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OVERVIEW

What is Alzheimer’s disease?

Alzheimer Dementia is a type of dementia. Dementia is a condition that describes a wide range of symptoms. The symptoms are associated with physical and functional changes in the brain. Dementia usually affects a person’s memory, thinking abilities, and personality. In the later stages, a person who has dementia has difficulty caring for themselves.

Alzheimer Dementia is the most common cause of dementia among older persons. However, other things can also cause dementia.  Alzheimer’s disease is common in people older than 65 years of age. According to The Alzheimer Society of Canada, 564 000 Canadians are currently living with dementia.  1 in 20 Canadians over age 65 and 1 in 4 of those over age 85 have Alzheimer’s disease. People who are younger than 65 years of age can also have Alzheimer’s disease. This is called early onset Alzheimer’s.  In Canada, 16 000 people under the age of 65 are currently living with dementia (source: The Alzheimer Society of Canada)

SYMPTOMS

What are the symptoms of Alzheimer’s disease?

The Alzheimer’s Society of Canada has identified 10 warning signs and symptoms of Alzheimer’s disease (see the list below). It’s important to remember that every person is different and may not have all or even most of these warning signs. Contact your healthcare provider if you notice 1 or more of these signs in yourself or a loved one.

• Memory loss that affects daily life: Examples include forgetting important dates or things you just learned; asking the same question over and over; or relying heavily on reminder notes, technology, or other family members to remember things.
• Changes in the ability to follow a plan or solve a problem: This may include having trouble concentrating on a problem, such as a math problem; following a plan, such as a recipe; or keeping track of regularly scheduled tasks, such as paying monthly bills.
• Changes in the ability to complete familiar tasks: Alzheimer’s disease can make it hard to do the things that you used to do all the time. For example, it might be hard to do chores at home, run errands, or finish a routine task at work.
• Becoming confused about time or place: Examples include losing track of how much time has passed or the date or the day of the week and forgetting where you are and how you got there.
• Problems with vision or understanding visual information: Examples include trouble reading, identifying colors or judging distances, or getting confused about what you see.
• Problems with words: Examples include forgetting words in the middle of a conversation, repeating parts of a conversation, or problems with vocabulary, such as calling things by the wrong names.
• Misplacing things: Examples include putting things in unusual places, losing things often, being unable to retrace steps in order to find a lost object, and even accusing others of stealing.
• Poor judgment: Examples include paying less attention to appearance or cleanliness and using poor judgment with money, such as giving large amounts of money to solicitors.
• Withdrawal from activities: Examples include withdrawing from social activities, work projects, or family gatherings, or abandoning a hobby, sport, or favorite activity.
• Changes in mood and personality: Examples include becoming unusually confused, suspicious, upset, depressed, fearful, or anxious, especially when in new or unfamiliar places.

Alzheimer’s disease is called a “progressive” disease. This means that its symptoms usually start slowly and are mild. A person’s cognitive (brain) and functional (self-care) abilities get worse over time. In the later stages of the disease, a person who has Alzheimer Dementia is no longer able to communicate and depends entirely on other people for care.

Also, as the disease progresses, a person can experience health complications, including:

• Depression.
• Unreported pain, illness, or medicine side effects (due to the inability to communicate).
• Falls.
• Pneumonia or other infections.
• Malnutrition or dehydration.

If you think that a loved one might be experiencing any of the complications listed above, talk to their healthcare provider. They can provide medicine or other treatments to help keep your loved one comfortable

CAUSES & RISK FACTORS

What causes Alzheimer’s disease?

Healthcare providers don’t know exactly what causes Alzheimer’s disease. It appears that Alzheimer’s disease develops when clumps of abnormal proteins grow in the brain. This growth likely begins with a series of many small changes in the brain that start long before any symptoms are noticeable. Over time, these changes add up. Eventually, brain cells become damaged and die.

What are the risk factors for Alzheimer’s disease?

Healthcare providers don’t know exactly what causes Alzheimer’s disease. It appears that Alzheimer’s disease develops when clumps of abnormal proteins grow in the brain. This growth likely begins with a series of many small changes in the brain that start long before any symptoms are noticeable. Over time, these changes add up. Eventually, brain cells become damaged and die.

Also, healthcare providers believe certain things increase a person’s risk for developing Alzheimer’s disease. Those risks factors include:

• Age: The older you are, the greater your risk of developing Alzheimer’s disease. After age 65, your chance of developing Alzheimer’s doubles every 5 years.
• Genetics and family history: You are more likely to get Alzheimer’s disease if you have a family history of Alzheimer’s disease, meaning that one or more of your parents, siblings, or children has the disease. Scientists also think that certain genes in your DNA may increase your risk for Alzheimer’s disease.
• Down syndrome: People who have Down syndrome have a much higher risk for Alzheimer’s disease than the general population.
• Environmental/lifestyle factors: It is likely that your environment and your lifestyle habits also affect your risk for Alzheimer’s disease. A history of head trauma, cardiovascular or heart problems, diabetes, and obesity appear to increase your risk for Alzheimer’s disease. To help prevent these health problems, wear a helmet when riding a bicycle, always buckle your seat belt when in the car, establish a regular exercise routine, eat right, and avoid tobacco products.

There has been some debate on whether Alzheimer’s disease being more common in women than in men. According to the Alzheimer’s Society of Canada, international evidence has not consistently shown this to be true. More research is required to determine if other factors than age may heighten a women’s chances of developing Alzheimer’s disease.

DIAGNOSIS & TESTS

How is Alzheimer Dementia diagnosed?

An Alzheimer’s disease diagnosis may take some time. There is no test that can tell your healthcare provider whether you have the disease. Give your healthcare provider plenty of information to help determine the cause of your symptoms. Your healthcare provider may want to evaluate the following in you or your loved one:

• Current health and medical history.
• Daily routine and any changes in your behavior.
• Memory, problem-solving, attention, and language abilities.
• Lab tests, such as blood or urine tests.
• Brain scans to look for problems, such as stroke, that may be causing symptoms

Based on this information, your healthcare provider can almost always tell whether you have dementia. Your healthcare provider can tell whether Alzheimer’s disease is the cause of your dementia about 90% of the time. But Alzheimer’s disease can only be diagnosed with 100% accuracy after death, when the brain is examined under a microscope. The brain of a person who had Alzheimer’s disease will show very distinct changes that only happen when Alzheimer’s is the cause of dementia.

If you are worried that you or a loved one might have some of the warning signs of Alzheimer’s disease, talk to your healthcare provider. An early diagnosis will help you get treatment earlier. Also, it will give you time to address questions of care, finances, and legal issues with your family.

Can Alzheimer Dementia be prevented or avoided?

No one knows how to prevent or avoid Alzheimer’s disease. However, healthcare providers believe that healthy living and keeping your brain active can help lower your risk. Or it may delay its onset. That means eating a healthy diet, lowering your alcohol consumption, not smoking, staying physically and socially active, and challenging your mental abilities with brain games.

TREATMENT

There is no cure for Alzheimer’s disease. Instead, treatment may focus on the following:

• Slowing the progression of symptoms such as memory loss.
• Addressing behavior changes such as depression and aggression.
• Helping to relieve other symptoms, such as sleep problems.

Some medicines are currently being used to treat memory and behavior symptoms of Alzheimer’s disease. These medicines do not stop the disease. They may not work for every person or may help for only a short time.

Medicines for memory

• Three cholinesterase inhibitors have been approved by Health Canada to treat Alzheimer’s disease. In Canada, Aricept, Exelon, and Reminyl can treat mild to moderate Alzheimer’s. Typical side effects of these drugs include diarrhea, nausea, and vomiting.
• Ebixa (Memantine hydrochloride) is approved to treat moderate to severe Alzheimer’s disease. It may be used alone or in addition to one of the cholinesterase inhibitors listed above. It may cause side effects such as dizziness and headaches.

Your healthcare provider may recommend or prescribe medicine for behavioral changes. The type of medicine will depend on the behavior and the severity of the problem. Over-the-counter medicine might include pain relievers. Prescription medicine might include antidepressants, anti-anxiety medicines, and sleep medicines.

Drugs don’t always help relieve the symptoms of Alzheimer’s disease. Non-drug treatments for a person who has Alzheimer Dementia often include managing your loved one’s environment and establishing a routine to help reduce stress and anxiety.

Living with Alzheimer’s disease

The life expectancy for a person diagnosed with Alzheimer’s disease differs with each person.  People diagnosed with Alzheimer’s can live actively for many years. Early diagnosis is important, as some treatment options are more effective in the early part of the disease.

FOR MORE INFORMATION

Alzheimer Society of Canada
www.alzheimer.ca

Alzheimer Society of Nova Scotia
Tel: 902-422-7961 or toll free within Nova Scotia 1-800-611-6345

Alzheimer Society of PEI
902-628-2257
Toll-free: 1-866-628-2257

Caregivers Nova Scotia
Toll-free:  1.877.488.7390
http://caregiversns.org/