Alzheimer's disease

About Alzheimer's disease

Alzheimer's disease is the most common cause of dementia, affecting nearly 500,000 people in the UK. Dementia is the medical term used to describe a number of conditions that cause a change in the way your brain works. These changes can cause memory problems and can alter your behaviour and emotions. You may also have problems making decisions and solving problems, or be unable to carry out your usual daily activities, such as driving, getting dressed or eating. The effects of dementia are different for each individual.

Alzheimer's disease changes the structure of your brain and causes your brain cells to die. It also affects the chemicals that are responsible for transmitting signals between your brain cells, which means that nerve messages aren't passed on properly. Over time, as more and more areas of your brain become damaged, your symptoms will get progressively worse.

Most people who develop the condition are over 65, although it can also develop in younger people. If you have Alzheimer's disease, you will usually live with the illness for several years, but this depends on when you’re diagnosed.

Video - An introduction into dementia

Arlene Phillips talks to Professor Graham Stokes, Bupa's Director of dementia, about early signs of dementia.

Symptoms of Alzheimer's disease

Alzheimer's disease is a condition that develops over many years. The symptoms get progressively worse over time. If you develop Alzheimer's disease before you're 65 (early-onset), your symptoms may get worse more rapidly than in people who develop it later.

One of the first symptoms of Alzheimer's disease is forgetfulness – for example, forgetting the name of an acquaintance or forgetting where you have put something. However, this isn't always caused by dementia and may just be a sign of getting older or simply the stress of a busy life. You might also have trouble finding the right words when talking or writing.

As Alzheimer's disease develops, you, or your family or friends, may notice other symptoms. Alzheimer's disease affects everyone differently. You may have some but not all of the symptoms listed below.

  • You may become confused or disorientated – for example, you may not know what time of day it is, feel bemused and believe you're somewhere you're not, or you may not recognise familiar places or people.
  • You may feel irritable, become less interested in life, or become depressed or anxious.
  • You may have problems doing everyday tasks, such as preparing a meal, laying the table, getting dressed, shopping or dealing with money.
  • You may take less care of yourself, for example, not washing regularly or eating properly.
  • Communicating may become more difficult. You may struggle to complete sentences or understand all of what is being said to you. You may also have difficulty finding the words you need.

If you start to notice these symptoms, see your GP.

During the later stages of the disease, you're likely to be frail and increasingly dependent on other people. In general, your memory loss will get worse, and you may not recognise your close family or your partner. Eventually, you will become dependent on others to care for you.

The symptoms of Alzheimer's disease can cause a great deal of distress and upset for you, and your carers and family, who may feel they have lost the person they once knew.

Complications of Alzheimer’s disease

As Alzheimer's disease progresses, you will become less mobile and less able to carry out your usual activities. You may be more likely to develop infections, such as pneumonia and bladder infections. Having Alzheimer's disease means it can be difficult to deal with these kinds of infections and illnesses, which can make it harder to recover.

Many people who have Alzheimer's disease live for years with the condition. When people die from Alzheimer's disease, it's normally due to a related problem, such as an infection, rather than the disease itself. However, Alzheimer's disease can also be fatal itself if it progresses to the point where the areas of your brain that control essential functions, such as breathing, swallowing and balance, are affected.

Causes of Alzheimer's disease

Doctors don't know exactly why some people develop Alzheimer's disease, but it's associated with a number of risk factors. These may include:

  • ageing – Alzheimer's disease mainly affects older people two-thirds of people who have Alzheimer’s disease are over 80 years old
  • genetics – you may be more likely to develop Alzheimer's disease if your parents or a close relative has it
  • a previous severe head injury
  • lifestyle factors, such as smoking or obesity
  • diabetes
  • raised blood pressure and raised blood cholesterol levels

If you have Down's syndrome, you are also at greater risk of developing Alzheimer's disease as you get older.

Diagnosis of Alzheimer's disease

Alzheimer's disease can be difficult to diagnose, especially in the early stages.

Your GP may ask you a series of questions designed to test your memory and thinking, for example, using a test called the Mini-Mental State Examination. He or she may also test your urine or do blood tests to see whether any other condition may be causing your symptoms, which may be treatable.

If your GP thinks that you may have Alzheimer's disease, he or she is likely to refer you to a Memory Assessment Service to see specialist doctors and nurses for more tests. These may include further tests to check your memory and thinking, and observation of your behaviour. You may be asked to have a CT or MRI brain scan.

Treatment of Alzheimer's disease

Treatments for Alzheimer's disease can't cure the condition but, for some people, they may slow down the development of the disease for a period of time.

Medicines

People with Alzheimer's disease don’t have enough of a chemical called acetylcholine in their brain. Acetylcholine helps nerve signals to travel across the gaps (synapses) between nerve cells (neurones). Medicines called acetylcholinesterase inhibitors can help to stop the level of acetylcholine in your brain falling any further. There are three acetylcholinesterase inhibitors available: donepezil hydrochloride, rivastigmine and galantamine.

You may be given these medicines if you have mild or moderately-severe Alzheimer's disease, because they can help slow down the development of symptoms for a while. However, they are unlikely to extend your lifespan.

If you have late-stage Alzheimer's disease, your doctor may prescribe a medicine called memantine. This works in a different way to acetylcholinesterase inhibitors. It may help to improve your thinking and memory and allow you to do more basic everyday activities such as washing and eating.

Your doctor may also prescribe medicines to help treat some of the symptoms of Alzheimer's disease, such as anxiety, sleep disturbance or irritability. If you also have depression, your doctor may prescribe antidepressants to treat it.

Talking therapies

Your doctor may suggest other treatments that can help you to deal with memory loss, emotional symptoms and changes in your behaviour. Some of the main ones are listed below.

  • Cognitive stimulation therapy. This uses memory and reasoning exercises, as well as reminiscence and multisensory stimulation to improve your ability to learn, remember and think. The programme helps with memory problems, day-to-day activities and reality orientation.
  • Multisensory stimulation. This can help to improve your quality of life and includes music and pet therapy, aromatherapy and massage.
  • Psychological interventions can help to reduce problems such as anger, agitation and depression.
  • Meaningful activities and engagement such as having conversations, ‘life story’ work (focusing on the person’s past), painting and drawing, cooking and games. These can help you to express yourself and improve your quality of life and sense of wellbeing.

Help and support

If you have Alzheimer's disease, you may be looked after at home, in a care home or sometimes in hospital. The people who care for you can help you to look after yourself and stay healthy and safe.

If you're looking after someone with Alzheimer's disease at home, you're likely to need extra help and support. Looking after someone with dementia can be stressful and sometimes carers can neglect their own health and wellbeing.

As a carer, it's important to take regular breaks so that you can look after yourself and take some time to relax. Respite care is when someone comes into your home to care for the person with dementia while you take a break, or when the person with dementia attends a day centre or goes into a care home or hospital for a period of time. Organisations such as the Alzheimer's Society and Carers UK can give you more information about respite care.

Prevention of Alzheimer’s disease

There are many risk factors for Alzheimer’s disease but as yet no definite ways to help prevent you developing it. There’s nothing you can do about your genes or your age, but aiming to live a healthy lifestyle may give you some protection. It has been found that the same risk factors for cardiovascular disease can increase your risk of Alzheimer’s disease. By making certain healthy lifestyle changes, you may be protecting yourself against both diseases. Try to do the following to stay healthy.

  • Exercise regularly – it’s recommended that you do 150 minutes a week in bouts of 10 minutes or more.
  • Don’t smoke.
  • Maintain a healthy weight.
  • Take measures to control high blood pressure or high cholesterol if you have it.
  • Control your blood glucose if you have diabetes.
  • Eat a healthy, balanced diet with lots of fruit and vegetables and low amounts of saturated fat.
  • Only drink alcohol within the recommended limits.

As well as making lifestyle changes, some studies suggest that trying to keep as active as possible, with lots of interests and hobbies might help prevent Alzheimer’s disease. Other researchers have found that spending more time in education may also help to lower your risk.

It’s not yet known whether eating oily fish or taking B vitamins can reduce the risk of Alzheimer’s disease because studies so far have had mixed results.

Further videos

See our videos related to this topic:

  • An introduction into dementia care homes
  • Depression in old age
  • Helping elderly people live independently
  • Life story

I have been diagnosed with mild cognitive impairment. Does this mean I will develop Alzheimer's disease?

Answer

No, a diagnosis of mild cognitive impairment doesn't mean that you will necessarily develop Alzheimer's disease.

Explanation

Mild cognitive impairment is a term used by doctors to describe age-related exaggerated absent-mindedness. If you have this, it means you have some problems with your memory, but it doesn’t mean that you have dementia.

Mild cognitive impairment isn't a specific medical condition or disease. People with it don’t usually have any other signs or symptoms of dementia. It's very common to have memory problems, particularly as you get older, and most people will have this at some time in their lives.

There can be a number of reasons why you may have developed memory problems. With age, memory becomes more inefficient. However, exaggerated forgetfulness can also be caused by stress, anxiety, depression or a physical illness. It's important to see your GP if you have memory problems.

Although many people with mild cognitive impairment find their memory improves or remains stable and they don't go on to develop dementia, for some it can be an early symptom of Alzheimer's disease.

There aren't any tests to find out the cause of mild cognitive impairment or to tell if it will lead to Alzheimer's disease or another type of dementia. Talk to your GP if you're worried about mild cognitive impairment and Alzheimer's disease.

Does aluminium cause Alzheimer's disease?

Answer

Doctor's don't yet know exactly what causes Alzheimer's disease, but it's thought to be a combination of factors. At the moment, there is no direct evidence to show that aluminium causes the condition.

Explanation

Aluminium is a metal found in some of the foods we eat and in drinking water. It's also used to make packaging, cooking pots and pans, and some medicines. The aluminium that you eat or drink passes through your body and very little of it is taken in.

During the 1960s and 1970s researchers discovered a possible link between aluminium and Alzheimer's disease. Since then, more research has been done that found some links but hasn't shown that aluminium causes dementia. It's difficult for researchers to be more sure of the effects of aluminium because Alzheimer's disease is a common condition that has many causes, and because aluminium is found in many places in our environment.

Can Ginkgo biloba help to treat Alzheimer’s disease?

Answer

Ginkgo biloba is a herbal remedy traditionally used to improve memory. The results of research on the effects of taking Ginkgo biloba to treat Alzheimer's disease are uncertain. Some research shows that it may help to improve symptoms whereas other research shows no effects.

Explanation

Ginkgo biloba comes from the maidenhair tree and has been used in traditional Chinese medicines for many years. A number of research trials have looked at whether or not Ginkgo biloba may be able to treat dementia. The results of this research have been mixed, some showing that it may help to improve symptoms and other research showing no effect. A study published in the Journal of the American Medical Association found that Ginkgo biloba was no better than a placebo (dummy pill) for preventing cognitive decline in older adults.

Ginkgo biloba can cause bleeding if you take it with warfarin or aspirin and it may also cause health problems if mixed with some other medicines. Don’t start taking any herbal remedies without speaking to your GP or pharmacist first.