Around 60% of people diagnosed with dementia will have Alzheimer’s disease. Although you can have Alzheimer’s under the age of 65, it’s 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.
How does Alzheimer’s develop?
Research suggests that 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, for example, trouble finding words, frequent repetition and problems following and taking an active part in conversations.
People with Alzheimer’s may also 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.
Changes in ability to process and interpret visual information may lead to problems with spatial awareness, judging distance and steps or stairs.
People with Alzheimer’s may have difficulties with decision making, problem solving, planning and sequencing tasks.
The changes in the hippocampus may also 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 peopleunder 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.
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:
Some risk factors are not modifiable, but research suggests up to one in three cases of Alzheimer’s disease are preventable. Some ways to reduce your risk factors are:
Have regular health care checks with your GP. If you have a long-term condition like diabetes or thyroid problems, it’s important to keep it well managed.
Take advantage of ‘well-person health checks’ at your GP surgery so your blood pressure, weight and cholesterol levels are well managed.
If you’re prescribed medication make sure you understand what it’s for, that you take the right dose, 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 make sure you’re eating healthily and the weight loss is maintained.
If you smoke ask your GP about support to stop so you’re more likely to be successful.
Keeping physically fit is very important, so take regular exercise like walking and swimming and do group activities like tennis and fitness classes.
Making sure you keep socially active is vital too, so you’re talking to people in group situations 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.
People with Alzheimer’s may be prescribed a type of medication called cholinesterase inhibitors. There are three options: Donepezil, Rivastigmine or Galantamine.
These medications can delay worsening of memory, thinking, language and thought processes for 6-12 months, although there is now some evidence showing 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 help with memory, reasoning, language and attention.
Planning ahead if you’ve been diagnosed
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 and 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 and Advance Care Plan in place. Doing this will give you and your family time to look at available treatments and support and make sure you’re aware of all the choices available to you for the future.
Getting some financial advice as soon as you can will help you get your finances in order and make sure you’re protected. A Lasting Power of Attorney is an important safeguard for you and anybody who is helping you with your finances. It’s best to get support from a solicitor or an organisation like Age UK with this.
Financial support is available to you regardless of your financial status. You can claim Attendance Allowance (which is non-means tested) if you’re over 65 or Personal Independence Payment if you’re under 65. 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’re renting you can get support from your local authority housing department. There are also assisted living and sheltered housing options.
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.
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
Admiral Nurses are specialist dementia nurses who give much-needed practical and emotional support to family carers, as well as the person with dementia.