As they get older many people report experiencing problems with memory and attention. This can happen naturally as the brain cells age and the rate at which they send electric impulses slow down. However, for some people early memory problems could be the first signal of Alzheimer’s Disease.
Alzheimer’s Disease is a neurodegenerative condition caused by accumulation of harmful proteins.
Beta-amyloids tend to accumulate primarily around the hippocampus, affecting learning, memory and spatial navigation functions.
As the disease progresses, pathology spreads to other brain regions harming language, movement and bodily functions.
The first signs of Alzheimer’s often are attention and concentration problems, which with time progress into memory deficits. Being aware of these symptoms is unpleasant, making the patients irritable, depressive, avoid people and unfamiliar situations. Alzheimer’s often causes apathy, sleep disturbances, disorientation and wandering.
Vascular disease, diabetes, head injury, exposure to harmful chemicals and certain genes increase the likelihood of developing this disease.
This is the most common form of dementia and depending on the country covers between half and three quarters of total dementia cases. Scientists are still researching effective ways to cure Alzheimer’s and reverse its pathology; however, most medications only alleviate symptoms, slow disease progression, or help psychologically.
What causes Alzheimer’s symptoms?
Alzheimer’s Disease is a neurodegenerative condition, meaning that as the pathology grows, neuronal cells die, and with their loss the brain functions deteriorate.
One of the main signs of Alzheimer's Disease is accumulation of Beta-amyloids, harmful proteins that stick together to form plaques in the gaps between neurons. These protein plates disrupt brain cell connections and interfere with the process by which the nerves pass information to each other.
Normally we clear of the Beta-amyloids during sleep as our bodies recover. However, Alzheimer’s Disease interferes with the restorative processes that happen during sleep, so these accumulations are no longer cleared and continue to collect between brain cells. In Alzheimer's Disease, the brain begins to shrink every year losing more volume than it would aging healthily.
Since the harmful proteins that cause this disease tend to accumulate primarily around the hippocampus, Alzheimer’s Disease mainly affects the functions performed by this part of the brain, such as learning, memory and spatial navigation. However, as the disease progresses, pathology spreads to other brain regions affecting their functions as well. In advanced stages of Alzheimer’s we see patients struggling with language, movement and bodily functions.
How to recognize Alzheimer's Disease?
Alzheimer’s Disease doesn’t happen overnight - the first symptoms are barely noticeable, but over time they progress, and memory problems get worse. However, the earlier it’s identified, the sooner it’s possible to start treatment and delay the progression. So what signs to look for if you or your family member is worried about Alzheimer’s?
The first symptoms of the disease are usually noticed by the patients themselves or their relatives. In the early stage, which lasts for several years, patients begin to complain of slowed perception and concentration problems, which make it hard to keep up with the pace of the conversation. They often lose personal items or leave them in an unusual place - a common example frequently reported by family members is patients leaving the TV remote in the refrigerator or plates of food in the bathroom. Unable to find their belongings patients may even blame the loved ones for their misappropriation. With time such attention problems progress to memory deficits. Patients start to forget about recent events, repeat stories over the course of a conversation or ask the same questions several times.
Not being able to perform simple tasks or convey your message across is frustrating, making the patients irritable and emotional. Noticing deterioration in one’s cognition is unpleasant, leaving the patients feeling insecure. They start to withdraw from social settings and avoid new situations in which these disorders would unfold. For example, fearing that the cashier might see how difficult it is for them to count the money, they tend to bring the biggest notes to a shopping trip, even when the small ones would suffice.
Since writing is an extremely challenging activity, it is often one of the first places where Alzheimer’s symptoms become noticeable. Feeling insecure about their cognitive abilities the patients begin to avoid writing anything themselves, especially in front of other people. They start asking their loved ones to fill out forms for them or to put appointments in the diary.
The onset of dementia is often associated with apathy and depressive symptoms - decreased interest in other people or activities, in which the person has previously been involved and which gave them pleasure in the past. Memory and attention problems can make reading or watching TV difficult and as these activities gradually become unpleasant, they are abandoned. Loss of pleasure in eating may lead to decreased appetite and weight loss.
Symptoms as the disease progresses
As the disease progresses, so do problems with spatial orientation. The patient gets lost more often and starts having problems finding the right way not only in novel, but also in familiar environments. Since it becomes difficult to navigate not only outside but also indoors, even simple household chores, such as shopping at a grocery store or finding the restroom, become overwhelming.
Alzheimer's Disease provokes sleep disturbances and increase in night-time awakenings. After waking up, the patients begin to wander around the rooms with limited orientation in space or time, can even open doors and go outside at night. Such walks are particularly dangerous in winter due to the possibility of falls or catching a cold.
Since recent happenings become too difficult to remember, the conversations start to relate to the events in the distant past, more often revolving around their youth or childhood. As their memories weaken, the patients start calling their grandchildren names of their children.
As the disease progresses, well-known words or facts are forgotten. At this stage the patient no longer can remember the names of his children or name the correct date and location. The patient is no longer capable of taking care of himself or live independently, and needs assistance even for personal hygiene matters, such as taking a shower. Becoming completely dependent on others is unpleasant, thus often the patient can resist help.
In the last stage of the disease the pathology and neurodegeneration is widespread, affecting most of the brain functions. The patient can no longer voluntarily perceive, think, talk, or even move. It takes an average of 15 years from the onset of the disease to complete dependency confined to bed.
Will I get Alzheimer’s?
People with vascular disease, diabetes, high cholesterol, and high blood pressure are more likely to develop Alzheimer's Disease. It is also more common in those who experienced head injuries in the past or worked with harmful chemicals. Genetic studies reveal that individuals with a particular genotype - an allele of the apolipoprotein E (APOE) ε4 gene - are up to 20 times more likely to develop Alzheimer's Disease. Although the presence of this gene alone does not mean that you will get the disease, it is recommended that people who find out that they have the APOE ε4 allele spend more time performing the physical and mental activity and focus on disease prevention.