Alzheimer’s disease – Causes, signs, and management

The cells, tissues, and nerves in the human brain go through regular and frequent changes due to aging, cardiovascular diseases, diabetes, trauma or injury, or long-term unhealthy lifestyle habits. The changes can lead to declining cognitive functions like learning, memory, concentration, decision-making, language, and communication. Dementia refers to a group of neurological conditions caused by such changes, and Alzheimer’s is its most common form.

Definition of Alzheimer’s
Alzheimer’s disease is a degenerative and irreversible form of dementia that gradually destroys all cognitive skills. As the disease progresses, speaking, communicating, remembering, eating, and engaging in day-to-day tasks become difficult. With reduced ability to eat, Alzheimer’s leads to malnutrition, reduced immunity, frequent infections like pneumonia, accidents, and injuries. In severe cases, Alzheimer’s can also be fatal. Currently, there is no definitive cure or prevention, but many treatment options are available for delaying and managing it.

Main causes and risk factors of Alzheimer’s disease

Causes
The human brain consists of approximately 100 billion nerve cells that work together to send and receive signals to and from different areas of the body. However, these cells can be damaged due to various reasons, causing a gradual decline in their associated functions. As the brain continues to shrink and cells die or become damaged, it has a detrimental effect on every function of the human body, eventually leading to death. Alzheimer’s disease is a prime example of the changes in brain cells that can lead to this outcome. The causes include:

  • Plaque build-up in brain cells
  • Tau (a type of protein) deposits in the brain cells
  • Reduced levels of acetylcholine – a neurotransmitter
  • Age-related shrinking of the brain

Risk factors
Research on patients with Alzheimer’s has shown that there are several common risk factors among them. It is important to note that having a high-risk factor does not necessarily mean that a person will develop Alzheimer’s, just as having a low risk does not guarantee that they won’t develop it.

Age
People above the age of 65 are at higher risk of Alzheimer’s, and it increases as they grow older. In rare cases, early-onset Alzheimer’s affects people around 40.

Genetics
If a parent has Alzheimer’s, the children have a slightly increased risk of developing it. Genetic testing is still not foolproof, but it can help identify the risk if a person experiences any associated symptoms.

Head injury
Any traumatic brain injury or any head injury suffered early in life can cause changes in the brain cells that are responsible for cognitive skills, eventually leading to Alzheimer’s.

Cardiovascular diseases
Reduced heart function as one age, mid-life hypertension, late-life low blood pressure, untreated hypertension, and other cardiovascular diseases can affect blood flow and supply of oxygen to the brain. This can cause death or damage to some brain cells, leading to cognitive decline and Alzheimer’s.

Mild cognitive impairment
Mild cognitive impairment (MCI) refers to any decline in cognitive function unusual for one’s age. The risk of MCI developing into Alzheimer’s later is high. Early diagnosis, treatment, and lifestyle changes can stall its progression.

Down syndrome
Alzheimer’s may affect people with Down Syndrome 10 to 15 years ahead of others; it could start around the age of 50 or 55.

Lifestyle and habits
Current data shows many patients with Alzheimer’s have similar lifestyles and habits that are now classified as risk factors. The risk can be reduced by changing to a healthier lifestyle, avoiding certain unhealthy habits, and engaging in physical activity. Some risk factors of Alzheimer’s include:

  • Sedentary lifestyle
  • Irregular or lack of adequate sleep
  • High BMI
  • Type 2 Diabetes

Symptoms of Alzheimer’s
Symptoms of Alzheimer’s disease are unique to each patient, but most individuals experience memory loss as one of its early signs. As the condition advances, these symptoms become more severe. Initially, a person may forget where they placed an object, but as the disease progresses, they may forget their own identity and address.

  • Frequent misplacing of things
  • No memory of recent conversations
  • Frequent and repetitive questioning
  • Poor judgement
  • Lack of flexibility
  • Anxiety
  • Agitation
  • Restlessness
  • Speech and language difficulties
  • Mood changes
  • Obsessive and impulsive behavior
  • Delusion and hallucination
  • Wandering
  • Aggression
  • Loss of appetite
  • Difficulty in swallowing
  • Lack of bladder control
  • Inability to perform daily tasks without assistance

Treatment for Alzheimer’s
A team of neurologists, geriatricians, and a primary physician treat Alzheimer’s intending to maintain and ease the impact of cognitive, mental, and behavioral symptoms and to delay the progression of the disease. A combination of pharmacological treatments, behavioral therapies, rehabilitation, and lifestyle changes are the main methods of treatment for Alzheimer’s.

  • Doctors prescribe antipsychotic and antidepressant treatments as the first line of treatment to manage symptoms like anxiety, aggression, agitation, delusions, and hallucinations. Some treatments may cause mild to severe side effects, and doctors closely monitor the patients’ progress to control them.
  • Cognitive stimulation and rehabilitation therapy train the patients and their caregivers to manage their daily tasks. Patients are trained to use the unaffected and healthier areas of the brain to be as independent as possible. Patients undergo therapy from trained behavioral therapists and occupational therapists for many months. Therapists also help the patients participate in group activities, games, and exercises that improve memory.