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Alzheimer Disease

What is Alzheimer disease?

Alzheimer disease (AD) is an irreversible brain disorder that results in the gradual loss of memory. In AD, parts of the brain die and cannot make normal levels of brain chemicals. This causes problems with how you think, behave, and remember things. The disease usually starts at about age 65 to 70 years but can start earlier. AD usually lasts from 2 to 10 years, but some people may live 20 years or more with the disease. The exact cause of AD is not known.

What increases my risk of Alzheimer disease?

The risk of AD increases with age, but it is not a normal part of aging. AD is likely caused by more than one factor. People who have one or more of the following may have a greater risk of getting AD:

  • Genetics: Your risk is greater if you have a family history of AD. More than half of the people with AD have inherited a protein related to AD. A protein called ApoE, which normally carries cholesterol in the blood, may cause AD. Everyone has ApoE, but one type of ApoE seems to protect a person from getting AD. Another type of ApoE seems to make it more likely to get the disease.

  • Medical conditions: Your risk for AD is increased if you have diabetes and high cholesterol. History of a heart attack or head injury and depression may also increase your risk.

What are the signs and symptoms of Alzheimer disease?

  • Mild AD: The mild symptoms of AD may last from 1 to 3 years. The earliest signs and symptoms of AD may be minor and considered normal signs of growing old.

    • Memory loss is the most common symptom. You can remember what happened years ago, but you may not remember things from yesterday. You may be confused about what month or season it is. You may forget to brush your teeth or comb your hair. You may forget the names of common things or people you know.

    • It may be hard to work on your checkbook or to take care of your house. You may find it hard to make decisions that were once easy. You may not be as interested in your usual activities. You may feel depressed, angry, or confused about the changes you notice. Walking may become harder for you.

  • Moderate AD:

    • You may have problems choosing what clothes to wear or doing simple jobs. It may be hard to feed yourself, brush your teeth, or shave. You may think that taking care of your body is no longer important. You may not recognize people familiar to you. It may be hard to find words to say what you mean. You may have trouble talking in normal sentences. Your speech may be hard to understand. You may quickly change topics when you are talking.

    • You may feel anxious, restless, and agitated at night. This is often called "sundowner's syndrome." You may become loud, violent, and hard to control. You may be confused and wander off or start pacing. You may seem depressed or worried.

    • You may put things in strange places and not remember where you put them. You may not be able to make choices and decisions. It may be hard to reason or solve problems. You may be unable to plan and follow through with activities.

    • You may find it hard to control your emotions. Sometimes you may act like a child because you cannot control your anger. You may be less patient than normal. You may get tired easily. You may think that something is true even though it is not. You may see things that are not actually there. Sometimes you may not be able to control when you urinate.

  • Severe AD: As AD gets worse, you may have a complete loss of your memory and speech. You may have incontinence (loss of bladder and bowel control). It may be very hard to walk. You may become angry and out of control. You may be aggressive and destroy things. Over time, you will not be able to care for yourself and will need someone to take care of you.

How is Alzheimer disease diagnosed?

Your caregiver will examine you. He will ask questions about your symptoms and when they started. He will ask you questions to check memory, problem solving, and language skills. He will ask if you have other family members with AD. He will also ask what medicine you take and if you drink alcohol or use tobacco.

  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your skull and brain. You may be given dye, also called contrast, before the test. Tell the caregiver if you are allergic to dye, iodine, or seafood.

  • Magnetic resonance imaging: This test is also called an MRI. It uses magnetic fields, radio waves, and computers to take pictures of your brain.

  • Positron emission tomography scan: This is also called a PET scan. It records the activity of chemicals in your brain.

How is Alzheimer disease treated?

There is no known cure for AD. Treatment includes keeping a good quality of life, for as long as possible. Ask your caregiver for more information about the most current treatment available. Your caregiver may suggest one or more of the following:

  • Medicine:

    • Cholinesterase inhibitors: Cholinesterase inhibitors help increase the amount of normal chemicals in your brain. They may help you think better and make it easier to do every day activities.

    • NMDA receptor antagonist: This medicine may help slow the death of brain cells.

    • Antidepressants: This medicine may be given if you feel depressed or anxious.

    • Antianxiety medicine: This type of medicine may help you feel less nervous and restless. It may also help you sleep better.

    • Incontinence medicine: You may need this type of medicine to help with your bladder and bowel control.

    • Anticonvulsants: This medicine may be used if you are easily angered or restless.

    • Antipsychotics: This medicine may be used to control delusions (false beliefs), hallucinations (seeing or hearing things that are not there), or violent behaviors.

  • Counseling: Counseling can teach ways to cope with your disease. It may be done one-on-one with a caregiver or may include family members or other persons with AD. Counseling may include the following:

    • Cognitive therapy: This therapy helps make you aware of how you see things and helps you to see them in a more positive way.

    • Behavioral modification: This teaches you how to control your actions and emotions.

    • Stimulation therapy: This therapy is used to help keep your mind active. Caregivers may use music, art, or animals in this type of therapy.

Where can I get more information?

  • Alzheimer's Association
    225 N.Michigan Ave, FL 17
    Chicago , IL 60601-7633
    Phone: 1- 800 - 272-3900
    Web Address: http://www.alz.org
  • Alzheimer's Disease Education and Referral Center
    P.O. Box 8250
    Silver Spring , MD 20907
    P.O. Box 8250
    Silver Spring , MD 20907
    Phone: 1- 800 - 4384380
    Web Address: http://www.alzheimers.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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