Alzheimer's disease
Answers to frequently asked questions about Alzheimer's disease. For service users, families, friends or anyone with concerns.
What is it?
Alzheimer's Disease (AD) is the commonest type of dementia. It mostly affects people over 65. Dementia is the name given to a group of diseases which affect thinking, memory and other functions of the brain. Brain cells are destroyed leading to confusion, loss of memory, behaviour and personality changes. The onset of the illness is often gradual, and it gets progressively worse. These brain changes cannot be reversed.
Dementia can also be the result of a stroke, head injury, or infectious diseases such as Creutzfeld Jacob disease and HIV (the virus that causes AIDS) infection.
AD is very rare in people under 65. It is slightly more common in women than men. According to the Alzheimer's Association in the US, one in 10 people 65 years of age and nearly half of those over 85 suffer from the disease. Today, about 500,000 people in Britain have AD. In America, the number is 4 million. Worldwide, there are an estimated 12 million people with the disease. That number is predicted to double by the year 2050. As more people in developing countries survive into old age, the number of those with AD is increasing dramatically and will soon far outstrip the number of people with AD in industrialised nations.
Common signs of Alzheimer's disease include:
- Loss of short-term memory - forgetting appointments, names and deadlines, even forgetting what has just been said.
- Mistakes and confusion - when performing familiar or even mundane tasks.
- Difficulty in thinking things through - not being able to add up the shopping bill or understand a simple argument.
- Disorientation - getting lost in places that should be familiar, perhaps even wandering around, unable to find the way home.
- Odd decisions - like wearing the wrong clothes for the season.
- Confusion with time - not knowing the day of the week, the date or even the hour.
- Mood swings - sudden changes of mood for no reason, often resulting in great anger, sadness, happiness or other emotions.
- Changed personality - confident people may become fearful, relaxed people may become anxious or paranoid.
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What causes it?
The cause of dementia and Alzheimer's disease is not known and there is no effective treatment.
Most of the time, it is not possible to predict who will get the disease - it occurs randomly in people over 65. 5% of cases of AD occur in much younger people and appear to be linked to faulty genes. One of the genes that causes this kind of AD is located on the same gene that causes Down's syndrome. All people with Down's syndrome develop the brain changes associated with AD by the time they are 40. But not all of them develop dementia.
It is most likely that Alzheimer's disease is caused by a variety of factors. From post-mortem studies, researchers have found that the brain of a person with AD contains abnormal deposits (called plaques) and tangles between and within cells. These deposits prevent the brain from working properly. In addition, AD causes a decrease in vital brain chemicals (called neurotransmitters) that help nerve cells to communicate with each other. As the damage to the brain increases, cells die and the connections between them are broken.
Plaques and tangles are also found, in smaller amounts, in the brains of people who show no signs of dementia. No one knows what causes the abnormal build-up of deposits that results in AD, though several different theories are being investigated.
Where do I go for help?
It is important to see your family doctor (General Practitioner/GP) if you have many of the symptoms or experiences listed above. If you are worried about a friend or relative, offer to go with them to their GP. It can be difficult to see a doctor when there is the possibility of bad news, but Alzheimer's disease shares symptoms with many other conditions, ranging from depression to a brain tumour. Many of these are treatable, especially if caught early.
Although Alzheimer's can't be cured, if you get diagnosed and treated at the early stages of the illness, the progress of the disease can be slowed down. Early diagnosis also means that you and your carers can prepare yourselves and your financial and legal affairs for the future.
If a doctor suspects you have Alzheimer's disease, he or she will usually refer you to an old age psychiatrist in the UK. In other countries, you may be referred to a neurologist. An occupational therapist may also be involved in helping you with your daily routines and activities.
In general, a relative or partner often has a very active role in looking after someone with Alzheimer's disease. Groups, run by organizations like Age Concern, The Carer's Association or the Alzheimer's Disease Society in the UK, offer great support. They run Carer's support groups and respite care. Reminiscence groups that focus on early memories (for example by showing slides of World Ward II) offer members a chance to retrieve old memories (which are often still intact) and a chance to bond with others in a similar situation.
What is the treatment?
There is no cure for AD, but there are drugs that can slow down the progress of the disease and help with the symptoms which are part of the illness, such as aggression, depression, etc.
The only licensed medication for Alzheimer's is called cholinergic therapy. Drugs like donepezil, rivastigmine and galantamine, can maintain (and possibly restore) cognitive and other functions in some people. But they may only work for a short time. On the whole these drugs are quite well tolerated, though some people can experience side-effects.
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There are other treatments for Alzheimer's being developed. Some alternative measures include:
What can I do to help myself?
For people with Alzheimer's disease
The following measures can help maintain or improve your quality of life:
- Take gentle exercise: Walking is good exercise and getting out is stimulating. People with AD should be accompanied if they are likely to become confused.
- Eat properly: A good diet is essential and pleasurable. Research has shown that diet rich in vitamins, minerals, energy sources and antioxidants may help prevent or slow down the progress of the disease.
- Exercise the mind: Reading, hobbies, handicrafts or enjoyable study all provide mental stimulation.
- Avoid smoking - though for some time it was thought smoking provided some protection against Alzheimer's disease, recent evidence suggests it does not.
- Avoid self-medication - (including the excessive use of alcohol) this is commonly a source of undesirable side effects
We are grateful to the advice of Dr. Alfredo Toledano, Alzheimer research scientist at the Ramón y Cajal Institute, Madrid, and Chairman of Alzheimer España for this information.
For carers
In order to look after someone else, carers need to look after their own health and well-being. It is important that carers get all the help they can. Help and support for people with AD and their families is available from medical services, social services and voluntary organisations. These services can provide information and help on legal and financial matters, day-to-day care, nursing and residential care, and coping.
See below for further information.
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Support
There are Alzheimer support groups worldwide - see (www.alzheimer-europe.org/dutch/association.html) . There will usually be one in every large town. They provide all kinds of practical aid and information, including help-lines and groups.
Alzheimer's Association in the US
Alzheimer's Disease International
Alzheimer's Disease Education and Referral (ADEAR) Center
Alzheimer's Society in the UK
Alzheimer Research Forum
Other pieces on emental-health.com
History - insight into history of approaches to Alzheimer's disease.
Biology - referenced guide to diagnosis, biological techniques and findings
Treatment - referenced guide to approaches to treatment and the way they work.
Fastfacts - a quick guide to who gets it, how it's treated, and hot topics.
Links - to other resources
Personal accounts
Read others' experiences of Alzheimer's
John Bayley's account of looking after Iris Murdoch during her illness
Please email us with other questions you would like to see featured.
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