Alzheimer's disease

What is Alzheimer's disease?

Dementia is a set of symptoms relating to mental abilities, like memory loss and problems with language and thinking. This can develop when your brain is affected by diseases, including Alzheimer's.

Alzheimer's is a physical disease that causes shrinking of your brain tissue (called ‘atrophy’) and the death of brain cells. It’s a progressive disease, which means there’s a gradual decline in brain function over time.

What causes Alzheimer's disease?

In healthy brains, billions of nerve cells connect with one another, and chemicals play an essential role in helping to send messages between these cells.

In Alzheimer's, proteins can build up and create ‘plaques’ and ‘tangles’, causing these connections to become lost. There is also a drop in levels of your brain’s chemical messengers, and signals aren’t passed efficiently between cells.

Over time, more parts of the brain become affected and eventually, there is loss of brain tissue, and nerve cells die.

Who gets Alzheimer's?

The following factors are thought to increase your risk of developing Alzheimer's:

• Older age

• Family history of Alzheimer's

• Lifestyle factors like smoking and obesity

• Conditions linked to cardiovascular diseases, diabetes, high blood pressure and high cholesterol

• Having Down’s Syndrome

• Having a severe head injury

Alzheimer's symptoms and stages

Alzheimer's symptoms worsen progressively over time and can generally be grouped into early, mid and late-stage symptoms. The rate of progression is different for everyone and can be affected by other conditions, like stroke.

Early-stage symptoms

In the early stages of Alzheimer's, the main signs and symptoms are related to memory problems and can often be dismissed as a normal part of ageing. For example, you might have problems:

• Remembering recent conversations or interactions

• Recalling names and places

• Thinking of the right word

• Remembering where you have left items like your phone and keys

Other signs in the early stages include:

• Becoming inflexible and reluctant to try new things

• Finding it hard to make decisions

• Mood changes

• Anxiety

• Feeling agitated and confused

Mid-stage symptoms

Many of the early-stage symptoms become worse, like struggling to remember names of family and friends and beginning to have difficulties recognising who they are.

Other common symptoms include:

• Easily becoming disorientated – you may get lost in familiar places or wander around for no reason

• Communication problems with speech and language

• Difficulties sleeping

• Changes in mood and emotions, like mood swings, anger, frustration, depression and anxiety

• Becoming deluded, paranoid or suspicious and not trusting carers

• Experiencing hallucinations, where you see or hear things that aren’t there

• Needing help and support with day-to-day activities like dressing, washing and eating

Later-stage symptoms

The later stages of Alzheimer's can be distressing for people with the disease and their carers and relatives. At this stage, symptoms become more severe, and full-time care is usually needed to help with moving, eating and other daily activities.

Symptoms can include:

• Vivid hallucinations and delusions

• Increased mood swings and emotional problems, which can turn to violence

• Difficulties speaking or losing speech over time

• Problems with eating and swallowing

• Unintentional weight loss

• Urinary or bowel incontinence

Alzheimer's diagnosis

If you’re concerned about your memory, or someone else’s, it’s best to see the GP as soon as possible. There are many other causes of minor memory loss – including stress, anxiety and depression, specific medication and other health conditions – so the GP will start with some simple procedures to rule these out.

These might include:

• Mental ability tests to look at your memory and thinking skills

• Blood tests

• Asking about your symptoms and medical history

• Talking to someone close to you about your symptoms

If the GP is unsure whether you have Alzheimer's, they’ll refer you to a specialist, like a geriatrician (a physician who specialises in elderly care) or memory clinic.

There’s no single test to diagnose Alzheimer's, but the specialists will carry out more in-depth mental ability tests, called cognitive assessments. They may also recommend brain imaging like CT scans or MRI scans.

It can take several months to get a clear diagnosis, and this can be a stressful time if you’re having tests or supporting someone else having them. Talk to the GP about information and support that you can access through organisations like Alzheimer's Society. This can help you through the process and come to terms with the diagnosis.

Alzheimer's treatment

There’s no cure for Alzheimer's disease, but there is a range of treatments that can help to reduce symptoms. The treatment plan will depend on the stage of Alzheimer's, the signs and how severe they are.

The main types of treatment for Alzheimer's are:

• Medication – Acetylcholinesterase (AChE) inhibitors are prescribed by specialists and help brain cells communicate with each other. Other medicines that may be recommended include antipsychotics to help treat challenging behaviour and antidepressants to treat depression and anxiety.

• Cognitive therapy – This can be very effective to improve memory and cognitive skills and may involve group activities and exercises or one-to-one help with everyday tasks.

• Reminiscence therapy – This involves talking about your past and your life story using meaningful objects and pictures as prompts. It can be a great way to help boost your mood and emotional wellbeing.