What is Alzheimer's Disease? Understanding Its Impact on Seniors

1. Age. The majority of people with Alzheimer’s are 65 and older. In fact, more than 10% of the U.S. population over the age of 65 has Alzheimer’s.^[05] However, Alzheimer’s is not just a disease of old age. Early-onset Alzheimer’s can affect people in their 40s or 50s.
2. Genetics. Genetics also play a role in the onset of Alzheimer’s disease. Those with a direct family history of Alzheimer’s, particularly a parent or sibling, may have a higher risk. Certain genes have been linked to the disease, and having these doesn’t guarantee that you’ll get Alzheimer’s, but it does increase the likelihood.
3. Lifestyle factors. Overall health can influence a person’s risk as well.^[06] Conditions that damage the heart or blood vessels, such as high blood pressure, heart disease, stroke, diabetes, and high cholesterol, can all increase the risk of Alzheimer’s disease. Additionally, habits such as smoking, excessive alcohol consumption, lack of physical activity, exposure to harmful air quality, and a poor diet can contribute to the onset of Alzheimer’s.
4. Previous severe head injuries. Severe head trauma, especially injuries involving loss of consciousness or amnesia, has been linked to a higher risk of developing Alzheimer’s disease later in life. The damage caused to the brain during such incidents may initiate a series of neurological changes that lead to the development of Alzheimer’s-related brain changes and symptoms over time.
5. Lower levels of formal education. Research indicates that lower levels of formal education are associated with a higher risk of Alzheimer’s.^[06,07] This could be due to the “cognitive reserve” theory, which suggests that activities stimulating the mind, like education, build connections between brain cells, thus delaying the onset of Alzheimer’s symptoms and reducing the impact of brain changes associated with the disease.

• Memory loss that disrupts daily life. This may include forgetting recently learned information, important dates or events, and asking for the same information over and over.
• Challenges in planning or solving problems. Some people may experience changes in their ability to develop and follow a plan or work with numbers.
• Difficulty completing familiar tasks. This could include trouble driving to a familiar location or remembering the rules of a favorite game.
• Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons, and the passage of time.
• Trouble understanding visual images and spatial relationships. For some, vision problems are a significant symptom of Alzheimer’s. They may also have problems judging distance and determining color or contrast, which can cause issues with driving.
• New problems with words in speaking or writing. They may struggle with vocabulary, have problems finding the right word, or call things by the wrong name.
• Misplacing things and losing the ability to retrace steps. This is not just about forgetting where they placed their keys but could also involve placing things in unusual locations.

What are the early warning signs?

• Difficulty remembering recent events while older memories remain intact
• Repetition, such as asking the same question in a short time frame
• Difficulty finding the right words in conversations or while writing
• Increasing confusion about time, dates, and places
• Increasing difficulty in making decisions, judging distances, and understanding visual images
• Changes in mood or personality, including becoming confused, suspicious, depressed, fearful, or anxious
• Withdrawal from work or social activities that were once enjoyed ^[09]

1. Preclinical Alzheimer’s disease: This is the stage before any noticeable symptoms of Alzheimer’s appear, and it can last for years or even decades. During this phase, changes like the formation of plaques and tangles are happening in the brain, but daily functions are not yet affected.
2. Mild (early-stage) Alzheimer’s disease: During this stage, a person may start to exhibit signs of Alzheimer’s, such as memory lapses, difficulty finding the right words, or trouble with problem-solving and planning. These symptoms might be mild, but they could be noticeable enough to prompt a visit to the doctor. This stage can last from two to four years.
3. Moderate (middle-stage) Alzheimer’s disease: This stage is typically the longest and can last for many years. Symptoms become more evident and start to interfere with daily tasks. You might notice the person having difficulty remembering their own personal history, feeling moody or withdrawn — especially in socially challenging situations — or being unable to recall their own address or telephone number.
4. Severe (late-stage) Alzheimer’s disease: In this final stage, individuals lose the ability to respond to their environment, carry on a conversation, and, eventually, control movement. They may still say words or phrases but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals will need help with daily activities.

1. Medications for cognitive symptoms. Certain drugs can help manage memory loss, confusion, and other cognitive symptoms of Alzheimer’s. The most commonly used are cholinesterase inhibitors and memantine. They work by regulating neurotransmitters, the brain’s chemical messengers, helping to maintain communication among nerve cells.
2. Behavior management techniques. Symptoms like sleeplessness, agitation, wandering, anxiety, and depression are often managed through a combination of medications, environmental modifications, and behavioral strategies like validation and redirection. In some cases, certain antipsychotic medications might be prescribed.
3. Supportive services and therapies. Occupational therapy can help the individual cope with changes in their abilities, while physical therapy can help them maintain mobility. Additionally, speech therapy might be useful for those struggling with language and communication issues.
4. Lifestyle changes and home remedies. Maintaining a healthy lifestyle can help your loved one feel better overall and may reduce some Alzheimer’s symptoms. Regular physical exercise, a nutritious diet, adequate sleep, and socially engaging activities can be beneficial.
5. Clinical trials and studies. Participating in clinical trials for Alzheimer’s disease can give access to experimental treatments that aren’t available otherwise.^[10]