Alzheimer's and dementia
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease is one form of dementia that gradually gets worse over time. It affects memory, thinking and behavior.
The neuroscience experts at the Edward-Elmhurst Health Dementia Clinic and Linden Oaks Behavioral Health can help you recognize the signs and symptoms of Alzheimer’s disease and other forms of dementia, and discuss individualized treatment options. Find a neurologist.
Learn more about Linden Oaks Behavioral Health programs for adults 50 and older who are dealing with dementia, depression or other mental health conditions.
What you need to know about Alzheimer’s
There are two types of Alzheimer's:
- Early onset Alzheimer's: Symptoms appear before age 60. This type is much less common than late onset. However, it tends to get worse quickly. Early onset disease can run in families. Several genes have been identified.
- Late onset Alzheimer's: This is the most common type. It occurs in people age 60 and older. It may run in some families, but the role of genes is less clear.
The cause of Alzheimer's is not clear. Your genes and environmental factors seem to play a role.
You are more likely to get Alzheimer's disease if you:
- Are older. However, developing Alzheimer's is not a part of normal aging
- Have a close blood relative, such as a brother, sister, or parent with Alzheimer's
- Have certain genes linked to Alzheimer's, such as APOE epsilon4 allele
The following may also increase your risk, although this is not well proven:
- Being female
- Having high blood pressure for a long time
- History of head trauma
Symptoms of Alzheimer’s
Dementia symptoms include difficulty with many areas of mental function, including:
- Emotional behavior or personality
- Thinking and judgment (cognitive skills)
Mild cognitive impairment (MCI)
Dementia usually first appears as forgetfulness. MCI is the stage between normal forgetfulness due to aging, and the development of Alzheimer's. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops Alzheimer's.
Symptoms of MCI include:
- Difficulty performing more than one task at a time
- Difficulty solving problems
- Forgetting recent events or conversations
- Taking longer to perform more difficult activities
The early symptoms of Alzheimer's can include:
- Difficulty performing tasks that take some thought, but used to come easily, such as balancing a checkbook, playing complex games (such as bridge), and learning new information or routines
- Getting lost on familiar routes
- Language problems, such as trouble finding the name of familiar objects
- Losing interest in things previously enjoyed, flat mood
- Misplacing items
- Personality changes and loss of social skills
As the Alzheimer's becomes worse, symptoms are more obvious and interfere with your ability to take care of yourself. Symptoms can include:
- Change in sleep patterns, often waking up at night
- Delusions, depression, agitation
- Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, and driving
- Difficulty reading or writing
- Forgetting details about current events
- Forgetting events in your own life history, losing awareness of who you are
- Hallucinations, arguments, striking out, and violent behavior
- Poor judgment and loss of ability to recognize danger
- Using the wrong word, mispronouncing words, speaking in confusing sentences
- Withdrawing from social contact
- Swallowing problems
People with severe Alzheimer's can no longer:
- Understand language
- Recognize family members
- Perform basic activities of daily living, such as eating, dressing and bathing
Diagnostic tests for Alzheimer’s
In the Edward-Elmhurst Dementia Clinic, we can diagnose Alzheimer's disease with the following steps:
- Complete physical exam, including neurological exam
- Asking questions about your medical history and symptoms
- A mental status examination
To diagnose Alzheimer's, your doctor will also need to rule out other possible causes of dementia, including:
- Brain tumor
- Chronic infection
- Intoxication from medication
- Severe depression
- Thyroid disease
- Vitamin deficiency
We may use computed tomography (CT) or magnetic resonance imaging (MRI) of the brain to look for other causes of dementia, such as a brain tumor or stroke. In the early stages of dementia, brain image scans may be normal. In later stages, an MRI may show a decrease in the size of different areas of the brain. While the scans do not confirm the diagnosis of Alzheimer's, they do exclude other causes of dementia (such as stroke and tumor).
The only way to know for certain that someone has Alzheimer's is to examine a sample of their brain tissue after death. The following changes are more common in the brain tissue of people with Alzheimer's:
- "Neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell)
- "Neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, and protein)
- "Senile plaques" (areas where products of dying nerve cells have accumulated around protein)
Treatment for Alzheimer’s
Unfortunately, there is no cure for Alzheimer's. We provide a variety of treatment options in order to:
- Slow the progression of the disease (although this is difficult to do)
- Manage symptoms, such as behavior problems, confusion and sleep problems
- Change your home environment so you can better perform daily activities
- Support family members and other caregivers
We may also use certain medicines to help slow down the rate at which symptoms become worse. However, the benefit from these drugs is usually small, and you and your family may not notice much of a change.
Other medicines may be needed to control aggressive, agitated or dangerous behaviors. Examples include: haloperidol, risperidone, and quetiapine. These are usually given in very low doses due to the risk of side effects, including an increased risk of death.
It may be necessary to stop any medications that make confusion worse. Such medicines may include painkillers, cimetidine, central nervous system depressants, antihistamines, sleeping pills and others. Never change or stop taking any medicines without first talking to your doctor.