What is Alzheimer’s?
Alzheimer’s disease is a type of dementia that causes memory and thinking problems that worsen over time.
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Warning Signs
If you or a loved one is experiencing issues with memory loss and are concerned it could be Alzheimer’s disease, the Alzheimer’s Association has 10 Warning Signs that can alert you to symptoms that need further evaluation.
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Neurofibrillary Tangles
This theory involves highways, or microtubules, inside brain cells that start to crumble because their support proteins (tau proteins) begin to deteriorate causing the brain cell to no longer function and die.
Causes
Alzheimer’s disease is a result of progressive degeneration of nerve cells that is not a normal part of aging. No one really knows for certain what causes Alzheimer’s, but several theories have been proposed based on changes in the microscopic appearance of abnormal proteins found in the brain.
Amyloid
Our brains produce a certain protein called amyloid precursor protein, which is essentially “cut” by enzymes.
Learn MoreWhat is Alzheimer’s?
Dr. Alois Alzheimer documented the first case of Alzheimer’s disease more than 100 years ago. Since then, it has become an epidemic and will worsen unless we can prevent it or find effective treatment.
Alzheimer's is the most common form of dementia making up more than 60 percent of all diagnosed dementias. Alzheimer's causes a gradual onset of memory loss followed by a continued decline in other areas of thinking and decline in physical functioning.
In addition to other symptoms, people with dementia and Alzheimer’s are prone to mood swings and behavior changes that can include agitation, loss of motivation and social withdrawal. People with Alzheimer’s or dementia can also show compulsive or obsessive behavior, decreased interest in hobbies or other activities they previously enjoyed and may display socially unacceptable behaviors.
Alzheimer’s usually leads to difficulty managing everyday activities, such as household affairs, eventually followed by losing the ability to care for oneself after some years. Communication abilities are lost over time, and walking, bladder and bowel control are often affected in late stages of the illness.
While people in their 40’s and 50’s can get Alzheimer’s, the greatest risk factor is getting older: the average age at onset is in the 70’s. Life expectancy ranges from 8 – 10 years following diagnosis.
Warning Signs
1. Memory loss – problems remembering recent events/information.
2. Difficulty performing common tasks – everyday activities, such as paying bills, taking medications, household chores, etc. become more difficult.
3. Problems with language – forgetting simple words or substituting unusual words on a frequent basis.
4. Disorientation to time and place – forgetting the day of the week or time of day and/or getting lost in familiar places.
5. Poor or decreased judgment – buying unnecessary items from telemarketers, giving away money or making bad decisions that are inconsistent with past behavior.
6. Problems with abstract thinking – more difficulty with complex mental tasks such as planning and organizing, forgetting how to use familiar items such as a computer, etc.
7. Misplacing things – finding missing items or things in unusual places – like finding car keys in the refrigerator.
8. Changes in mood or behavior – ranging from a depressed/withdrawn mood to becoming more irritable and getting angry and upset easily.
9. Changes in personality – becoming confused, dependent, fearful, suspicious and/or self-absorbed.
10. Loss of initiative – loss of interest in usual activities; may be sleeping more or watching TV throughout the day.
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Amyloid
If cut the right way, in a healthy brain, the pieces left are easily eliminated from the brain. But, for whatever reason, the cutting of this protein in the brain of people predisposed to Alzheimer’s is inappropriate. The pieces that are left clump together and form “amyloid plaques,” and it is believed that this cascade of events results in damage to the brain cells.
The Toll of Alzheimer's
Alzheimer’s takes a devastating financial, physical and emotional toll on individuals with the disease as well as their families.
Who's Affected
Currently, about 5.4 million people in the U.S. are affected by Alzheimer’s disease, and that number is only expected to increase as baby boomers age. According to the Alzheimer’s Association, someone in America develops Alzheimer’s every 70 seconds.
Cost
The cost of health care for someone with Alzheimer’s disease is three times more than for people without dementia. A recent report notes that the federal government alone spends in excess of $100 billion per year on Alzheimer’s-related care. This data foreshadows an emerging national health care crisis.
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Help End Alzheimer's disease
There are many ways to support Banner Alzheimer’s Institute in its mission to end Alzheimer’s.
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Make a Gift
Many of the vital patient care programs, community services and technological advances at Banner Alzheimer’s Institute are made possible by generous contributions from individuals, corporations and foundations that recognize their value and responded to a call for support.
Make a Gift >
Volunteer
At Banner Alzheimer's Institute, we are fortunate to have the faithful support of volunteers who recognize and embrace the many benefits of giving back.
Volunteer >
Clinical Trials
Virtually any advancement in the treatment and prevention of Alzheimer’s disease is tied to research and the commitment of individuals who are willing to take part in the study process.
Learn about clinical trials >Help End Alzheimer's
Charitable gifts are a welcome investment in the health and wellness of our community and the world. A gift of your time and talent as a volunteer at our facility to make a difference in the lives of Alzheimer’s patients and caregivers is appreciated.
For those who qualify, signing up for a clinical trial is a gift that could benefit future generations.
No matter what way you support Banner Alzheimer’s Institute and the Banner Alzheimer’s Foundation, you play a vital role.
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Prevention
While there is no proven way to reduce a person’s risk of getting Alzheimer’s disease, a number of risk-reducing strategies have been suggested, including lifestyle changes along with other health-promoting activities.
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Lifestyle
As the medical and scientific community continues to look for ways to prevent Alzheimer’s disease, they do know that lifestyle can be one factor in prevention. While there are no definitive answers yet, the Alzheimer’s Association recommends eating a brain-healthy diet and staying mentally, socially and physically active to reduce your risk factors.
Trials
Clinical Trials
We are providing access to tomorrow’s treatments today and giving hope to those touched by Alzheimer’s. In order to do this, we need the continued support and involvement of an engaged global community of people with or at risk of Alzheimer’s and other forms of dementia and families willing to participate in the research process.
Clinical Trials >
Research
Everyone can help make the evaluation of treatments to prevent Alzheimer’s disease a national priority. We can all help researchers launch the era of Alzheimer’s prevention research, find faster ways to evaluate the range of promising prevention therapies, and demonstrate which ones work as quickly as possible. Together, we may be able to make a difference!
Alzheimer's PreventionInitiative >
Diet
A diet that is heart healthy is also shown to be brain healthy. It is recommended that a diet low in fat and cholesterol reduces the risk of heart disease, controls diabetes and will also encourage blood flow to the brain. This blood flow helps deliver nutrients to your brain to help it function at its best.
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Exercise
Exercise keeps your body moving and blood flowing to the brain and encourages new brain cell development.
Learn MorePrevention
While the list of suggested but unproven risk-reducing treatments is long, here are a few recommendations:
• Exercise your body, exercise your mind, and remain socially active.
• Stop smoking, lose those extra pounds, and treat your diabetes.
• Lower your cholesterol, lower your blood pressure, and recognize the growing evidence suggesting a relationship between a healthy heart and healthy brain.
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Diet
The Alzheimer's Association makes the following recommendations:
• Manage your weight to promote health of your body and brain.
• Reduce consumption of fat and cholesterol.
• Eat foods that reduce your risk of heart disease and stroke such as omega-3 fatty acids, vegetables and fruit that contain antioxidants and nuts that are a source of Vitamin E.
• Vitamins, such as E and C, and vitamin B12 and folate, may help reduce your risk of developing Alzheimer’s.
- Source: Alzheimer's Association.
Exercise
Aerobic exercise doesn’t have to be strenuous to improve oxygen consumption, which benefits your brain. A daily dose of 30 minutes of exercise not only helps your brain, it benefits your heart too. And to further increase the benefits include activities that make you flex some mental muscle such as using a map for your walking route or exercising with a partner for the added benefit of social interaction.
- Source: Alzheimer's Association.
Telling Family and Friends
Deciding if and when to let friends and family know that you have been diagnosed with dementia can be a difficult decision. When diagnosed with a chronic illness, many people fear that others will treat them differently, which can lead to social phobia.
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Know Yourself
It is important to know what your diagnosis means and what it doesn’t. You want to be prepared to answer questions asked by family and friends. Therefore, you must educate yourself first. Ask questions of your doctor that you think other people might want to know. Having answers will better equip you to let friends and family know how they can help support you.
Where, When, Who
Take a planned and thoughtful approach to disclosing your diagnosis to friends and family.
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Know Your Resources
Banner Alzheimer’s Institute offers valuable resources for patients and caregivers through our Family and Community Services program. The Alzheimer’s Association also is an excellent resource for you to begin to learn more about your disease.
Family and Community Services >Telling Family and Friends
However, the most important thing you can do after being diagnosed is to keep on living life to its fullest and change as few things as possible. It is also important to know what to expect and what the future may hold, and take a realistic approach to emphasizing your abilities while finding support for your disabilities.
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Where, When, Who
Consider who will provide you with support and who will cause you distress. By doing this, the fear of disclosure can be replaced with the security of knowing that your friends and family will be there for you when you need them.
Only disclose when you are ready and when you feel it will be beneficial to you. Use a strict need to know rule if you find yourself questioning which friends or family members to tell. Choose a setting and time when you can meet personally and address your family member or friend’s concerns, and come prepared with information to help answer their questions. Let them know how they can support you now and in the future.
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Caring for a Loved One
Today, an estimated 10 million Americans are caring for someone with Alzheimer’s disease or another dementia. According to the Alzheimer’s Association, more than 40 percent of caregivers rate their emotional stress level as high or very high.
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Our Aproach to Care
Banner Alzheimer’s Institute provides a unique model of care. We not only care for the patient, we help the patient and caregiver live in the moment and find joy.
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Resources
Our resources were designed to help the person with dementia and their care partners understand some of the basic principles of living with dementia.
resources >
Classes
Our unique model of care supports patients and the entire family. To help everyone cope, learn and find joy, we offer a variety of ways to learn how to live successfully with Alzheimer’s disease/dementia and care for someone with a progressive illness.
classes >
Support
As one of the nation’s leading providers of clinical resources for Alzheimer's disease, we offer a comprehensive series of support programs to help caregivers.
support groups >Caring for a Loved One
A diagnosis of Alzheimer's disease or related dementia can impact family and friends as much as the diagnosed person. But remember, you’re not alone. Banner Alzheimer’s Institute’s renowned, passionate team is here to provide hope and help now by connecting you to the information, resources, and support programs that will assist you along the journey.
Our Approach to Care
Living with Alzheimer’s disease, or being a caregiver for someone with Alzheimer’s disease, is a struggle.
No two people with dementia or their families are the same in how they live with Alzheimer’s disease or a related dementia. Each will have to create their own “road map” along the way.
We are here to help. We believe that people living with Alzheimer’s/dementia and their caregivers can both survive and thrive.
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Diagnosis
Just because some memory and thinking changes are a part of normal aging, doesn’t mean all are. It’s estimated that one-third of older adults with memory loss never receive a diagnosis for their symptoms.
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When
Families may be unsure about whether to seek a diagnosis or believe that nothing can be done. Some may think that the memory loss is not severe enough to warrant an evaluation, or are generally fearful of what may be found.
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Why
Early diagnosis of Alzheimer's disease can help patients begin treatment as soon as possible in an effort to slow progression of the disease. Early diagnosis can also help the patient and family prepare for what’s to come.
How
At Banner Alzheimer’s Institute, we use the following tools to test for and diagnose Alzheimer’s disease:
Learn MoreDiagnosis
The diagnosis of Alzheimer’s disease is based on comprehensive medical testing and examination. During that process, it can gradually become clear that the picture is typical for Alzheimer’s, and other diseases are gradually excluded. A thorough evaluation leads to a clear diagnosis most of the time. However, there is no single test that can diagnose Alzheimer’s yet: the only way (so far) to be 100% certain is to have a careful clinical evaluation and also see characteristic brain tissue changes under the microscope. Remember, it can take several years for symptoms of the disease to appear fully.
When
Families often seek a diagnosis when:
• Memory impairment is evident and affecting daily function.
• Episodes of confusion are noted.
• Problems with finding or substituting words is a growing concern.
• Personality changes from the normal.
• Complaints of declining memory increase.
• Safety issues arise, including living alone and driving.
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How
• Medical history and interview with family/caregiver
• Physical and neurological examination
• Cognitive testing
• Blood analysis
• Brain imaging
• Additional neurological testing if necessary
We, and others, only consider brain biopsies in very unusual circumstances (such as in young people with rapidly progressive symptoms).
When It's Not Alzheimer's
In addition to Alzheimer’s disease, there are an estimated 4 million to 5 million people living with non-Alzheimer’s dementias and other forms of cognitive impairment.
Mild Cognitive Impairment (MCI)
Mild cognitive impairment is a term used to describe subtle but notable changes in language, attention, reasoning, judgment, reading and writing.
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Lewy Body Dementia (LBD)
LBD is a form of dementia that shares symptoms of both Alzheimer’s and Parkinson’s disease.
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Vascular Dementia (VaD)
Vascular dementia, often occurring in combination with Alzheimer’s disease, is a deterioration of mental function caused by multiple strokes (infarcts) in the brain.
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Fronto - Temporal Dementia (FTD)
FTD is a term referring to a group of similar conditions that affect the front (frontal lobes) and the sides (temporal lobes) of the brain.
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Mild Cognitive Impairment (MCI)
The most common complaints noted are memory problems. People with MCI carry out everyday activities without difficulty; therefore they do not meet the criteria for having dementia. The most common type of MCI is called “amnestic MCI,” because it involves memory changes. Not everyone with MCI will go on to develop Alzheimer’s disease. Currently, there is no approved treatment but it is recommended to treat other health problems such as diabetes, high blood pressure and depression. Managing these problems can often improve mental functioning.
Lewy Body Dementia (LBD)
LBD is characterized by gradual onset and vivid and reoccurring visual hallucinations occurring at times. Brief periods of unexplained loss of consciousness, repeated falls, sleep disturbance and sensitivity to some anti-psychotic medications also frequently occur. Life expectancy following diagnosis ranges from 5-7 years.
Vascular Dementia (VaD)
The onset may be sudden, depending on the size and location of the stroke. Although vascular dementia is not reversible, treatment of risk factors, particularly high blood pressure, may modify or slow its progression.
Losses in function, memory and language may appear much like Alzheimer’s, although due to continued strokes, sudden changes may be more evident. Life expectancy for someone with vascular dementia is highly individual and depends on the nature of the cardiovascular problems that are causing the dementia, along with the person’s age and other medical conditions.
Fronto - Temporal Dementia (FTD)
The first symptoms often involve changes in personality, judgment, planning and social functioning; sometimes the ability to speak or understand speech is the first sign. The former is referred to as the behavioral variant, the latter as the language variant.
In the behavioral variant, individuals may make rude or inappropriate remarks to family or strangers. They may make unwise decisions about finances or personal matters and are prone to excessive eating and/or sexual disinhibition. Some individuals may demonstrate difficulty with language that includes the inability to produce a sentence, while others may not be able to understand what is being said. Most people affected by FTD are between 50-70 years of age. Life expectancy averages about 8 years following diagnosis.
Disease Progress
Alzheimer’s disease and related dementias are serious neurological conditions that worsen over time.
All types of progressive dementias will eventually lead to extensive deterioration of the brain, but each person will change differently over time.
Stages
Alzheimer’s disease progression is grouped into three stages that measure how someone thinks and goes about their daily life: mild, moderate and advanced.
Treatment
Currently there is no cure for Alzheimer’s, but there are several medications approved for use in people who have Alzheimer’s disease.
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Mild
During the mild stage, which is early in the disease, the following symptoms become apparent:
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Advanced
Some specific examples of behaviors that people exhibit in the advanced stage include:
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Moderate
Some specific examples of behaviors that people exhibit in the moderate stage include:
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Lifestyle
There are some general guidelines for diet and proper nutrition for those with Alzheimer’s and dementia.
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Treatment
As a general rule these medications do not bring much improvement. However, they may slow the progression and help people maintain daily living skills longer into the disease. They may also prevent the emergence of behavioral and psychiatric symptoms such as depression, paranoia, illusion, and persistent false ideas. Medications used in Alzheimer’s include cholinesterase inhibitors and memantine (Namenda™).
The cholinesterase inhibitors are also known as “cholinergics.” There are currently three medications approved in this category:
• Aricept™
• Exelon™
• Razadyne™
One of these medications should be prescribed as soon as the diagnosis is made. As a general rule, the medication is continued indefinitely unless the caregiver and physician determine together that the medication is no longer benefiting the person. Only one of these medications is given at a time.
Mild
• Difficulty with short-term memory
• Poor decision-making, concentration
• Inability to function appropriately in emergencies
• Loss of ability to live alone
• Problems remembering the right word or name
• Diminished reading comprehension
• May become depressed or socially withdrawn
• Trouble handling finances
• Gets lost/mixed-up when driving in familiar places
• May be involved in “fender benders”
• Difficulty with medication management and administration
Advanced
• Severely impaired memory for recent and past events
• Unable to follow simple commands
• Unable to carry on a meaningful conversation
• May cry out spontaneously
• Difficult to engage, appears withdrawn
• Has difficulty interacting/responding to surroundings
• Forgets how to walk without help; may lead to eventual loss of body movement
• Relies totally on caregivers for:
- Dressing
- Grooming
- Bathing
- Feeding
- Bladder/bowel
• May forget to chew food or swallow
• May lose ability to sit up, hold head up and/or smile
At this stage, hospice care can be very beneficial for both the person with dementia and the family.
Moderate
• Difficulty with short- and long-term memory
• Forgets own personal history
• May begin to forget friends and family members
• No sense of time
• Repetitive questions and behaviors
• May not understand what is being said
• Little or no reading comprehension
• More easily upset and frustrated
• May appear to lack emotion
• Fatigues quickly
• Onset of late-day confusion, agitation
• Needs increased daytime rests to maintain function and mood
• Needs help with bathing, grooming, dressing
• Bladder and Bowel
- Difficulty finding the toilet
- Does not recognize mirror image thus evacuated in inappropriate places
- Forgets to wipe and/or flush
- Incontinent episodes
• Movement
- Shuffles
- Postural change - leans forward
- Frequent falls
• Eating
- Forgets to eat or drink
- Forgets how to use silverware
- May lack table manners
Lifestyle and Diet
• Eat a good balanced diet that is rich in protein, fruits, whole grains, vegetables and some starch.
• Appetite may come and go, try five or siz small meals a day instead of larger meals, if they have a poor appetite use small frequent feedings of high calorie foods.
• A multivitamin can help to maintin proper nutrition.
• Commercial nutritional supplement drinks are not better than real food, but if you enjoy milkshakes use instant breakfast drinks mixed with whole milk.
• Drink enough fluids. Lack of hydration leads to constipation, urinary infections and can cause early loss of bladder control.
