One person develops dementia every three minutes. In this video, Wendy Mitchell tells us about her day to day experiences of living with Alzheimer’s, and how she has learned to live with the disease. Read on to find out the answers to your questions about the disease’s causes, symptoms, progress and treatment, and to learn what you should do if you are concerned that you may be at risk.
What is Alzheimer’s Disease?
Alzheimer’s disease is the most common cause of dementia (a set of symptoms incorporating memory loss and language issues with difficulties in thinking and problem solving). There are currently 520,000 sufferers in the UK.
Alzheimer’s causes a gradual loss of brain tissue. Proteins build up in the brain to form structures called plaques and tangles. These structures disrupt connections between nerve cells, causing them to die. The disease also causes a shortage of important chemical transmitters in the brain. It is a progressive disease, which means that, over time, more areas of the brain become damaged, causing new symptoms to develop and existing symptoms to become more severe.
What are the symptoms?
No two people with Alzheimer’s will experience the condition in exactly the same way. However, the earliest symptoms tend to be memory lapses, as initial brain damage often occurs to the hippocampus, an area which is key to the formation of new memories. Sufferers may have difficulty recalling recent events and learning new information.
As the condition progresses, memory loss will increasingly tend to interfere with daily life, as sufferers begin to misplace items around the house, forget appointments or anniversaries and struggle to find the correct words in conversation. Eventually, they may become lost in familiar places or on familiar journeys.
Changes in mood are also common in the early stages of the disease. Those with the condition may become anxious, irritable, withdrawn or depressed, and lose interest in hobbies and activities.
Some people may also experience issues with language, developing a tendency to repeat themselves or struggling to follow conversations.
Visuospatial deficits can result in difficulties in judging distances, parking cars or navigating stairs.
Sufferers may also struggle to make decisions, solve problems and carry out simple sequences of tasks (e.g. cooking a meal), become confused or lose track of the day or date.
How does the disease progress?
As the disease progresses, symptoms become increasingly severe, necessitating additional day to day support. Some sufferers experience delusions or hallucinations, or develop behaviours which may seem out of character, such as restlessness, pacing, aggressive reactions and calling out.
As brain cells continue to die, the natural reflexes which keep us alive, including swallowing, coughing and breathing, are slowly lost, along with the abilities to speak and move independently. Sufferers also gradually lose awareness of what is happening around them. In the latter stages of the disease, they will require help with all daily activities.
Most people die from complications such as aspiration pneumonia, which can lead to seizure or stroke. This is caused by inhaling food due to forgetting to chew and/or losing the ability to swallow, resulting in food or drink being deposited in the lungs. Late-stage Alzheimer’s patients may lack either the physical ability or conscious awareness of the need to cough to dislodge the food.
Sufferers also become more susceptible to infections due to malnutrition, caused by loss of appetite, and loss of strength, caused by lack of movement.
In addition, becoming bed bound due to an inability to move independently may result in blood clots and heart disease, leading to heart attacks.
The speed with which Alzheimer’s progresses varies considerably – on average, sufferers survive for 8-10 years after first experiencing symptoms, but some live for up to 20 years. The most advanced stages of the disease typically last around two years.
How is it treated?
There is currently no cure for Alzheimer’s, although a drug currently being trialled, based on an antibody called aducanumab, has been hailed as a potential breakthrough. Early results indicate that it may be able to destroy plaques in the brain and slow cognitive decline in early-stage Alzheimer’s patients.
Existing drug treatments can alleviate or slow the progression of certain symptoms in some people.
In the mild to moderate stages, drugs such as donepezil (Aricept), rivastigmine (Exelon) or galantamine (Reminyl) may be prescribed to help with memory problems, improve concentration and motivation and boost sufferers’ abilities to carry out everyday activities such as cooking, shopping and participating in hobbies.
In the moderate to severe stages of the disease, memantine (Ebixa) may be prescribed. This drug may assist with mental abilities and daily living, and ease distressing or challenging symptoms such as agitation and delusions.
Persisting with hobbies and engaging in social interaction is recommended, whilst reading or puzzles may help to maintain cognitive stimulation. Practical strategies, such as developing routines, and simple tools, such as weekly pill boxes, can help sufferers to navigate daily life.
The Alzheimer’s Society provides a range of support services and practical tools. If you, or someone you know, is suffering from Alzheimer’s, call the National Dementia Helpline on 0300 222 1122 or visit the Talking Point online discussion forum at alzheimers.org.uk/talkingpoint.
Am I at risk?
Most people develop Alzheimer’s after the age of 65, but 40,000 people in the UK are currently living with young-onset dementia. Once you reach the age of 65, your risk of developing Alzheimer’s roughly doubles every five years. One in six people over 80 has been diagnosed with dementia.
Alzheimer’s affects twice as many women as men. Experts believe this may be linked to post-menopausual oestrogen deficits.
If a close family member has been diagnosed with the disorder, you do have an increased risk of developing the disease, but it is not inevitable. Leading an active, healthy lifestyle will lower your risk.
Medical conditions including diabetes, stroke, heart problems, high blood pressure and high cholesterol increase your risk of developing Alzheimer’s. Mid-life obesity and depression are also associated with the disease.
What should I do if I am concerned?
If you think you, or someone you are close to, might have Alzheimer’s, consult your GP. There is no single test for the condition, as conditions with similar symptoms must first be ruled out. These include infections, nutritional deficiencies and the side effects of medication. You may be referred to a specialist or be asked to undergo a brain scan before a final diagnosis can be made.