Alzheimer’s Disease: A Brief Overview

By Austen Smith, DO, Family Medicine Resident

The Centers for Disease Control and Prevention (CDC) describes Alzheimer’s disease as “an irreversible, progressive brain disease that affects an estimated 5.7 million Americans.” Symptoms of Alzheimer’s often first appear in the seventh decade of life (age 60-69) and rarely present before age 60. 

Alzheimer's Disease quick facts:

  • The most common form of dementia 
  • An estimated 13.8 million Americans over the age of 65 will have this diagnosis by 2050 
  • The 6th leading cause of death in the United States, but is estimated to be the 3rd leading cause when including disease complications (negative disease consequences)
  • The greatest known risk factor is age, with the risk doubling every 5 years after the age of 65 

How is Alzheimer’s disease diagnosed?

The diagnosis of Alzheimer’s disease is clinical, meaning patient symptoms and history are used to establish the diagnosis. In 2011, the National Institute on Aging and the Alzheimer's Association revised and updated the criteria for diagnosing Alzheimer’s. They describe the disease progressing on a spectrum through three stages. The stages are highlighted below. 

  1. Preclinical Alzheimer’s disease – During this stage, brain changes begin to occur but individuals are asymptomatic, or lack symptoms. Changes often include the accumulation of a protein, beta-amyloid, between nerve (brain) cells. These protein deposits disrupt nerve cell communication and lead to nerve cell death. 
  2. Mild cognitive impairment – Symptoms begin to surface during this stage and include impairments with problem solving, retaining new information, and learning. The symptoms are mild and do not interfere with normal everyday life. To rule out other explanations for the symptoms, healthcare providers may review medication lists, order blood tests, and use brain imaging.
  3. Alzheimer’s dementia – This final stage is characterized by symptoms which are significant enough to disrupt daily functioning and independence. These symptoms are noticeable to family, friends and healthcare providers and include changes in personality and behavior, becoming lost in familiar places, repeating questions, and difficulty with expressing ideas. 

What are the modifiable (able to be changed) risk factors for Alzheimer’s disease?

  • Hypertension, or high blood pressure 
  • High cholesterol, specifically LDL 
  • Obesity 
  • Type 2 diabetes 
  • Cigarette smoking 
  • Sedentary lifestyle with lack of exercise 
  • Poor sleeping habits 
  • Brain trauma or injury 

Is treatment available for Alzheimer’s disease? 

Although there is no current cure for Alzheimer’s disease, medication and non-medication treatments are available to maintain and possibly improve quality of life. The treatments target the symptoms of the disease including memory, confusion, sleep changes, depression, anxiety, agitation and paranoia. 

What can be done to prevent Alzheimer’s disease? 

New research reported in July of this year highlights the importance of implementing healthy choices to reduce the risk of developing Alzheimer’s. The study was outlined in The Washington Post and focused on the five lifestyle choices listed below. Mentally stimulating activities such as reading, completing crosswords or puzzles can help reduce your risk of developing Alzheimer's disease.
 

  1. Healthy diet – consisting mostly of vegetables, nuts, berries, beans, whole grains, seafood, poultry and olive oil; while avoiding red meats, butter, cheese, pastries, fried food, and sweets. 
  2. Moderate to vigorous physical activity – such as biking, walking, swimming, gardening, and weight training at a minimum of 150 minutes per week. 
  3. Avoid smoking.
  4. Light to moderate alcohol intake – such as limiting consumption to no more than one glass of wine per day.
  5. Mentally stimulating activities – such as reading books or the newspaper, playing chess or checkers, completing crosswords, puzzles and Sudoku at a minimum of 2-3x per week

Participants of the study who implemented at least four of the healthy habits experienced a 60% reduction in developing Alzheimer’s compared to participants who implemented no more than one of the habits. This makes sense, as most of the healthy lifestyle choices studied target the modifiable risk factors of Alzheimer’s disease which are listed above. 

Alzheimer’s disease is a potentially fatal disease that disrupts the life of the individual diagnosed and surrounding loved ones. Embracing a healthy lifestyle may reduce your risk of developing the disease. If you have questions or concerns about Alzheimer’s, contact your physician or other healthcare professional.