Alzheimer's Disease in Adults

by Beth Rogan,BA, RN, Marketing and Community Outreach Manager at MSPP

What is Alzheimer’s Disease?

Alzheimer's Disease is a progressive, degenerative disorder that occurs when brain cells die; it causes problems severe enough to affect work, life-long hobbies and eventually the ability to carry out even the simplest tasks. The brain cells (neurons) that are affected are the ones that produce the chemical neurotransmitter acetylcholine. When they can no longer produce it, they break connections with other nerve cells and ultimately cease to function, leading to one or more of the following symptoms.

• serious memory loss
• confusion
• problems with concentration
• restlessness
• personality changes
• poor judgment
• language deterioration
• inability to follow directions
• impaired thought processes involving visual and spatial awareness
  

Alzheimer's Disease is named for a German physician, Dr. Alois Alzheimer. In 1906, he presented a case history at a medical meeting involving a 51-year-old woman who suffered from a rare brain disorder. An autopsy of her brain helped identify the main characteristics of Alzheimer's: plaques, tangles and a loss of connections among nerve cells (neurons).

Alzheimer’s Disease is the most common form of dementia found among older people, accounting for 50% to 70% of all cases. Typically Alzheimer’s Disease begins after 65 years of age. Dementia is the general term used to describe a loss of memory and cognitive functioning severe enough to interfere with daily life.  According to the Alzheimer’s Association, as many as 5.3 million Americans are living with this disease.

Younger-Onset

Younger-Onset, or Familial, Alzheimer’s Disease refers to a rare form of the disease that occurs between 30 and 65 years old. Five to 10 percent of the people with Alzheimer’s develop symptoms before 65 years. While it is very uncommon to develop the disease between ages 30 and 40, it occurs with greater frequency after the age of 50. This rare disorder tends to run in families and follows a genetic inheritance pattern. Misdiagnosis may be more likely in Younger-Onset Alzheimer’s. Middle-age individuals with Alzheimer’s and their families face unique issues as they are often still employed and may have children living at home. 

Changes in the Brain

Although what triggers the Alzheimer's disease process remains unknown, two abnormal structures found in the brain of its sufferers are the prime suspects in damaging nerve cells. The first is plaques containing protein fragments and cellular material called beta-amyloid that build up between nerve cells. The second is tangles -- twisted fibers composed largely of a protein called tau -- that form inside dying nerve cells. Most scientists believe that somehow these plaques and tangles block communication among nerve cells; as more of these form in particular brain areas, healthy neurons begin to work less efficiently. They eventually lose the ability to function and communicate with each other, and then die.

Causes of Alzheimer’s Disease

While the causes of Alzheimer’s Disease are not fully understood, scientists know its development involves a complex series of events over a long period of time. Likely causes include age, genetic make-up, environmental factors and lifestyle.

Slowed thinking and occasional problems remembering are typical signs of aging, but serious memory loss, confusion and other changes in the way the mind functions are not normal. According to the Alzheimer’s Association, the following are warning signs or symptoms of this disease:

• Memory changes that disrupt daily life
• Challenges in planning or solving problems
• Difficulty completing familiar tasks at home, at work or at leisure
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality

Individuals may experience one or more of these in different degrees.

Diagnosis

Since there is as yet no single diagnostic test for Alzheimer’s, the only way to definitively diagnose this disease is through autopsy. However, doctors have several methods and tools available which enable them to make a diagnosis with about 90% accuracy; they can:

• complete a medical history along with neurological, motor and sensory exams;
• conduct tests of memory, problem solving, attention, counting, and language;
• ask questions about a person’s ability to carry out daily activities;
• carry out medical tests of blood, urine and spinal fluid;
• perform brains scans, CAT scans or MRI tests.

Treatment

There is no known cure for Alzheimer's disease. Current treatment focuses on helping people maintain mental function and manage behavioral symptoms.  The Food and Drug Administration (FDA) has approved medications, known as cholinesterase inhibitors, for Alzheimer's disease patients. These drugs inhibit the enzyme that breaks down acetylcholine, and may help slow the worsening of symptoms. However, they do not impact the underlying disease process and may provide help for only a few months to a few years.

Help for Caregivers

Caring for a person with Alzheimer’s can be physically and emotionally demanding. Support, education and guidance for the caregiver are essential.

The information in the article above was drawn from the following sources:

• About Alzheimer's: Definition of Alzheimer’s, from the Alzheimer’s Foundation of America.
• Alzheimer’s Disease Fact Sheet, from the National Institute On Aging's Alzheimer’s Disease Education & Referral Center.
• Conditions and Treatment: Alzheimer’s Disease, from the Massachusetts General Hospital.
• What is Alzheimer’s , from the Alzheimer’s Association.
• Early-onset Alzheimer's: When symptoms begin before 65 , from Mayoclinic.com.
• About Alzheimer’s Disease , from Alzheimer’s Prevention, a web site of the Alzheimer’s Foundation of America.

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Additional Sources of Information

• The Forgetting: A Portrait of Alzheimer's Disease, a PBS web site on Alzheimer's disease offering information on symptoms, risk factors, coping, and additional resources.
• Alzheimer's Disease Caregiving: A Resource List. This resource list from the National Institute on Aging contains more than 80 books, booklets, fact sheets, DVDs, and other materials specifically for people with Alzheimer's disease and their caregivers.
• Community Resource Guide to Services for Alzheimer's Disease and Related Disorders, from the West Suburban Area Alzheimer's Partnership, is a local resource guide for elders with Alzheimer's and their families. This guide provides a listing of local adult day health centers,assisted living facilities, care managers; diagnostic center,; financial and legal resources, home health agencies, housing options, nursing homes and support groups for individuals and families caring for a loved one with Alzheimer's disease. To request a copy, call Springwell's Information and Referral Department at 617-926-4100 or download a printer-friendly version of the guide by clicking on the title, above.

General Resources on Aging and Wellness

• From the MSPP INTERFACE Referral Service: Caregiver Resources.
• Geriatric Mental Health Foundation.
• “Older Adults and Mental Health,” from Mental Health: A Report of the Surgeon General.
• PubMed, a collaboration of the U. S. National Library of Medicine and the National Institute of Health, provides a comprehensive list of journal articles regarding mental health and older adults.