Alzheimer’s disease is a neurocognitive disorder that is the most common cause of dementia; it accounts for 60 to 80% of cases of dementia in the elderly. In the United States, it is estimated that 10% of people are over 65 and suffer from Alzheimer’s. The percentage of people with Alzheimer’s disease increases with age.
The disease is twice as common in women than in men, which is partly due to the longer life expectancy of women. The prevalence of the number of patients in developed countries is associated with an increase in the proportion of elderly people in them.
Causes of the disease
To date, science knows two main reasons for the development of this disease:
- The destruction of neural connections. Nerve tissue forms the nervous system of the brain and spinal cord, which provides the interaction between the tissues, organs and systems of our body. Nerve tissue consists of neuron cells that are connected by processes to transmit information to each other, they form a single network. As a result of brain activity, a pathological beta-amyloid protein is formed, which is normally produced and removed, but for reasons unknown to science, the moment comes when this protein ceases to be removed, its concentration increases, and it blocks (destroys) neural connections. The transmission of information and communication of neurons cease. The functions of the higher nervous activity of the brain (such as memory, spatial orientation, recognition of the forms of objects, the ability to learn, live in a world of their kind (socialization) and the ability to serve oneself) begin to be disrupted. An increase in the concentration of pathological beta-amyloid protein is perceived by the body as an invasion of the “alien”. An autoimmune inflammatory process begins, and the cells of our immune system (macrophages) additionally destroy, as they think, the enemy – the neurons. It turns out a double blow: both neural connections and the neurons are destroyed.
- Brain cells cannot fully nourish and dry out. Neurons, like any other cells, receive nutrition from the intercellular space for their vital functions. Metabolic processes take place inside the cell, substances are processed, but there comes a time when the tau protein, which is part of the neuron, becomes toxic and begins to interfere with the spread of nutrients inside the cell, some reactions do not go, the cell cannot fully exist and eventually dies. From these processes, the brain begins to “dry out” and decrease in size, which leads to the loss of many of its functions.
Alzheimer’s disease risk factors
Although we still don’t know all the reasons why some people have Alzheimer’s disease, research has made it possible to better understand what factors make people more vulnerable to the disease.
- Age. Elderly age is a major risk factor for Alzheimer’s. Most people with Alzheimer’s disease are at least 65 years old. Although Alzheimer’s disease can begin earlier. It is estimated that the number of such patients is up to 5%. Often, manifestations of Alzheimer’s disease at a younger age are misdiagnosed;
- Relatives with Alzheimer’s. If one of your parents or siblings suffers from Alzheimer’s, then you are more likely to get sick than those who do not have such relatives. Scientists do not fully understand the causes of familial cases of Alzheimer’s disease, but it is possible that genetic and environmental factors and lifestyle play a role;
- Genetic factor. Scientists have identified several genes whose mutations increase the risk of developing Alzheimer’s disease. The APOE gene e4 allele is the most common risk gene for Alzheimer’s disease; it is estimated that it played a role in the development of the disease in about a quarter of cases. Unlike the risk gene, the determining gene guarantees the development of the disease. Only one case is known when Alzheimer’s disease arose as a result of inheritance of the determining gene. The development of Alzheimer’s disease due to the presence of a determining gene occurs rarely, in less than 1% of cases. Alzheimer’s disease caused by the presence of a determining gene is called “autosomal dominant Alzheimer’s disease (ADBA)”;
- Mild cognitive impairment. Symptoms of moderate cognitive impairment include changes in thought processes, but they do not interfere with the performance of everyday functions and are not as serious as in Alzheimer’s disease or other progressive dementia. The presence of mild cognitive impairment, especially related to memory problems, increases the risk of developing Alzheimer’s disease and other dementia. However, mild cognitive impairment does not always progress. In some cases, they are reversible or remain at the same level;
- Cardiovascular diseases. Research suggests that brain health is directly related to cardiovascular health. Through the blood, the brain receives oxygen and nutrients necessary for normal functioning, and the heart is responsible for the flow of blood to the brain. Therefore, the causes that lead to cardiovascular disease may also be related to an increased risk of Alzheimer’s disease and other dementias. These include smoking, overweight, diabetes, high cholesterol and blood pressure in middle age;
- Education level. Studies have found a link between fewer years of formal education and an increased risk of Alzheimer’s and other dementias. Although there is no obvious reason for this addiction, some scholars believe that more years of formal education may help strengthen the connection between neurons, thereby allowing the brain to use alternative signaling pathways from neuron to neuron for changes caused by Alzheimer’s disease and other dementias;
- Traumatic brain injuries. The risk of Alzheimer’s disease and other dementia increases as a result of moderate to severe head injuries, such as blows to the head or other injuries to the skull, which lead to loss of memory or consciousness for more than 30 minutes. 50% of all traumatic brain injuries are caused by traffic accidents. Those who constantly receive blows to the head and other craniocerebral injuries, such as athletes or participants in military conflicts, are also at increased risk for developing dementia and cognitive impairment.
First signs of the disease
First of all, short-term memory suffers. Complaints of elderly people about forgetfulness, requests for the same information several times are quite typical both for age-related features of the functioning of the brain and for the first stages of Alzheimer’s disease. In the presence of the disease, forgetfulness increases, it becomes difficult to process new information, remember not only the location of familiar things but also the names of relatives, one’s age, basic information.
The second symptom of the early stage of the disease is apathy. The interest in the usual forms of pastime is reduced, it becomes more difficult to engage in your favorite hobby, to leave your house for a walk, to meet friends. Apathy comes to the loss of hygiene skills: patients cease to brush their teeth, wash, change clothes.
Common symptoms include speech impairment, starting with an attempt to recall a familiar word and ending with a complete inability to understand the heard, read and the speech itself, isolation, distance from loved ones, spatial orientation disorders: difficulty finding out places, losing the way home, etc.
In men, the state of apathy is often replaced or alternated with increased aggression, provocative acts, and violations of sexual behavior.
Often, early diagnosis of the disease is impossible, since the patients themselves are not aware of the symptoms of the pathological process or attribute them to the effects of fatigue, stress. One of the common mistakes at this stage is attempts to “relieve stress and relax” with alcohol: alcohol-containing drinks significantly accelerate the death of brain cells and cause an increase in symptoms.
Unfortunately, it is not yet possible to cure a patient suffering from Alzheimer’s disease. Scientists fail to come to a common opinion about its cause; they discuss various hypotheses but have not created a final theory. This seriously complicates the search for medicinal and other treatments for Alzheimer’s disease.
The fight against the disease has become today one of the most important public health problems worldwide (in connection with the aging of the world’s population). More than one billion US dollars are allocated for its solution. Large pharmaceutical companies, associations and foundations, as well as governments of developed countries, participate in the financing.
What treatment for Alzheimer’s is available today? Existing treatment does not eliminate the causes of the disease, but allows solving two important problems: slow down the degenerative process and reduce the severity of symptoms associated with this process. In addition, it is designed to help the body withstand some factors leading to the death of neurons.
Treatment of Alzheimer’s disease includes the following components:
- anti-dementia drug therapy – the use of drugs that improve the connection between neurons (memantine, acetylcholinesterase inhibitors);
- improved blood circulation in the brain;
- normalization of metabolic processes;
- blood pressure control;
- moderate mental and physical stress (in the early stages);
- behavioral therapy;
- a diet rich in natural antioxidants to reduce free radicals;
- antidepressants and antipsychotics (for behavioral disorders).
Alzheimer’s disease prevention
Can Alzheimer’s be prevented? Experts agree that in the vast majority of cases, this disease, like other chronic diseases, probably develops as a result of complex interactions between various factors, including age, genetics, environment, lifestyle and associated diseases.
Factors such as age or genes cannot be changed, however, everything else can be minimized to reduce the risk of Alzheimer’s. The main objective of the preventive steps is to improve cognitive processes, contribute to the construction of new neural connections in the brain.
- Brain training: learning new information (words, poems), intellectual games, playing musical instruments and even performing the usual rituals with your left hand or changing the route to work, can strengthen the neural networks of the brain and slow down their weakening during aging. These steps reduce the risk of the disease by 2.4 times;
- Special nutrition: a balanced diet with a low glycemic index prevents not only cardiovascular disease and diabetes but also dementia. For the health of the brain and the whole body, the daily diet should include lean meats, sea fish, whole grain products, eggs, fruits and vegetables, especially greens, nuts, legumes, sour-milk products, and high-quality fats. An excess of carbohydrates, fried foods, trans fats and sweets should be avoided because consuming 30 grams of sugar per day increases the risk of illness by 33%;
- Sport and physical activity: to prevent Alzheimer’s, you don’t have to spend hours in the training room, it is much more important to regularly and moderately load the body with various types of activities. This can be walking, running, playing sports several times a week, dancing. Scientists claim this helps not only improve muscle tone, the blood supply to the whole body but also improve cognitive functions;
- Socialization and a sense of happiness: loneliness, chronic stress, and depression increase the likelihood of Alzheimer’s development because due to the high level of cortisol (stress hormone), the brain areas responsible for memory are reduced. Therefore, communication, friendship and self-realization are no less important for the elderly than at a young age.
What to do if you suspect Alzheimer’s
The first thing is to contact your family doctor and describe all the symptoms that worry you. The doctor will ask you additional questions and, perhaps, offer to take a series of tests – urine, blood (including thyroid hormones). Some signs of impending dementia are similar to symptoms of other diseases – endocrine disorders, depression, anemia – and here it is important not to confuse them.
If a doctor confirms your suspicions, you will receive a referral to a neurologist. A narrow-field specialist will evaluate your condition and offer the most suitable preventive measures. Unfortunately, it is impossible to completely prevent Alzheimer’s disease. But you can suspend its development.