What is Alzheimer’s?

Alzheimer’s is the most common form of dementia.

Dementia is an umbrella term for a number of memory loss conditions, which also include problems with thinking and behavior. This frightening disease affects over 28,000 New Zealanders.

What Causes Alzheimer’s?

Alzheimer’s is a complex disease, but scientists believe the cause is a combination of genetic, lifestyle, and environmental factors. However, the root causes aren’t yet fully understood, making finding a cure difficult.

What is certain is that Alzheimer’s damages and kills brain cells. Someone who has Alzheimer’s has fewer brain cells, and the connections between those cells are less numerous than someone with a healthy brain.

As the disease progresses, the brain shrinks and develops plaques. These plaques destroy brain cells and interfere with cell-to-cell communication. An affected brain may also show the presence of tangles. Threads of protein twist into tangles inside the brain cells, which leads to the failure of the brain’s nutrient transport system.

Even a century after Alzheimer’s was first described, scientists still do not have a definitive cause.

What Are The Symptoms Of Alzheimer’s?

Are you frequently forgetting things?

Relax.

Everyone has memory lapses, so being forgetful does not mean you have Alzheimer’s.

What separates Alzheimer’s from common forgetfulness is persistent and worsening memory loss over time. Eventually, memory becomes so bad it will affect an individual’s ability to carry out everyday functions.

According to the Mayo clinic, people with Alzheimer’s may:

• “Repeat statements and questions over and over, not realizing that they’ve asked the question before.
• Forget conversations, appointments or events, and not remember them later.
• Routinely misplace possessions, often putting them in illogical locations.
• Get lost in familiar places.
• Eventually forget the names of family members and everyday objects.
• Have trouble finding the right words to identify objects, express thoughts or take part in conversations.”
  

Reasoning ability may be affected. Problems involving simple numbers may become more and more difficult. More complex numerical tasks, such as managing finances, balancing checkbooks, and paying bills on time may become impossible.

Judgement can be affected. Is a person making basic but significant errors when undertaking familiar tasks, like driving, cooking or housework? Eventually, people with advanced Alzheimer’s struggle with the most basic tasks; including getting dressed, going to the bathroom or having a shower.

A person may experience a combination of more benign conditions; such as depression, mood swings, irritability, loss of inhibitions, and mild delusions. Again, these are common conditions and do not necessarily mean someone has Alzheimer’s, but if a person experiences a combination of these conditions, and the problems appear to be getting worse, they should see a doctor for evaluation.

Curiously, skills learned early in life, like reading, speaking and singing are among the last abilities to be lost as the disease progresses. This is because Alzheimer’s affects different areas of the brain, not related to these skills, first.

Alzheimer’s Disease Stages

Alzheimer’s is a progressive disease. It gets steadily worse over time, and brain changes can begin many years before the signs of the disease appear. This time period is known as preclinical Alzheimer’s disease.

Whilst there is some overlap, the general stages are characterised as:

• Mild
• Moderate
• Severe

Mild Alzheimer’s may be barely noticeable. Moderate will involve noticeable issues, but the person may still be able to function. Whereas, severe Alzheimer’s involves a significant breakdown of common functions needed for everyday life.

There is additionally a more granular scale which breaks the progression of Alzheimer’s disease into seven stages. These stages range from “No Impairment” through to “Very Severe Decline”. In this final stage, patients lose the ability to respond to their environment or communicate.

On average, a person with Alzheimer’s lives four to eight years after diagnosis. However, some people can live as long as twenty years.

Alzheimer’s Treatment

There is currently no cure for Alzheimer’s. However, medications can help manage memory symptoms and other cognitive changes.

The most common drugs in use include:

Cholinesterase inhibitors: These drugs work by boosting levels of cell-to-cell communication. Cholinesterase inhibitors can also help to improve symptoms, such as agitation or depression.

Memantine (Namenda): This drug slows the progression of symptoms in moderate-to-severe stages of Alzheimer’s disease. It is sometimes used in combination with a cholinesterase inhibitor.

Sometimes, more common medications are used in combination with those listed above. These include sleep and anti-anxiety medications.

There has been considerable interest in a range of other treatments, not traditionally used for Alzheimer’s, too. Whilst there is much quackery, there are some treatments and products that may help:  

“It has been suggested that oestrogen replacement therapy for postmenopausal women might delay the onset of Alzheimer’s disease, or prevent postmenopausal women from ultimately developing Alzheimer’s disease.”

Statins are also being tested:

“These cholesterol-lowering drugs have been associated with a lower risk of developing dementia, but to date no study has shown that these agents are effective in the treatment of dementia. One large trial is in progress using a statin and Aricept.”

Even Folic Acid:

“At least two studies have suggested that high levels of homocysteine and/or low levels of folic acid may be associated with a higher rate of developing Alzheimer’s disease later on. One trial of folate supplementation in those with normal cognition, showed a reduced risk of cognitive decline, but at this stage there is no evidence that folate prevents Alzheimer’s disease”

Can We Reverse The Process Of Alzheimer’s?

Sadly, no drug will stop Alzheimer’s, or cause the condition to reverse. Alzheimer’s can only be managed.  

However, new research has been encouraging. A new drug called Aducanumab is in clinical trial. This drug helps to prevent the buildup of plaques in those patients with early stage Alzheimer’s, and is showing interesting and encouraging results.

Meanwhile, a new way to treat Alzheimer’s has reached phase II of testing in the United States. Proprietary drug bryostatin is designed to be used on moderate-to-severe patients and is showing great promise.

There have been claims made that natural remedies may help, including Coconut oil:

“A recent University of Oxford study suggested that although the effects of coconut oil may be temporary, Alzheimer’s and dementia patients have indeed seen short-term benefits resulting from its use. This research supports Dr. Newport’s theory that ketones, which are byproducts of the breakdown of fats in the body, play an important role in brain health. The idea is that by boosting ketones, found in coconut oil, we can improve cognitive function.”

However, there is no concrete evidence that Coconut oil will do anything to stop Alzheimer’s.

Further Resources:

• Alzheimer’s New Zealand – A very useful website that provides general information and support to the New Zealand Alzheimer’s community.
• What is Dementia? – A more broad article about Dementia and the group of diseases that come under this term.
• Your Local Alzheimer’s Support – A list of local Alzheimer’s Support Organisations and Representatives can be found here.