Alzheimer's disease

Alzheimer's disease gradually damages the way the brain works, which affects a person's memory, ability to communicate, and their ability to make decisions and carry out their daily activities. The disease develops slowly, usually over many years.

About Alzheimer's disease
Symptoms of Alzheimer's disease
Causes of Alzheimer's disease
Diagnosis of Alzheimer's disease
Treatment of Alzheimer's disease
Help and support

About Alzheimer's disease

Alzheimer's disease is the most common cause of dementia. Dementia is the medical term used to describe a number of conditions that cause a change in the way your brain works. These changes can cause memory problems and can alter your behaviour and emotions. You may also have problems making decisions and solving problems, or be unable to carry out your usual daily activities, such as driving, getting dressed or eating. The effects of dementia are different for each individual.
 
Alzheimer’s disease changes the structure of your brain and causes your brain cells to die. It also affects the connections between brain cells, which means that nerve messages aren’t passed on properly. Over time, as more and more areas of your brain become damaged, your symptoms will get progressively worse.
 
People with Alzheimer’s disease usually live with the illness for several years but this depends on when you are diagnosed.
 
Eventually, Alzheimer’s disease is fatal. However some people with Alzheimer’s disease may die from other conditions such as pneumonia, as their health gets worse.
 
Of the 750,000 people living with dementia in the UK, about 460,000 have Alzheimer’s disease. Most people who develop the condition are over 65, though it can also develop in younger people.
 
There is no cure for Alzheimer's disease, though there are treatments that can help to control your symptoms for a period of time.

Symptoms of Alzheimer's disease

Alzheimer's disease is a condition that develops over a period of years. The symptoms get progressively worse over time. If you develop Alzheimer’s disease when you’re under the age of 65 (early onset), then your symptoms may get worse more rapidly than in older people.
 
Alzheimer's disease affects everyone differently. You may have some but not all of the symptoms listed below.
 
One of the first symptoms of Alzheimer’s disease is forgetfulness – for example, forgetting the name of an acquaintance or forgetting where you have put something. However, this isn’t always caused by dementia and may just be a sign of getting older or simply the stress of a busy life. You might also have trouble finding the right words to speak or write.
 
As Alzheimer’s disease develops you, or your family or friends, may notice other symptoms. The main ones are listed below.

• You may become confused or disorientated – for example, you may not know what time of day it is, feel bemused and believe you are somewhere you’re not, or you may not recognise familiar places or people.
• Your behaviour may change and you may have mood swings, become less interested in life, or become depressed or anxious.
• You may have problems doing everyday tasks such as preparing a meal, laying the table, getting dressed, shopping or dealing with money.
• You may take less care of yourself, for example not washing regularly or eating properly.
• Communicating may become more difficult. You may struggle to complete sentences or understand all of what is being said to you. You may also have difficulty finding the words you need.

During the later stages of the disease, you’re likely to be frail and increasingly dependent on other people. In general, your memory loss will get worse, though you may have times when you know what is going on around you. You may not recognise your close family or your partner and you may have trouble walking and eating. Eventually, you will become dependent on others to care for you.  
 
The symptoms of Alzheimer's disease can cause a great deal of distress and upset for you, and your carers and family, who may feel they have lost the person they once knew.

Causes of Alzheimer's disease

Doctors don't know exactly why people develop Alzheimer's disease and dementia, but it's associated with a number of risk factors. These may include:

• ageing – Alzheimer’s disease mainly affects older people
• genetics – you may be more likely to develop Alzheimer’s disease if your parents or a close relative has it
• a previous severe head injury
• lifestyle factors such as smoking or obesity
• diabetes
• raised blood pressure and raised blood cholesterol levels

People who have Down’s syndrome are also more likely to develop Alzheimer’s disease as they get older.

Diagnosis of Alzheimer's disease

Alzheimer's disease can be difficult to diagnose, especially in the early stages.
 
Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may ask you a series of questions designed to test your memory and thinking. He or she may also test your urine or do blood tests to see whether any other condition may be causing your symptoms.
 
If your GP thinks that you may have Alzheimer’s disease, he or she is likely to refer you to a Memory Assessment Service to see specialist doctors and nurses for more tests. These may include further tests to check your memory and thinking, and observation of your behaviour. Your may be asked to have a brain scan.

Treatment of Alzheimer's disease

Treatments for Alzheimer’s disease can’t cure the condition but, for some people, treatment may slow down the development of the disease for a period of time.

Medicines

People with Alzheimer’s disease don’t have enough of a chemical called acetylcholine in their brain. Acetylcholine helps nerve signals to travel across the gaps (synapses) between nerve cells (neurones). Medicines called acetylcholinesterase inhibitors can help to stop the level of acetylcholine in the brain from falling any further. There are three acetylcholinesterase inhibitors available: donepezil hydrochloride, rivastigmine and galantamine.
 
You may be given these medicines to take if you have mild or moderately severe Alzheimer's disease because they can help to slow down the development of your symptoms for a period of time.
 
If you have late-stage Alzheimer's disease, your doctor may prescribe a medicine called memantine. This works in a different way to acetylcholinesterase inhibitors. It may help to improve your thinking and memory and allow you to do more basic everyday activities such as washing and eating.
 
If you also have depression, your doctor may prescribe antidepressants to treat it. He or she may also prescribe medicines to help treat some of the symptoms of Alzheimer’s disease, such as anxiety, sleep disturbance or irritability.
 

Talking therapies

Your doctor may suggest other treatments that can help you to deal with memory loss, emotional symptoms and changes in your behaviour. Some of the main ones are listed below.

• A structured group cognitive development programme. This uses memory and thinking exercises, as well as reminiscence and multi-sensory stimulation. This is useful if you have mild to moderate dementia and usually runs as a course over several weeks. The programme helps with memory problems, day-to-day activities and reality orientation.
• Multisensory stimulation. This can help to improve your quality of life and includes music and pet therapy, aromatherapy and massage.
• Behaviour management. This can help to treat problems such as depression and aggression. Behaviour management is usually given by your carer with support from your doctor or nurse.
• Meaningful activities and engagement such as having conversations, painting and drawing, cooking and games can help you to express yourself and improve your quality of life and sense of wellbeing.
• Early psychological therapy can also be helpful. Counselling can help you to deal with feelings of insecurity, hopelessness and loss of control, while talking about how you feel and what you want in the future can be therapeutic. Group therapy, sometimes involving family supporters, to talk about the future and practical support can also help to make you feel happier and less isolated.

Help and support

If you have Alzheimer’s disease, you may be looked after at home, in a care home or sometimes in hospital. The people who care for you can help you to look after yourself and stay healthy and safe.
 
If you’re looking after someone with Alzheimer's disease at home, you’re likely to need extra help and support. Looking after someone with dementia can be stressful and sometimes carers can neglect their own health and wellbeing.
 
As a caring partner, child or sibling it’s important to take regular breaks from caring so that you can look after yourself and take some time to relax. Respite care is when someone comes into your home to care for the person with dementia while you take a break, or when the person with dementia attends a day centre, or goes into a care home or into hospital for a period of time. Organisations such as the Alzheimer's Society and Carers UK can give you more information about respite care.