Alzheimer's disease is a neurological disorder in which the death of brain cells causes memory loss and

cognitive decline.

It is the most common type of dementia, accounting for 60 to 80 percent of cases of dementia in the
United States.

In 2013, 6.8 million people in the U.S. had been diagnosed with dementia. Of these, 5 million had a
diagnosis of Alzheimer's. By 2050, the numbers are expected to double.

Alzheimer's is a neurodegenerative disease. At first, symptoms are mild, but they become more severe
over time.

Fast facts on Alzheimer's disease

Alzheimer's disease is the most common type of dementia.

It happens when plaques containing beta amyloid form in the brain.

As symptoms worsen, it becomes harder for people to remember recent events, to reason, and to
recognize people they know.

Eventually, a person with Alzheimer's is likely to need full-time assistance.

To receive a diagnosis of Alzheimer's, the person must have experienced a decline in cognitive or
behavioral function and performance compared with how they were previously. This decline must
interfere with their ability to function at work or in usual activities.

The cognitive decline must be seen in at least two of the five symptom areas listed below:

1. Reduced ability to take in and remember new information, which can lead, for example, to:

repetitive questions or conversations

misplacing personal belongings

forgetting events or appointments

getting lost on a familiar route

2. Impairments to reasoning, complex tasking, and exercising judgment, for example:

poor understanding of safety risks

inability to manage finances

poor decision-making ability

inability to plan complex or sequential activities

3. Impaired visuospatial abilities that are not, for example, due to eye sight problems. These could be:

inability to recognize faces or common objects or to find objects in direct view

inability to use simple tools, for example, to orient clothing to the body

To receive a diagnosis of Alzheimer's, the person must have experienced a decline in cognitive or
behavioral function and performance compared with how they were previously. This decline must
interfere with their ability to function at work or in usual activities.

4. Impaired speaking, reading and writing, for example:

difficulty thinking of common words while speaking, hesitations

speech, spelling, and writing errors

5. Changes in personality and behavior, for example:

out-of-character mood changes, including agitation, apathy, social withdrawal or a lack of interest,
motivation, or initiative

loss of empathy

compulsive, obsessive, or socially unacceptable behavior

If the number and severity of symptoms confirm dementia, the following factors can then confirm
Alzheimer's.
a gradual onset, over months to years, rather than hours or days

a marked worsening of the individual's normal level of cognition in particular areas

If symptoms begin or worsen over the course of hours or days, you should seek immediate medical
attention, as this could indicate an acute illness.

Alzheimer's is most likely when memory loss is a prominent symptom, especially in the area of learning
and recalling new information.

Language problems can also be a key early symptom, for example, struggling to find the right words.

If visuospatial deficits are most prominent, these would include:

inability to recognize objects and faces

difficulty comprehending separate parts of a scene at once

difficulty with reading text, known as alexia

The most prominent deficits in executive dysfunction would be to do with reasoning, judgment, and
problem-solving.

Other early signs

In 2016, researchers published findings suggesting that a change in sense of humor might be an early
sign of Alzheimer's.

Recent research suggests that the features of Alzheimer's, such as brain lesions, may already be present
in midlife, even though symptoms of the disease do not appear until years later.

Stages
The progression of Alzheimer's can be broken down into three main stages:

preclinical, before symptoms appear

mild cognitive impairment, when symptoms are mild

dementia

Diagnosis

There is no single test for Alzheimer's disease, so doctors will look at the signs and symptoms, take a
medical history, and rule out other conditions before making a diagnosis.

They may also check the person's neurological function, for example, by testing their balance, senses,
and reflexes.

Other assessments may include a blood or urine test, a CT or MRI scan of the brain, and screening for
depression.

Sometimes the symptoms of dementia are related to an inherited disorder such as Huntington's disease,
so genetic testing may be done.

After ruling out other possible conditions, the doctor will carry out cognitive and memory tests, to assess
the person's ability to think and remember.

Cognitive assessment

To confirm a diagnosis of Alzheimer's, the following must be present and severe enough to affect daily
activities:

gradual memory loss

progressive cognitive impairment

Questions that may be asked to test cognitive ability include:

woman looking confused

Alzheimer's can make it hard to remember things.

What is your age?

What is the time, to the nearest hour?

What is the year?

What is the name of the hospital or town we are in?

Can you recognize two people, for example, the doctor, nurse, or carer?

What is your date of birth?

In which year did (a well-known historical event) happen?

Name the president.

Count backward from 20 down to 1

Repeat an address at the end of the test that I will give you now (for example, "42 West Street")

A number of assessment tools are available to assess cognitive function.

Genetic testing

In some cases, genetic testing may be appropriate.

A gene known as the APOE-e4 is associated with higher chances of people over the age of 55 years
developing Alzheimer's.

Using this test early could indicate the likelihood of someone having or developing the disease. However,
the test is controversial, and the results are not entirely reliable.

In the future, emerging biological tests may make it possible to assess for biomarkers in people who may
be at risk of Alzheimer's.
Treatment

There is no known cure for Alzheimer's. The death of brain cells cannot be reversed.

However, there are therapeutic interventions that can make it easier for people to live with the disease.

According to the Alzheimer's Association, the following are important elements of dementia care:

effective management of any conditions occurring alongside the Alzheimer's

activities and day-care programs

involvement of support groups and services

Drug therapy

No disease-modifying drugs are available for Alzheimer's disease, but some options may reduce the
symptoms and help improve quality of life.

Cholinesterase inhibitors that are approved for symptomatic relief in the U.S. include:

Donepezil (Aricept)

Rivastigmine (Exelon)

Tacrine (Cognex)

A different kind of drug, memantine (Namenda), an NMDA receptor antagonist, may also be used, alone
or in combination with a cholinesterase inhibitor.

Other therapy
The need for quality-of-life care becomes more important as the person becomes less able to live
independently.

Results of a mouse study, published in Nature, suggested in 2016 that It may one day be possible to
restore memories for people with early Alzheimer's.

Causes and risk factors

Like all types of dementia, Alzheimer's is caused by brain cell death. It is a neurodegenerative disease,
which means there is progressive brain cell death that happens over time.

In a person with Alzheimer's, the tissue has fewer and fewer nerve cells and connections.

Autopsies have shown that the nerve tissue in the brain of a person with Alzheimer's has tiny deposits,
known as plaques and tangles, that build up on the tissue.

The plaques are found between the dying brain cells, and they are made from a protein known as beta-
amyloid.

The tangles occur within the nerve cells, and they are made from another protein, called tau.

Researchers do not fully understand why these changes occur. Several different factors are believed to be
involved.

The Alzheimer's Association has produced a journey of 16 slides that visualizes what happens in the
process of developing Alzheimer's disease. You can access it here.
Risk factors

Unavoidable risk factors for developing the condition include:

aging

a family history of Alzheimer's

carrying certain genes

Modifiable factors that may help prevent Alzheimer's include:

getting regular exercise

maintaining a healthy cardiovascular system

managing the risk of cardiovascular disease, diabetes, obesity, smoking, and high blood pressure

following a varied and healthful diet

participating in lifelong learning and cognitive training

Some studies suggest that staying mentally and socially engaged may possibly reduce the risk of
Alzheimer's.