|Areas of the Brain Affected by Alzheimer's Disease|
|Copyright © Nucleus Medical Media, Inc.|
- Plaques—Abnormal deposits of a substance called beta amyloid in different areas of the brain
- Neurofibrillary tangles—Twisted fibers (called tau fibers) within the nerve cells
- Age: 65 and older
- Previous serious, traumatic brain injury
- Lower educational achievement
- Obesity in middle-age
- Down's syndrome
- Down's syndrome in a first-degree relative
- Women under age 35 who give birth to a child with Down's syndrome
- Family history of Alzheimer's disease
- Presence of a certain type of protein (APOE-e4)
- Elevated levels of homocysteine
- Heart disease
- Early—Loss of memory, reasoning, understanding, or learning, but does not interfere with independence
- Intermediate—Increased mental loss, personality changes, and increased dependence on others for basic needs
- Severe—Loss of personality and bodily functions with total dependence on others for care
Increasing trouble remembering things, such as:
- How to get to familiar locations
- What the names of family and friends are
- Where common objects are usually kept
- How to do simple math
- How to do usual tasks, such as cooking, dressing, bathing, etc.
- Having difficulty concentrating on tasks
- Having difficulty completing sentences due to lost or forgotten words (may progress to complete inability to speak)
- Forgetting the date, time of day, or season
- Getting lost in familiar surroundings
- Having mood swings
- Being withdrawn, losing interest in usual activities
- Having personality changes
- Walking in a slow, shuffling way
- Having poor coordination
- Losing purposeful movement
- Neurological exams—Tests of your nervous system
- Psychological and mental status testing
- CT scan
- MRI scan
- Electroencephalogram (EEG)
- Blood tests and urine tests
- Lumbar puncture —To test for levels of certain brain proteins that increase with Alzheimer’s disease and to rule out other disorders
- Positron emission tomography (PET) scan of the brain—A test that makes images showing activity in your brain
Medications for Symptoms and Disease Progression
- Cholinesterase inhibitors—Recommended for mild-to-moderate Alzheimer's disease (donepezil, rivastigmine, galantamine)
- N-methyl-D-aspartate (NMDA) receptor antagonist—For moderate-to-severe Alzheimer's disease (memantine)
- Creating an environment in which you can receive the care you need
- Keeping your quality of life as high as possible
- Keeping yourself safe
- Helping yourself learn to deal with the frustration of your uncontrollable behavior
- Providing a calm, quiet, predictable environment
- Providing appropriate eyewear and hearing aids, and easy-to-read clocks and calendars
- Playing quiet music
- Doing light, appropriate exercise to reduce agitation and relieve depression
- Encouraging family and close friends to visit frequently
- Confusion, paranoia, and hallucinations
Alzheimer's Association http://www.alz.org
Alzheimer's Disease Education and Referral Center http://www.nia.nih.gov/alzheimers
Alzheimer Society http://www.alzheimer.ca
Health Canada http://www.hc-sc.gc.ca
Albanese E, Dangour AD, et al. Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study. Am J Clin Nutr . 2009;90(2):392-400.
Alzheimer's disease. Activity based prevention strategies. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us . Updated July 11, 2012. Accessed August 22, 2012.
Alzheimer's disease and non-Alzheimer’s dementia. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary . Updated July 7, 2012. Accessed August 22, 2012.
Alzheimer's disease. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us . Updated July 11, 2012. Accessed August 22, 2012.
Alzheimer's disease medications fact sheet. National Institute on Aging website. Available at: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet . Updated July 2010. Accessed August 22, 2012.
American Academy of Neurology website. Available at: http://patients.aan.com/disorders/index.cfm?event=viewampdisorder%5Fid=844 . Accessed August 22, 2012.
Anstey KJ, Mack HA, et al. Alcohol consumption as a risk factor for dementia and cognitive decline: meta-analysis of prospective studies. Am J Geriatr Psychiatry . 2009;17(7):542-555.
Carillo MC, Blackwell A, et al. Early risk assessment for Alzheimer's disease. Alzheimers dementia. 2009;5(2):182-196.
Deweerdt S. Prevention: activity is the best medicine. Nature . 2011;475:S16-S17.
Gidoni R, et al. Cerebrospinal fluid biomarkers in Alzheimer’s disease: the present and the future. Neurodegen Dis . 2011;8:413-420.
Goetz CG. Textbook of Clinical Neurology . Philadelphia, PA: WB Saunders Company; 1999.
Green RC, Cupples LA, et al. Risk of dementia among white and African-American relatives of patients with Alzheimer disease. JAMA . 2002;287:329-336.
Hampel H, Frank R, et al. Biomarkers for Alzheimer’s disease: academic, industry and regulatory perspectives. Nat Rev Drug Discov . 2010;9:560-574.
Hayden KM, Welsh-Bohmer KA. Epidemiology of cognitive aging and Alzheimer’s disease: contributions of the Cache County Utah study of memory, health, and aging. Curr Top Behav Neurosci . 2011 Aug 2.
Kasper DL, Braunwald E, et al. Harrison's Principles of Internal Medicine . 16th ed. New York, NY: The McGraw-Hill Companies; 2005.
Neugroschl J, Sano M. An update on treatment and prevention strategies for Alzheimer’s disease. Curr Neurol Neurosci Rep . 2009;9:368-376.
Rakel RE, Bope ET. Conn's Current Therapy . 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Rowland LP, Merritt HH. Alzheimer's disease and related dementias. Merritt's Neurology . Philadelphia, PA: Lippincott Williams and Wilkins; 2000: chap 106.
Ruitenberg A, van Swieten JC, et al. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet . 2002;359(9303):281-286.
1/8/2010 DynaMed's Systematic Literature Surveillance. Available at: http://dynamed.ebscohost.com/about/about-us : Snitz BE, O'Meara ES, et al. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. JAMA . 2009;302:2663-2670.
5/4/2012 DynaMed's Systematic Literature Surveillance. Available at: http://dynamed.ebscohost.com/about/about-us : Buchman AS, Boyle PA, et al. Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology . 2012;78(17):1323-1329.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -