start to wander. As the disease progresses, they need round the clock care.
How is Alzheimer's diagnosed?
Diagnosing Alzheimer's disease in its early stages can be difficult as there is no simple test.
The first step is to rule out other possible reasons for the symptoms – depression or infection, for example, can cause dementia-like symptoms. More rarely a brain tumour or a vitamin deficiency can cause these kinds of symptoms.
Talking to your GP is the first step if you are worried about memory problems or you are concerned about someone close to you. The GP will probably do a physical examination and may do blood and urine tests to identify other conditions that could be causing confusion.
You may then be referred to a specialist for further tests to assess memory and cognitive skills. The specialist may be a neurologist, a psychiatrist or a geriatrician (a doctor who specialises in the care of older people).
The specialist may also suggest a brain scan which can detect certain changes to the brain and identify conditions, such as stroke and brain tumour. The specialist may also perform a chest X-ray, a Mini-mental State Examination (MMSE) and take into account the patient’s personal and family medical history.
Can Alzheimer's disease be treated?
There is no cure for Alzheimer's disease but there are treatments that can temporarily improve or stabilise some of the symptoms.
The drugs donepezil (Aricept®) galantamine (Reminyl®) and rivastigmine (brand name Exelon) are prescribed for patients in the middle stages of Alzheimer's disease although they may sometimes be prescribed to patients in the early stages, at a doctor's discretion.
These drugs, known as cholinesterase inhibitors help to reduce the breakdown of the chemical transmitter acetylcholine in the brain and improve levels of the chemical in the brain.
Another drug designed for patients with moderate-to-severe Alzheimer’s disease is memantine (Ebixa ®). It helps to protect brain cells by preventing too much calcium getting into brain cells and damaging them.
Current guidance from the National Institute for Health and Clinical Excellence (NICE) is that memantine should only be prescribed as part of a clinical trial.
Patients with Alzheimer's disease may also be prescribed medicines to help control some of the other symptoms associated with the disease such as anxiety, depression, sleeplessness and agitation.
Can I protect myself against Alzheimer's?
Although there is no known way to prevent Alzheimer's disease, it is thought that certain lifestyle changes may offer some protection.
The Alzheimer's Society recommends the following measures to help protect against dementia:
- Eat for your heart – there is growing evidence that what's good for your
heart may also be good for your brain. Eat a diet low in saturated fat and
salt, has plenty of antioxidant rich fruit and vegetables and which includes
oily fish like salmon or mackerel. The omega 3 fatty acids in oily fish may be
beneficial for the brain so eat at least one portion of oily fish a week
- Take regular exercise, at least 30 minutes on most days of the week.
Research suggests that this may help keep your brain as well as your body
healthy. It doesn't have to be too strenuous, walking or gardening both
count
- Get your blood pressure and cholesterol levels checked to ensure they are
kept at a healthy level. Raised levels are linked to an increased risk of
dementia
- Drink alcohol in moderation
- Don't smoke, as this may increase your risk of dementia
- Keep your brain active – maintain an active social life with plenty of outside interests and hobbies
Clickthrough information and support link:
Alzheimer's
Society
Alzheimer’s Research Trust
Alzheimer’s Disease
International
References:This article has been written for PruHealth by Dr Foster Research. All Dr Foster Research (DFR) health content is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional.
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