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Alzheimer's Disease
  What Is Alzheimer's Disease?

By Michele Simon, JD, MPH

Reviewed by Robin Bennett, MS, CGC
Last updated April 12, 2001



what is alzheimers diseaseAlzheimer's disease is a progressive, degenerative disorder that attacks the brain and results in disorientation, with impaired memory, thinking, and judgement. People with Alzheimers also undergo changes in their behavior. This combination of symptoms is also called dementia.


Who Gets Alzheimer's Disease?

About four million Americans have Alzheimer's disease, with men and women affected almost equally. Most people diagnosed with Alzheimer's disease are older than age 65 and the risk increases with age. However, it can also occur in people as young as in their 30s. One in ten people over age 65 and nearly half of those over age 85 have Alzheimer's disease. In a national survey, 19 million Americans said they had a family member with Alzheimer's disease.

The only established risk factors for Alzheimer's are older age, family history of dementia, and inheriting mutations in certain genes. In most cases, Alzheimer's disease isn't caused by any one factor. Instead, it is usually a result of genes and environmental factors that researchers have not yet identified. (For recent news about risk factors for Alzheimer's disease and who develops the disease, see Related News below.)


What Are the Signs and Symptoms?

Contrary to what many people believe, memory loss, confusion, and disorientation are not part of the normal aging process. The trick is to be able to distinguish normal, everyday forgetfulness from a disease process that could be Alzheimer's disease. Symptoms of Alzheimer's disease can include:

  • Gradual memory loss
  • Decline in ability to perform routine tasks
  • Disorientation
  • Difficulty in learning
  • Loss in language skills
  • Impairment of judgment
  • Personality changes

Alzheimer's disease begins slowly. The first symptoms may only be mild forgetfulness. As the disease progresses, symptoms become more noticeable. For example, someone with Alzheimer's may forget how to do simple tasks, such as brushing their teeth or combing their hair. They no longer think clearly and begin to have problems speaking, reading, or writing. People with Alzheimer's can also experience drastic changes in personality, mood, or behavior. They can also become extremely confused, suspicious, fearful, or quite passive. Eventually, people with Alzheimer's disease become completely incapable of caring for themselves. (For recent news about signs of Alzheimer's disease, see Related News below.)

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How Is Alzheimer's Disease Diagnosed?

Symptoms for Alzheimer's disease can also be caused by other conditions, some of which are treatable. These include thyroid gland problems, drug reactions, and severe depression. No single test exists to diagnose Alzheimer's disease, but a series of tests can rule out other illnesses and help doctors make their diagnosis. However, the only way to conclusively diagnose Alzheimer's disease is by examining the brain tissue after death for the brain alterations that are the hallmark of Alzheimer's disease.

A doctor will conduct a comprehensive evaluation that will likely include:

  • Complete health history
  • Physical examination
  • Neurological and mental assessments
  • Blood and urine analysis
  • EKG and chest x-rays

Also, keeping a written diary of symptoms and behaviors over time will help your health care providers understand your disease (or the disease of a loved-one). Your doctor may order additional tests such as computerized tomography (CT scan) and magnetic resonance imaging (MRI) to diagnose other possible disorders. In addition, some medical centers are beginning to offer genetic testing to individuals with a family history that is suggestive of hereditary Alzheimer's.


How Does Alzheimer's Disease Progress?

In people with Alzheimer's disease, changes to nerve fibers accumulate in the brain. These changes reduce the number and effectiveness of nerve cell connections. Short-term memory is affected first, followed by those sections of the brain that control other intellectual and physical functions. The rate of progression in Alzheimer's disease varies with each individual. Some people become rapidly worse, while others remain stable for a long time. Traditionally, researchers believed that people survived an average of 8 years after being diagnosed with Alzheimer's, but a recent study in the New England Journal of Medicine found that the average survival was only about 3.5 years. However, some people have been known to live as long as 20 years after diagosis. When death does come, it usually results from a related infection, such as pneumonia.

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What Treatment Is Available?

Although there is no cure available for Alzheimer's disease, certain interventions and medication can help treat the symptoms of the disease.

Two FDA-approved drugs used to treat Alzheimer's disease are tacrine and donepezil. Both of these drugs help maintain levels of the brain chemical acetylcholine, which is produced at much lower levels in people with Alzheimer's disease. They work by suppressing the enzyme that breaks down acetylcholine in the brain. However, they don't work for everyone and they do have significant side effects. Additional promising drugs are being developed, some of which may be available within the next few years.

Also, some medications may help control behavioral problems associated with Alzheimer's disease, such as insomnia, agitation, anxiety, and depression. Proper nutrition, exercise, and stimulating social activities are all important. People with Alzheimer's disease should be in a familiar environment that includes daily routines, maintains links with the outside world, and encourages communication. Effective management of Alzheimer's disease also includes education, counseling, and support for caregivers and other family members. ( For more information about research into Alzheimer's disease treatment, see Related News below.)

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Alzheimer's Association (http://www.alz.org).

McConnell, LM. (1999). Understanding Genetic Testing for Alzheimer's disease: Medical and Epidemiological Background. Genetic Testing 3(1): 21-27.

National Institutes of Health, Alzheimer's Disease Education and Referral Center (http://www.alzheimers.org).

Wolfson, C. (2001). A Reevaluation of the Duration of Survival After the Onset of Dementia. NEJM 344(15):1111-1116.


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