Understanding Alzheimer’s Disease
Alzheimer’s disease is one of a number of diseases associated with deterioration of the brain’s function or stability, which usually affects the elderly. Such degeneration is not entirely natural because not everyone will experience the disease, but rather this deterioration is caused by the presence of an insoluble substance called beta-amyloid. When this substance attaches on to the brain cells, it causes significant damage, interrupting vital messages being relayed between the cells and simultaneously lowering levels of acetylcholine, a substance that is directly responsible for memory function.
As beta-amyloid accumulate in the brain, they gradually decrease the brain’s function starting at the hippocampus, the part of the brain that is crucial for retaining new information. When the cells in this area are damaged, patients begin to experience issues regarding their short-term memory but then, as the damage spreads to other regions of the brain, so too do the negative effects, eventually affecting their learning skills, emotional stability, communication skills and general patterns of behavior.
Alzheimer’s Disease and Dementia
Many people may wonder whether these 2 words have the same meaning or not. Dementia is not a disease but a syndrome, or a condition that has a list of symptoms involving cognitive function (e.g. memory, decision making, problem solving, etc.) and also, in most cases, behavior and psychiatric symptoms (e.g. aggression, depression, delusion, etc.). Once a person is diagnosed with dementia, the physician has to find the cause or disease that causes the dementia. Alzheimer’s disease is the most common cause of dementia. This is why people are confused with these 2 words, as in more than half of people with dementia, the cause is Alzheimer’s disease. Other causes of dementia include stroke, hydrocephalus (excessive fluid in brain space), hypothyroidism, other non-Alzheimer’s type degenerative disease, vitamin B12 deficiency, and many other conditions.
- Reversible dementia, which makes up around 20% of all dementia cases, is usually a result of physical factors, such as some types of brain tumor, vitamin B12 deficiencies and hypothyroidism.
- Non-reversible dementia makes up the remaining 80% of dementia cases and includes those cases caused by Alzheimer’s disease, which account for 50% of this number, while the remainder are caused by the 5–6 types of dementia close to Alzheimer’s disease. It is therefore appropriate to refer to Alzheimer’s disease as being the most common cause of dementia in the elderly.
Age is another crucial factor, as the risk of developing Alzheimer’s disease increases as a person ages. Statistics have proven this link, with findings revealing that 5% of those aged above 65 have the disease, while 15% of those aged above 75 suffer from the condition and up to 40% of over 85s develop the illness. These numbers show a clear upward trajectory in terms of current Alzheimer’s cases, which is no surprise given that the general population is constantly aging.
Moreover, Alzheimer’s has been shown to be genetically transferrable, although figures show that such cases are in the minority, with a mere 5% of cases shown to develop hereditarily, while symptoms tend to appear between 50–60 years old among this group.
Alzheimer’s disease is not just about becoming forgetful
The early warning signs of Alzheimer’s disease include a deterioration of short-term memory function, but this is also a symptom of natural brain degeneration in the elderly. However, 80–90% of Alzheimer’s sufferers will begin to experience behavioral or psychological issues over time, and it is this group of symptoms that makes caring for these people especially difficult, particularly when their behavior becomes aggressive.
General symptoms of Alzheimer’s disease can be simply categorized according to the following stages of the illness:
- Initial stages — Patients will begin to suffer from noticeable short-term memory loss, often asking the same question or saying the same thing repeatedly. They may also become confused when navigating familiar routes, start to feel stressed, and become easily frustrated and depressed. However, they will usually be able to communicate and undertake daily tasks as usual, meaning loved ones should not have too many issues when providing care at this stage of the disease.
- Moderate decline stages — Symptoms will become more pronounced, with memory severely affected and patients susceptible to behavioral changes, such as leaving the house for no apparent reason. The disease can also completely change a whole persona, meaning that previously calm and collected people turn angry and aggressive, shouting and swearing, while others who were previously quite hot-tempered may become introverted and depressed. Moreover, as time passes, patients will be less able to undertake daily tasks, such as making a cup of coffee, using a remote control, or operating a mobile phone. They will find it difficult to think clearly and may experience alternate realities, including becoming paranoid that someone is out to get them or steal from them, or even thinking that their partner is having an affair. All of this makes caring for people with moderate levels of decline a difficult task
- Final stages — Patients experience further decline, becoming unresponsive to their surroundings and suffering from physical symptoms that leave them bed-ridden and unable to eat, move independently or do anything without assistance. The brain damage will have spread so far by this point that speaking becomes impossible and the body finds it increasingly difficult to fend off disease, with ultimately fatal consequences. The time it takes to navigate each stage of the disease is usually between 8–10 years from the time of the initial diagnosis.
Bumrungrad International Clinic Building,
Floor, Bumrungrad Hospital, Sukhumvit 33,
Soi 3, Khet Wattana, Bangkok 10110, Thailand
Telephone: 02 011 3994