Alzheimer’s disease

  • Around 60% of people diagnosed with dementia, will have Alzheimer’s disease, it is the most common form of dementia in the over 65 age group.
  • Although you can have Alzheimer’s disease under the age of 65 years old it is comparatively rare.
  • Alzheimer’s Disease is a condition that gets progressively worse over time.

What causes Alzheimer’s disease?

  • The exact cause is unknown but we do know that ‘plaques’ and ‘tangles’ form in the brain due to two proteins called amyloid (plaques) and tau (tangles).
      • Amyloid is a naturally occurring protein which for a reason that is not yet understood begins to malfunction, creating beta amyloid which is toxic to the brain cells. Plaques form consisting of dead cells and amyloid protein.
      • Tau protein naturally occurs in the brain and helps brain cells communicate with each other but for a reason that is not yet understood it can become abnormal and “clump together” leading to death of the brain cells affected.
  • People diagnosed with Alzheimer’s may additionally have a reduction of a chemical in the brain (called acetylcholine). This functions as a chemical messenger to take information to and from brain cells (neurons), so a reduction in this chemical leads to information not being transmitted.

What happens?

  • Current research suggests that the changes in the brain can occur up to 10 years before a person starts to show symptoms of Alzheimer’s disease.
  • The symptoms are usually mild at the beginning and gradually worsen over time.
  • Difficulties with language may develop e.g. word finding problems; frequent repetition; problems following and taking an active part in conversations.
  • The person experiencing the changes due to Alzheimer’s disease may become agitated or depressed and may withdraw from family and friends.
  • Memory lapses tend to be most common and these occur due to changes in the area of the brain (hippocampus) that manages the movement of information from short to long term memory and orientation.
  • Our ability to process and interpret visual information may lead to problems with: spatial awareness; judging distance; steps or stairs.
  • The person experiencing these changes may have difficulties with decision making, problem solving, planning and sequencing tasks.
  • The changes in the hippocampus may lead to disorientation of time or place, or a person not recognising familiar faces. 

Possible risk factors

  • Age: people diagnosed with Alzheimer’s disease tend to be over the age of 65. Over the age of 80 there is a one in six chance of developing Alzheimer’s.
  • Gender: twice as many women over the age of 65 are diagnosed with Alzheimer’s than men.
  • Genetics: in rare cases, Alzheimer’s disease can be passed from one generation to another. This type of dementia usually affects people under the age of 65.
  • Poor physical health or inadequately controlled physical disorders such as diabetes or heart disease.
  • Lifestyle choices e.g. smoking; lack of exercise; excessive use of alcohol.

Preventing dementia

Some risk factors are not modifiable, but research suggests up to one in three cases of Alzheimer’s disease is preventable. Individuals can reduce their risk factors by: 

  • Having regular health care checks with your GP, if you have a long term condition like diabetes or thyroid problems, is important to keep these conditions well managed. 
  • Take advantage of ‘well-person health checks’ at your GP surgery so that your blood pressure, weight and cholesterol levels are well managed. 
  • If you are prescribed medication make sure you understand what it is for, you are compliant with the dosage and that you have regular reviews with your GP. 
  • If your weight has changed over the years seek support with your diet and monitoring of weight loss to ensure you are eating healthily and the weight loss is maintained. 
  • If you smoke ask your GP about a smoking cessation programme so you have some support and care and are successful in giving up.    
  • Keeping physically fit is very important, so taking regular exercise like walking, swimming and group activity like tennis and fitness classes.
  • Making sure you keep socially active is important, so that you are talking to people in a group situation as well as one to one. 
  • Hobbies like art, woodwork, needlework, knitting, puzzles and listening to music help stimulate different areas of the brain and help with attention and concentration.

Medication

  • You may be prescribed one of three types of medication called cholinesterase inhibitors: Donepezil; Rivastigmine and Galantamine
  • These medications can delay worsening of memory, thinking, language and thought processes for six – 12 months although there is now some evidence showing that they can benefit a person for much longer. They support the communication between the nerve cells in the brain by stimulating the production of acetylcholine.
  • Memantine can also be prescribed in the moderate to severe stage of Alzheimer’s disease alongside one of the above medications.  This medication blocks the effects of excess glutamate in the brain. Memantine can assist memory, reasoning, language and attention.

Planning ahead if you have received a diagnosis   

  • Talk to your family and the people close to you about the future. Think about what help you would like. 
  • You may also like to think about things you would really like to do, people you would like to meet, holidays you would like to plan. Having some plans in place helps with a positive outlook on the future and opens up conversations with people who care about you and would like to support you.
  • Thinking about your future health needs can be difficult and feel like an unnecessary step but it will help you and the people who know you well to choose treatments and services that you would prefer in the future. You can put a Health and Welfare Power of Attorney in place and an Advance Care Plan. Putting these things in place will give you and your family time to look at treatments and support that is available and make sure you are aware of all the choices that are available to you for the future.
  • Gaining some financial advice as soon as you can will help you get your finances in order and make sure your finances are protected. A Lasting Power of Attorney is an important safeguard for you and anybody who is helping you with your finances. It is best to get support from a solicitor or an organisation like Age UK to help you with this. 
  • Financial support is available to you regardless of you financial status. You can claim for Attendance Allowance (which is non-means tested) if you are over 65 years or Personal Independence Payment if you are under 65 years. If you live with another person you can also claim a 25% council tax reduction from your local authority. 
  • There are a variety of housing options to choose from. If you are renting you can get support from you local authority housing department. There are also choices of housing in the assisted living and sheltered housing options.

Support

If you suspect you have Alzheimer’s disease, make an appointment with a GP so they can ask you questions about your concerns, and perform a physical examination to rule out any other potentially treatable conditions that could give similar symptoms e.g. infections, side effects of medication.

If your GP suspects Alzheimer’s disease they will make a referral to a memory clinic or other specialist clinic for further tests and diagnosis.

Contact our Admiral Nursing Direct helpline for support and advice: 0800 888 6678.

Research

Over the last couple of years more money has been pledged by the UK government and other countries world wide to research into the causes and find a cure for dementia. Subject to research processes and certain criteria, there are opportunities to be part of a research studies. To find out more or register your interest, see: Join Dementia Research