Alzheimer’s disease is a progressive neurological condition that changes the way a person thinks and functions over time. It is characterised by problems in thinking, learning, memory and judgment (Kraus, 2017). The accumulation of amyloid plaques between neurons in the brain, as well as the forming of neurofibrillary tangles, are thought to play a significant role in the development of Alzheimer’s disease. Plaques and tangles inhibit the brains ability to transfer nutrients from one part of the nerve cell to another. Over time, brain cells begin to die, and this will lead to a person requiring assistance to live independently.
What is the difference between Alzheimer’s disease and dementia?
The terms Alzheimer’s and dementia are often used interchangeably, but they are not the same thing. Dementia refers to a group of symptoms that suggest the presence of a disease. These could be caused by Alzheimer’s disease, or any other disease with similar symptoms.
Essentially, every person with Alzheimer’s disease has dementia, but not everyone with dementia has Alzheimer’s disease.
What are the symptoms of Alzheimer’s disease?
Early symptoms include short term memory loss, episodes of confusion or disorientation and changes in language (for example remembering the names of common objects). As Alzheimer’s disease progresses, more parts of the brain are affected and symptoms become more complex. These may include:
Apraxia – the inability for the person to make purposeful movements despite having the muscle strength and will to do so.
Aphasia – Difficulties with communicating including loss of ability to understand simple words, difficulty getting messages across, and misunderstanding what is being said.
Anomia – The inability to remember correct words. While knowing what an object is and what it is for, individuals may struggle to recall its name.
Agnosia – People experiencing agnosia struggle to identify familiar objects and/or people. When unable to identify an object, people will cease using it, and when unable to identify a person, people suffering from agnosia won’t interact with them.
Amnesia – More commonly known as short term memory loss. People suffering from amnesia may forget where they parked, or repeat things they have already said. As it worsens, people may even forget where they live, or how to get home from a friend’s house.
Does Alzheimer’s disease have stages?
Every person with Alzheimer’s disease experiences it differently. They may experience different symptoms at different times throughout the illness. Sometimes it has a slow progression and sometimes the onset and progression is quite rapid. There are also other factors which can have an impact such as the person’s life experiences, their overall mental and physical health as well as access to medical and psychosocial care and support. For these reasons there are no clear stages or reliable patterns of symptoms.
How is Alzheimer’s disease diagnosed?
Alzheimer’s disease is the most commonly diagnosed form of dementia in Australia, accounting for up to two thirds of diagnosed cases. The process of diagnosis is one of elimination and can take several months. There are general steps it is recommended to follow:
- Visit your doctor. The symptoms you are experiencing may be caused by another illness and it is important to rule this out first. Your doctor may order pathology tests at this stage.
- Your doctor may ask you to complete a Mini Mental State Exam (MMSE). This can be used in the future to track cognitive decline.
- Your doctor may refer you to a neurologist or geriatrician to conduct tests such as brain imaging or scans.
- Repeat visits may be required to ensure an accurate diagnosis.
A dementia diagnosis is not a simple process. It is important to rule out all other possibilities before a diagnosis is given.
What are the treatment options available for Alzheimer’s disease?
There is no cure for Alzheimer’s disease however there are treatments are available that may help to relieve some of the associated symptoms. They are approved for treatment of dementia but are not effective for everyone.
Cholinesterase inhibitors such as Aricept and Donezepil work by preventing a substance called acetylcholine from being destroyed. Acetylcholine is important for neurotransmission. This medication is most effective in the early to moderate stage of dementia.
Ebixa and Memanta are N-methyl-D-aspartate (NMDA) receptor antagonists. They work by blocking glutamate, a neurotransmitter found in high proportions in people with Alzheimer’s disease. This treatment is most commonly used in the later stages of dementia.
There are also a range of medications used to treat associated conditions which occur commonly in conjunction with dementia. Medications to treat depression, anxiety, sleep disturbances and to assist in the management of psychiatric symptoms such as hallucinations and delusions may also be prescribed.
Who is likely to develop Alzheimer’s disease?
Alzheimer’s disease can be genetic but most cases are sporadic meaning there is no known family history of the disease.
Alzheimer’s disease does not discriminate and anyone can develop dementia.