Alzheimer’s Disease, (AD) has been a complex and confusing, to say the least, topic. Many people find the diagnosis of a family member or themselves scary, like any other diagnosis. But when it comes to AD, what do you really know? Many people use the term, ‘dementia” as another term for AD, which is not true. The term dementia, is used as an umbrella term for symptoms and manifestations of the disease such as memory loss and abnormal behavior. The cause of Alzheimer’s Disease is unknown. incurable and of course, progressive. Many scientists believe that a combination of lifestyle, environment and genetic factors affect the brain. “Here is a difference in the opinions among the scientists with regard to the categorization of Alzheimer’s disease. Some of them consider it to be a factor that causes dementia, while others define the condition as a type of dementia. The latter opinion puts Alzheimer’s alongside other types of dementia, including:
- Mild cognitive impairment (MCI)
- Creutzfeldt-Jakob disease (CJD)
- Dementia with Lewy bodies (DLB)
- Vascular dementia
- Alcohol-related brain damage (ARBD)
- Young-onset dementia
- Frontotemporal dementia (FTD)
- HIV-related cognitive impairment (Patel, 2019)
The initial stages of Alzheimer’s Disease begins as mild forgetfulness that may progress into complete memory loss. This also includes having difficulty with decision making and daily routine, accompanied by changes in personality and other symptoms such as mood swings, depression, aggression and social withdrawal.
Mild Alzheimer’s includes the beginning of cognitive impairments. This stage of AD may limit/challenge IADL’s. For example, paying bills, and difficulty with remembering work tasks. At this stage, the person experiencing AD is still “functional” but does experience a tremendous amount of difficulty.
Moderate Alzheimer’s is more intense. At this point, there is a significant amount if neuronal damage. This is where the person becomes a bit more dependent on others, the confusion is more apparent due to memory loss and are not able to perform daily tasks which has been effected by sensory processing skills.
Severe Alzheimer’s includes the start of dying brain cells resulting in shrinkage of the brain tissue and sadly, many people have lost communication skills.
Early Onset Alzheimer’s is typically commonly found in older adults (65 years old) but can be diagnosed as young as 30, 40 and 50 years of age. People experiencing Early Onset Alzheimer’s have a type of the disease called, “familial Alzheimer’s Disease” meaning, they’re likely to have a parent or grandparent who has also developed Alzheimer’s Disease at a young age. This also includes, memory deficits, behavioral changes, and effects thinking. Similarly, there is no cure but there are measurements that can be taken to slow down the process such as avoiding alcohol and other substances, and by staying healthy with a good diet and exercise.
There are three genes that are linked to this- the APP, PSEN 1 and PSEN 2- that differ from the APOE gene that can increase your risk of Alzheimer’s in general (Radford, MD)”. Genetic testing for these mutations are available, but is recommended to pursue genetic counseling before hand.
Below includes examples of ‘Normal changes’ provided by authors, Lawrence Robinson and Jeanne Segal, Ph.D (Last updated: August 2019)
| Normal change: Can’t find your keys Early Alzheimer’s: Routinely place important items in odd places, such as keys in the fridge, wallet in the dishwasher |
| Normal change: Search for casual names and words Early Alzheimer’s: Forget names of family members and common objects, or substitute words with inappropriate ones |
| Normal change: Briefly forget conversation details Early Alzheimer’s: Frequently forget entire conversations |
| Normal change: Feel the cold more Early Alzheimer’s: Dress regardless of the weather. For example, wearing several skirts on a warm day, or shorts in a snow storm |
| Normal change: Can’t find a recipe Early Alzheimer’s: Can’t follow recipe directions |
| Normal change: Forget to record a check Early Alzheimer’s: Can no longer manage checkbook, balance figures, solve problems, or think abstractly |
| Normal change: Cancel a date with friends Early Alzheimer’s: Withdraw from usual interests and activities, sit in front of the TV for hours, sleep far more than usual |
| Normal change: Make an occasional wrong turn Early Alzheimer’s: Get lost in familiar places, don’t remember how you got there or how to get home |
| Normal change: Feel occasionally sad Early Alzheimer’s: Experience rapid mood swings, from tears to rage, for no discernible reason |
There are several organizations that provide information and resources for people who are experiencing Alzheimer’s Disease and for caretakers of people experiencing Alzheimer’s Disease. This is especially important because many people involved and who are around someone with AD, it can be very overwhelming and consume the caregivers life. Because this disease is so complex, it is also crucial to be an effective team member for the person experiencing AD. Alzheimer’s Support Groups and utilizing facilities that offer respite programs among others, help with support of all parties who can be managing stress or just need a break. Director, Geriatric Psychiatry and Neuropsychiatry of John Hopkin’s University states, “Care givers almost always feel guilty in some way…The disease itself (AD) and the care that people need that engenders or causes that guilt in caregivers (Rabins, 2021)”. Where this sounds well put, this same video also stated, “it’s okay to get annoyed because they forget”. While we are all human and deal with grief differently and where this is also older research, there can be many steps taken to prevent outbursts and enforce understanding.
Many adaptations and remedial tools can be used such as, sticky notes as reminders, whiteboards, alarms, using microwaves instead of stove top cooking and more.
Interestingly enough, this next podcast posted by the Mayo Clinic, describes the “redefined” diagnoses of AD. As mentioned previously, “dementia” is classified typically as an umbrella term. However, this podcast stated that ‘dementia’ and “Alzheimer’s Disease” is no longer going to be used interchangeably, which is great because it should not be described as such. Additionally, this research has been provided by Alzheimer’s Association and the National Institute on Aging. Alzheimer’s Disease will not be diagnosed via symptoms but by neuropathology (the disease or abnormality of the brain). It’s stated in the New Research Framework, “symptoms are consequences of the disease and not the definition of the disease.”(Alzheimer’s Dement 2018 Apr;14(4):535-562) Just as the previous videos have mentioned how tangles and plaques effect the brain, Mayo Clinic radiologist and Alzheimer’s researcher, Dr. Clifford Jack speaks in detail regarding neuropathology. “The diagnosis can be made biologically…(rather than clinically based) and there are two ways to get to a biologically based diagnosis, one is neuropathology… The second way is through bio-markers- regarding tangles and plaques (Jack, 2018)”. Furthermore, Jack also explains the incorrect terms and processes, and other neuropathologies, either alone or in combination, that have been used by in the past years. After the use of clinical trials, researchers began to “modify the underlying course of the disease” (AD)(Jack, 2018) . It was found that, “about 30% don’t have Alzheimer’s Disease (Jack, 2018)”.
Many other videos and sites have had similar suggestions however, there is not yet clear or concrete evidence confirming or denying the causes of AD. The Alzheimer’s Association states this is, “due to the need for more large-scale studies in diverse populations”. What is suggested is maintaining a healthy diet, avoid head injuries, staying social and participating in intellectual activity.
References:
(2018, April 23). Retrieved from https://www.youtube.com/watch?v=HeDEUlcb0D0
Causes and Risk Factors. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors.
How Alzheimer’s Changes the Brain. (2017, August 23). Retrieved from https://www.youtube.com/watch?v=0GXv3mHs9AU&feature=youtu.be.
What Happens to the Brain in Alzheimer’s Disease? (n.d.). Retrieved from https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease.
Patel, H. H. (2019, September 9). Types of Alzheimer’s Disease. Retrieved from https://www.news-medical.net/health/Types-of-Alzheimers-Disease.aspx.
Early-Onset Alzheimer’s Disease. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/earlyonset-alzheimer-disease.
Robinson, L., & Segal, J. (n.d.). Early-Onset Alzheimer’s Disease. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/earlyonset-alzheimer-disease.
Alzheimer’s Dement 2018 Apr;14(4):535-562. doi: 10.1016/j.jalz.2018.02.018
Redefining Alzheimer’s Disease: Mayo Clinic Radio. (2018, May 28). Retrieved from https://www.youtube.com/watch?v=_fACGPjiJ7Y.
Rabins, P. V. (2012, October 17). Caregiver Guilt- Memory and Alzheimer’s Disease. Retrieved from https://www.youtube.com/watch?v=l5-s68-hngk.