Alzheimer’s Disease Symptoms, Causes & Treatment Options

Alzheimer’s disease is a common form of dementia, which is a slow, gradual decline in learning, memory, thinking, and judgment. Symptoms include forgetting new information, confusion about one’s surroundings, language difficulties, insomnia, and emotional disturbances.

Alzheimer’s Disease Symptom Checker

Take a quiz to find out if your symptoms point to Alzheimer’s disease

Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Alzheimer’s Disease?

Summary

Alzheimer’s disease is a form of dementia, a slow, gradual decline in learning, memory, thinking, and judgment. Alzheimer’s disease is the most common form of dementia, responsible for 60 to 80% of cases in older adults [1]. The proportion of people affected by Alzheimer’s increases with age, with the condition affecting 3% of people ages 65 to 74 and nearly one-third of people over 85 [1].

Symptoms of Alzheimer’s vary from person-to-person and progress over a number of years. Common symptoms include forgetting new information, becoming confused about one’s surroundings, language difficulties, insomnia, and emotional disturbances. Over time, the condition can progress to an inability to carry out daily tasks and a loss of basic bodily functions.

The cause of Alzheimer’s disease is not completely understood, but it is believed to be related to the deposition of toxic proteins in the brain. Over time, these deposits may lead to the dysfunction of brain cells and the degeneration of brain tissue.

Treatment may consist of medications to slow disease progression or control symptoms, as well as adjustments to one’s daily routine to maximize safety and dignity as the disease progresses.

Recommended care

Alzheimer’s Disease Symptoms

Main symptoms

Alzheimer’s disease, like other forms of dementia, consists of a decline in a variety of cognitive abilities and general function. It is mostly characterized by significant impairments in recent memory. Symptoms vary across individuals and throughout the disease course but commonly include the following.

  • Memory loss
  • Language difficulties: such as difficulty finding words
  • Personality changes: for example, increases in apathy or anxiety
  • Disorientation: confusion about time and place
  • Difficulty completing daily tasks: Activities such as cooking, home projects, or paying bills may have been routine but can now seem impossible.
  • Disruptive behavior: Yelling, throwing, or hitting others can occur early or later in the course of the disease. Behavior changes may be due to forgetting social norms or misinterpreting stimuli as threatening.

Early symptoms

Symptoms appear gradually, often starting in the mid-60s, and progress over a number of years.

  • Forgetting new information: Although the ability to recall old memories remains intact, new memories are not easily formed, such as the names of new acquaintances or details of recent events. As a result, people may repeat questions or conversations or ask for things they have already received.
  • Language difficulties: People may use words incorrectly, or choose simpler or vague terms.
  • Disorientation: Due to difficulty processing spatial cues, people can get lost and confused, making driving difficult.
  • Difficulty thinking abstractly
  • Limitations in judgment: such as difficulty managing finances
  • Insomnia
  • Emotional lability: Feelings, such as anxiety or fear, may change rapidly.
  • Psychosis: At some point in the course of the disease, false beliefs (delusions), fears of persecution, and hallucinations may develop.

Later symptoms

Over time, symptoms worsen in severity (often with plateaus in between), to the point where individuals become dependent on others for most daily activities.

  • Forgetting old information: As the disease progresses, people may have difficulty recalling the past, such as their family members.
  • Worsening disorientation: People may find themselves lost within their own home.
  • Difficulty with basic activities: such as bathing, dressing, eating, and using the bathroom
  • Loss of basic body functions: Over time, people with Alzheimer’s may become unable to walk, incontinent, unable to swallow, and unable to eat.

Alzheimer’s Disease Causes

The causes of Alzheimer’s disease are complex and not completely understood. It is likely that changes occur in the brain for a decade prior to any observable changes in thinking or behavior [2]. Examination of brains affected by Alzheimer’s disease has shown two patterns, as follows.

  • Beta-amyloid plaques: Deposits of proteins accumulate outside cells in the brain.
  • Neurofibrillary tangles: Proteins accumulate inside brain cells.

The exact relationship between the pathologic plaques, tangles, and symptoms remains an active area of study. One theory suggests that the pathologic protein deposits initiate a chain of events leading to brain cell death, loss of connections between brain cells, and deficits in brain signals, which collectively lead to symptoms of dementia. The first changes occur in the hippocampus, a part of the brain essential for memory formation. As the disease progresses, the brain shrinks significantly [2].

Although in some cases the disease runs in families (5–15%), it usually occurs spontaneously. Some genetic variations may lead to increased deposition of amyloid plaques and neurofibrillary tangles and are often associated with onset earlier in life. These include [1]:

  • Amyloid precursor protein
  • Presinilin I
  • Presinilin II
  • Apolipoprotein E

Alzheimer’s Disease Symptom Checker

Take a quiz to find out if your symptoms point to Alzheimer’s disease

Treatment Options, Relief, and Prevention for Alzheimer’s Disease

Medication treatments

Currently, there are no medications capable of curing Alzheimer’s disease. However, several medications may help delay the progression of the disease.

  • Cholinesterase inhibitors: Medications such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) raise levels of acetylcholine, a brain-signaling chemical (neurotransmitter) involved in cognition. Although these medications have been associated with modest benefits on cognitive test scores in people with mild to moderate symptoms, their impact on daily life is limited. Side effects include diarrhea, decreased appetite, dizziness, abnormal heart rhythms, and weight loss.
  • NMDA antagonist: Memantine (Namenda), a medication that alters the effects of the neurotransmitter glutamate, has been found to have positive effects on cognition and functional status in people with moderate to severe Alzheimer’s. It is generally well-tolerated, but sometimes causes confusion or gastrointestinal side effects.
  • Vitamin E: This is believed to have antioxidant properties that protect brain cells (neurons).
  • Alternative treatments: Studies of ginkgo, omega-3 fatty acids, and estrogen have not been found to consistently treat Alzheimer’s disease [3,4].
  • Anti-psychotics: If anger, agitation, or paranoia become problematic, a doctor may recommend medications such as olanzapine (Zyprexa) and risperidone (Risperdal) to minimize these symptoms. However, the use of antipsychotics must be carefully considered, as these medications are associated with increased mortality in elderly populations [4].

Non-medication treatments

In addition to medications, a number of activities may help people with Alzheimer’s disease maintain healthy functioning.

  • Exercise: Although exercise has not been found to positively impact cognition in people with Alzheimer’s, it does slow physical decline, help improve balance and restlessness, and positively impact mood and sleep. Safe physical activity is an important part of treatment at any stage of Alzheimer’s disease.
  • Cognitive stimulation and leisure activities: Activities such as puzzles, gardening, games, and baking are beneficial for maintaining cognitive function, quality of life, and functional capacity.
  • Occupational therapy: Occupational therapists can help individuals with Alzheimer’s and their caregivers develop techniques to cope with declining abilities [3].
  • Group therapy: This can help people maintain social skills and find a support group.

Caring for someone with Alzheimer’s disease

Caring for people with Alzheimer’s disease requires you to balance your efforts to maintain dignity and individuality while making changes to routines to ensure safety.

  • Avoid correcting people with Alzheimer’s when they make mistakes: Instead, respond to the feeling expressed or gently move on.
  • Use simple and direct wording: Make one statement at a time.
  • Ensure home safety: Avoid clutter and tripping hazards, display emergency numbers near telephones, and store hazardous materials in safe places. A lengthy list of other considerations can be found here.
  • Decide when it is no longer safe to drive: Although it may still be safe to drive with mild memory impairment, driving can quickly become dangerous if attention and orientation become impaired.
  • Advanced care planning: Start discussing preferences for medical care and legal arrangements early while the person with Alzheimer’s can still participate [5].

Prevention

Although Alzheimer’s disease cannot be completely prevented, research suggests lifestyle changes may reduce the risk of cognitive decline. These changes include the following.

  • Engage in cognitively challenging activities: such as learning new skills
  • Stay socially engaged: Achieve this through regular contact with friends and family.
  • Exercise regularly
  • Control chronic conditions: such as high blood pressure, diabetes, or high cholesterol

When to Seek Further Consultation for Alzheimer’s Disease

If you are concerned for the physical or mental safety of someone with Alzheimer’s disease

As the disease progresses, people with Alzheimer’s disease are less able to care for themselves. If you are concerned about someone’s safety, call 911 or seek help from a professional as soon as possible.

If you feel overwhelmed about caring for someone with Alzheimer’s disease

Caring for a loved one with Alzheimer’s disease is challenging. If you feel overwhelmed, ask your physician for help. Consult social workers, occupational therapists, nurses, or other caregivers for support.

If you notice an abrupt change in someone with Alzheimer’s disease

People with Alzheimer’s disease often have difficulty expressing their needs and feelings. If you notice an abrupt change in someone’s behavior, such as worsening confusion or a decrease in appetite or eating, these may be signs of a related medical condition (for example, an infection) that could benefit from a prompt medical evaluation.

References

  1. Huang J. Alzheimer Disease. Merck Manual Professional Version. Revised March 2018. Merck Manuals Professional Version Link

  2. Alzheimer’s Disease Fact Sheet. National Institute on Aging. Reviewed May 22, 2019. NIA Link

  3. Epperly T, Dunay MA, Boice JL. Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and Functional Symptoms. Am Fam Physician. 2017 Jun 15;95(12):771-778. AAFP Link

  4. Winslow BT, Onysko MK, Stob CM, Hazlewood KA. Treatment of Alzheimer Disease. Am Fam Physician. 2011 Jun 15;83(12):1403-1412. AAFP Link

  5. Alzheimer’s Caregiving. National Institute on Aging. NIA Link