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Alzheimer’s Disease

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Is this topic for you?
Alzheimer’s disease is the most common cause of mental decline, or dementia. But dementia also has many other causes. For more information, see the topic Dementia.

What is Alzheimer’s disease?
Alzheimer’s disease damages the brain. It causes a steady loss of memory and how well you can speak, think, and carry on daily activities.

Alzheimer’s disease always gets worse over time, but how quickly this happens varies. Some people lose the ability to do daily activities early on. Others may still do fairly well until much later in the disease.

Mild memory loss is common in people older than 60. It may not mean that you have Alzheimer’s disease. But if your memory is getting worse, see your doctor. If it is Alzheimer’s, treatment may help.

What causes Alzheimer’s disease?
Alzheimer’s disease happens because of changes in the brain. These include lower levels of chemical messengers (neurotransmitters) that help brain cells work properly. What causes these changes is not clear.

The risk of getting Alzheimer’s disease increases as you get older. But this does not mean that everyone will get it. By age 85, about 35 out of 100 of people have some form of dementia1. That means 65 out 100 don’t have it. Dementia is rare before age 60.

Having a relative with Alzheimer’s raises your risk of getting it, but most people with Alzheimer’s disease do not have a family history of it.

What are the symptoms?
For most people, the first symptom of Alzheimer’s disease is memory loss. Often the person who has a memory problem does not notice it, but family and friends do. But the person with the disease may also know that something is wrong.

As the disease gets worse, the person may:

Have trouble making decisions.
Be confused about what time and day it is.
Get lost in places he or she knows well.
Have trouble learning and remembering new information.
Have trouble finding the right words to say what he or she wants to say.
Have more trouble doing daily tasks like cooking a meal or paying bills.
The symptoms of Alzheimer’s get worse slowly over time. A person who gets these symptoms over a few hours or days or whose symptoms suddenly get worse needs to see a doctor right away, because there may be another problem.

As people with Alzheimer’s get worse, they may get restless and wander, especially in late afternoon and at night. This is called sundowning. Over time, they may also start to act very different. They may withdraw from family and friends. They may see or hear things that are not really there. They may falsely believe that others are lying, cheating, using them, or trying to harm them. They may strike out at others.

Later, they may not be able to take care of themselves. They may not know their loved ones when they see them. They may forget how to eat, dress, bathe, use the toilet, or get up from a bed or a chair and walk.

How is Alzheimer’s disease diagnosed?
To check for the disease, your doctor will ask about your past health and do a physical exam. He or she may ask you to do some simple things that test your memory and other mental skills. Your doctor may also check how well you can do daily tasks.

The exam usually includes blood tests to look for another cause of your problems. You may have tests to look at a picture of your brain, such as CT and MRI scans. By themselves, these tests can’t show for sure whether you have Alzheimer’s. But they may find small changes in the brain related to the disease.

How is it treated?
There is no cure for Alzheimer’s disease, but there are medicines that may slow it down for a while and make it easier to live with. Drugs that may be prescribed include:

Medicines to help with memory and thinking problems, such as donepezil (Aricept).
Medicines to help with help with moderate to severe confusion and memory loss, such as memantine (Namenda).
These medicines may not work for everyone or have a big effect, but most experts think they are worth a try.

As the disease gets worse, the person may get depressed or angry and upset. The doctor may also prescribe medicines to help with these problems.

How can you help your loved one with Alzheimer’s disease?
If you are or will be taking care of a loved one with Alzheimer’s, start learning what you can expect. This can help you make the most of the person’s abilities as they change, and it can help you deal with new problems as they arise.

Work with your loved one to make decisions about the future before the disease gets worse. It is important to write a living will and a durable power of attorney. A living will states the types of medical care your loved one wants. A durable power of attorney lets your loved one pick someone to be his or her health care agent. This person makes care decisions when your loved one cannot.

Your loved one will need more and more care as the disease gets worse. In time, he or she may need help to eat, get dressed, or use the bathroom. You may be able to give this care at home, or you may want to think about using a nursing home. A nursing home can give this kind of care 24 hours a day. The time may come when a nursing home is the best choice.

Because people are living longer than they used to, Alzheimer’s disease is becoming a more common problem. Ask your doctor about local resources such as support groups or other organizations that can help as you care for your loved one. You can also search the Internet for online support groups. Help is available.