Alzheimer's Disease

Alzheimer’s disease is a progressive neurological condition that affects memory and other mental functions. It is the most common form of dementia, a group of brain disorders characterized by a general loss of mental abilities, including memory, judgment, language and abstract thinking.

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Symptoms

Symptoms of Alzheimer’s disease include:

  • Worsening memory
  • Trouble remembering new information
  • Routinely misplacing possessions or putting them in illogical locations
  • Repeating statements or questions
  • Becoming lost more often
  • Personality changes, including depression, social withdrawal, irritability or aggressiveness
  • Loss of inhibitions
  • Disorientation and confusion
  • Difficulty with reasoning and making judgments
  • Taking longer to perform daily tasks

The severity of these symptoms is related directly to the stage of disease, which often progresses slowly. Most patients are diagnosed once the disease progresses to mild dementia, when the patient or their family notice mood swings, personality changes, memory loss, or difficulty organizing and expressing thoughts or performing complex tasks. Patients may find themselves becoming more easily confused and having difficulty coping with new situations.  

As the disease progresses, patients may need help with daily activities that were once routine, such as grooming. In the late stages of Alzheimer’s disease, the patient’s physical capabilities will be affected.  


Causes and Risk Factors

The causes of Alzheimer’s disease are still under investigation, but scientists currently believe a combination of genetic, lifestyle and environmental factors is responsible.

While Alzheimer’s disease is not a normal part of the aging process, the risk of developing the disease increases significantly in patients older than 65. The risk of developing the disease also is increased if the patient has a parent or sibling diagnosed with the condition, or if they have experienced severe or repeated head trauma. In fewer than 5 percent of cases, the disease is linked to specific changes in a person’s genetic makeup.

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Diagnosis

There is not yet a diagnostic tool to definitively determine whether a patient has Alzheimer’s disease. However, physicians use a combination of physical and neurological exams, blood tests and brain imaging to decide whether Alzheimer’s disease is the most likely cause of a patient’s symptoms.

Physical and neurological tests include:

  • Coordination
  • Balance
  • Reflexes
  • Muscle tone and strength
  • Ability to stand up from a seated position and walk across the room
  • Vision and hearing tests

The patient’s physician may also order blood tests to rule out alternative causes for memory loss and confusion, such as nutritional deficiencies.

Commonly used imaging tests include magnetic resonance imaging (MRI) or computerized tomography (CT) scans. These are structural scans of the patient’s brain that may reveal other conditions that could be responsible for the symptoms, such as tumor or stroke.

Doctors also may order spinal fluid tests, or a positron emission tomography (PET) test, which allows them to see which parts of the brain are functioning normally and which are not.

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Treatments

There is no cure for Alzheimer’s disease, but medical and environmental options are available that may help moderate its symptoms.

Medications for memory loss and confusion can help slow the progression of the disease. Commonly used pharmaceuticals include cholinesterase inhibitors (Razadyne®, Exelon® and others), which help prevent the breakdown of the chemical messenger acetylcholine; and memantine (Namenda®), which blocks the action of a toxic chemical messenger known as glutamate.

Adapting the living situation of the patient can help reduce discomfort and agitation. New environments, obstacles, and other circumstances that may cause discomfort or distress to the patient should be reduced whenever possible. A calm environment that minimizes confrontation can help in managing the mood shifts associated with the disease.

These treatments are most effective when the disease is diagnosed early and overseen by a team of knowledgeable medical professionals, such as those in the Cedars-Sinai Department of Neurology. With treatment, caretakers and the medical team can work cooperatively in an effort to preserve the patient’s quality of life for as long as possible.

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