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Alzheimer’s disease

Alzheimer’s disease is a neurodegenerative disease most prevalent in the elderly and is the principal cause of dementia. The exact cause is still unknown; nonetheless, it is a multi-factorial dysfunction related to aging. Growing evidence supports the contribution of modifiable environmental factor and non-modifiable factors such as genetics and aging.

Symptoms

The Alzheimer’s Association has created a list of warning signs of Alzheimer’s disease and other types of dementia. Each individual may experience one or more of these signs in various differing degrees. If you notice any of these signs, you should check with your doctor.

1. Memory loss that disrupts daily life

One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.
What's a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.

 

2. Challenges in planning or solving problems

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things that they did before.

What's a typical age-related change? Making occasional errors when adding and subtracting.

 

 

3. Difficulty completing familiar tasks at home, at work or at leisure

People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

What's a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.

 

4. Confusion with time or place

People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What's a typical age-related change? Getting confused about the day of the week but figuring it out later.

 

5. Trouble understanding visual images and spatial relationships

For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.

What's a typical age-related change? Vision changes related to cataracts.

 

6. New problems with words in speaking or writing

People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock").

What's a typical age-related change? Sometimes having trouble finding the right word.

 

7. Misplacing things and losing the ability to retrace steps

A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

What's a typical age-related change? Misplacing things from time to time and retracing steps to find them.

 

8. Decreased or poor judgment

People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

What's a typical age-related change? Making a bad decision once in a while.

 

9. Withdrawal from work or social activities

A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

What's a typical age-related change? Sometimes feeling weary of work, family and social obligations.

10. Changes in mood and personality

The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

What's a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Prevention

Prevention in the pre-symptomatic phase is probably the most effective way to diminish the incidence of this associated unstoppable neurodegenerative condition and the burden that it has on the individual and on society.

Traditionally, prevention has been divided into three levels:

  • Primary prevention: the reduction of the incidence of the disease by means of eliminating or treating the specific risk factors that can increase or speed up the development of the specific illness
  • Secondary prevention: the objective is to detect the illness at an early stage, before there are any symptoms, when treatment can stop or limit its progression
  • Tertiary prevention: to minimize the impact of the complications and disability of the patient long term to help the patient maintain an acceptable quality of life

 

The origin of the illness is multi-factorial resulting from the complex interactions of aging, genetics, lifestyle and environmental factors.

The principal risk factors for late-onset development of Alzheimer’s disease are advanced age, APOE ε4 genotype, head lesions, family history, low levels of education and low participation in stimulating cognitive activities. Other non-genetic risk factors include high blood pressure, high cholesterol levels, poorly controlled diabetes and a history of head trauma. Of all of them, advanced age is the most important risk factor as it doubles each 5 years after the age of 65.

The incidence of Alzheimer’s disease could be reduced by a better access to education and the use of effective methods directed to reducing the risk factors of vascular illnesses (for example, physical inactivity, smoking, hypertension, obesity and diabetes) and depression.

Gene or region studied

  • APOE
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