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What Is Alzheimer's Disease: Types, Symptoms, and Risk Factors

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Being unable to recognize the faces of your loved ones, forgetting how to tie your shoelaces, or getting lost in your own home are just a few of the devastating realities that millions grappling with Alzheimer’s disease face every day. In the United States alone, Alzheimer’s affects more than 6 million people, projected to nearly triple by 2050. But beyond these staggering statistics are individual stories of lives disrupted and families turned upside down.

In today’s aging society, Alzheimer’s is not just a disease but an unseen pandemic that robs people of their memories, personalities, and, ultimately, identities. Despite its widespread impact, Alzheimer’s is often misunderstood, underdiagnosed, and underestimated. In this comprehensive article, we’ll take you on an exploratory journey to understand what Alzheimer’s is, how it manifests, who it impacts, and what can be done to manage or potentially slow its devastating effects. Whether you’re concerned for yourself a loved one, or simply curious, read on to demystify one of the most complex and common diseases affecting our time.

What Is Alzheimer’s Disease?

Alzheimer’s disease, often simply referred to as Alzheimer’s, is a complex and progressive neurological disorder that wreaks havoc on the brain, affecting cognition, behavior, and even physical capabilities over time. Although it is the most prevalent form of dementia, accounting for 60-80% of people living with dementia, it is essential to note that not all dementia is Alzheimer’s.

At the microscopic level, Alzheimer’s is characterized by two primary features: amyloid plaques and tau tangles. Amyloid plaques are sticky buildups of beta-amyloid proteins that accumulate outside nerve cells or neurons. Tau tangles are twisted fibers of another protein that build up inside neurons. Both abnormalities disrupt messages within the brain, affecting the neurons’ function and eventually leading to their death.

As neurons die, brain tissue shrinks, particularly in areas associated with memory and higher cognitive function. As the disease progresses, the damage spreads, affecting nearly all areas of the brain by its final stages. The result is a cascade of cognitive, behavioral, and functional impairments significantly impacting quality of life.

One of the most unsettling aspects of Alzheimer’s is its incremental nature. It usually starts with mild symptoms that might be brushed off as normal aging, like forgetfulness or misplacing things. Over time, these symptoms worsen, leading to more significant memory loss, confusion, and eventually severe cognitive decline. This gradual process often makes it difficult for families to recognize the warning signs early, delaying diagnosis and intervention.

Types of Alzheimer’s Disease

Alzheimer’s disease is not a monolithic condition but exists in multiple forms. While they all share the core symptoms of cognitive decline and memory loss, each type has unique characteristics, risk factors, and progression. Understanding these different forms of Alzheimer’s can help medical professionals tailor treatment and guide families in what to expect.

Late-Onset Alzheimer’s Disease (LOAD)

This is the most common form, affecting people 65 years and older. Late-onset Alzheimer’s accounts for an estimated 90-95% of all Alzheimer’s cases. Researchers believe that a combination of genetic, environmental, and lifestyle factors contribute to the onset of this type of Alzheimer’s. The APOE-e4 gene is the most well-known genetic risk factor. Still, it’s worth noting that having the gene doesn’t guarantee the development of the disease — it merely increases the risk.

Early-Onset Alzheimer’s Disease (EOAD)

Early-onset Alzheimer’s affects people between the ages of 30 and 65. It is much rarer, accounting for 5-10% of cases. Unlike late-onset Alzheimer’s, early onset often has a stronger genetic component and can run in families. Mutations in genes like APP, PSEN1, and PSEN2 have been associated with the familial form of early-onset Alzheimer’s.

Familial Alzheimer’s Disease (FAD)

Familial Alzheimer’s Disease is a specific subset of early-onset Alzheimer’s with a clear genetic link. Suppose a parent carries one of the mutated genes associated with FAD (APP, PSEN1, PSEN2). In that case, their children have a 50% chance of inheriting it. Those who do often develop Alzheimer’s at a relatively young age. However, FAD is rare, accounting for less than 1% of all Alzheimer’s cases.

Identifying the type of Alzheimer’s disease can help tailor treatment and interventions specific to the patient’s symptoms. It also aids in setting expectations for the disease’s progression, as some types may advance more rapidly than others. Moreover, understanding the specific type is crucial for clinical trials and research to develop targeted therapies.

By recognizing the heterogeneity of Alzheimer’s disease, we take a step closer to providing personalized health care solutions that can improve the quality of life for patients and their families.

Alzheimer’s Symptoms

It is more than just memory loss. The symptoms of Alzheimer’s span a broad spectrum and affect cognitive, emotional, and even physical domains. Moreover, these symptoms often develop slowly, sometimes over several years, making it difficult to pinpoint when the disease begins. Here are some signs and symptoms that are categorized by stages:

Early-Stage Symptoms: The Subtle Signs

During the early stages of Alzheimer’s, symptoms are usually mild. They can easily be attributed to age-related changes or stress. They include:

  • Forgetfulness: Forgetting recent events or conversations is often the earliest sign.
  • Misplacing items: Frequently losing or misplacing belongings.
  • Difficulty planning: Challenges with organizing tasks or making plans can emerge.
  • Word-finding issues: Momentary lapses in finding the right word during conversations.

Mid-Stage Symptoms: The Growing Concerns

As the disease progresses to the mid-stage, symptoms become more noticeable and interfere significantly with daily life.

  • Worsening memory loss: Forgetting personal history or recognizing close family and friends.
  • Mood swings: Emotional changes, including irritability, frustration, and even depression.
  • Confusion: Difficulty understanding where they are or what day or time it is.
  • Impaired judgment: Poor decision-making, such as wearing winter clothes in summer.
  • Difficulty in performing tasks: Challenges in executing everyday tasks like meal preparation.

Late-Stage Symptoms: Severe and Debilitating

The late stage of Alzheimer’s is often the most challenging for patients and their caregivers.

  • Severe memory loss: May not recognize themselves or close family members.
  • Loss of physical abilities: Difficulty walking, sitting, or even swallowing.
  • Increased susceptibility to infections: Especially prone to pneumonia.
  • Non-verbal or non-responsive: May lose the ability to speak or respond to external stimuli.
  • Inability to perform basic activities: Eating, dressing, or using the toilet unaided.

Other Cognitive and Behavioral Symptoms:

While not neatly fitting into any one stage, these symptoms may appear sporadically or progressively:

  • Apathy: A lack of interest in previously enjoyed activities.
  • Agitation: May exhibit restless or aggressive behavior.
  • Anxiety: Feelings of unease or worry without an identifiable cause.
  • Hallucinations: Seeing or hearing things that aren’t there (more common in certain types of Alzheimer’s).
  • Sleep disorders: Difficulty sleeping or changes in sleep patterns.

Physical Symptoms:

Though less talked about, Alzheimer’s can also produce physical symptoms:

  • Motor issues: Difficulty coordinating movements or trouble walking.
  • Incontinence: Loss of bladder or bowel control in later stages.

While no treatment can reverse Alzheimer’s, some medications can alleviate symptoms or slow their progression. Awareness of these symptoms also enables families and caregivers to seek professional help early and prepare for the challenges ahead emotionally and logistically.

Alzheimer’s doesn’t just affect the person diagnosed. Its ramifications ripple through entire families. Caregivers, often close family members, find themselves under immense stress, both emotionally and financially, as they grapple with the progressive demands of the disease. This changes the dynamics within a family, impacts work commitments and personal well-being, and often leads to caregiver burnout.

Risk Factors

What could put you or a loved one at risk for Alzheimer’s? Let’s dive into the factors that matter.

  • Age: The risk of Alzheimer’s increases after the age of 65.
  • Family history: A family history of Alzheimer’s can increase the likelihood of developing the disease.
  • Genetic factors: Specific genes like APOE-e4 are associated with higher risk.
  • Lifestyle: Poor diet, lack of exercise, and limited mental stimulation may contribute to the disease’s onset.

Understanding Alzheimer’s disease is not just about recognizing its symptoms or identifying its types. It’s about grasping the profound impact it has on patients and their families and being aware of the options available to mitigate its effects.

As researchers and scientists continue their tireless work to find more effective treatments and, eventually, a cure, it’s crucial for the general public to be educated and empathetic. Alzheimer’s doesn’t discriminate — it can affect anyone.

Getty image by Cravetiger

Originally published: October 20, 2023
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