Alzheimer's disease

Alzheimer’s disease is a neurological disorder in which the brain slowly degenerates, leading to problems with memory, daily function and behavior.

Alzheimer’s disease overview

Alzheimer’s disease is a progressive brain disorder, in which the brain gradually degenerates. It most frequently occurs in people aged above 65–70 years.1

Over the course of the disease, areas of the brain degenerate, resulting in cellular loss and dysfunction, a gradual loss of memory, problems with reasoning or judgment, disorientation, difficulty in learning, loss of language skills and decline in the ability to perform routine tasks.2 These changes increasingly impact upon the person’s daily life, reducing their independence, until ultimately, they are entirely dependent on others.

Alzheimer’s disease also has an enormous impact on those who care for an individual with Alzheimer’s disease.3 Most caregivers are close relatives who provide care in the home – a demanding and exhausting role that represents a huge emotional and physical burden.3

Symptoms

The symptoms of Alzheimer’s disease emerge gradually, over a period of years, and vary from person to person. The first symptoms to appear are usually forgetfulness and mild confusion. Symptoms of Alzheimer’s disease can be broadly categorized into cognitive, functional and behavioral/psychological changes.

Cognitive changes – impaired short-term memory (such as impaired knowledge of recent events, repeating oneself, losing items around the house, poor organization), difficulty in making decisions, reduced understanding of the concept of time and space, reduced ability to learn and problems recognizing friends and family.4-6  

Functional changes – reduced ability to perform daily activities: difficulty handling money, travelling and self-care (eating, getting dressed, maintaining personal hygiene)) as well as problems with balance and unsteady movements.4 Ultimately, those with Alzheimer’s disease will usually become completely dependent on caregivers.4, 7

Behavioral/psychiatric changes – patients may also develop behavioral disturbances, which increase the burden of care. It includes withdrawal from social activities, apathy/indifference, depressed mood, anxiety, and agitation.4 Behavioral changes are particularly difficult for family and carers to cope with, and are often the reason for patients being moved to institutional care.8

Early warning signs9

  1. Memory loss that disrupts daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work or at leisure
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

Epidemiology and burden

Worldwide, 50 million people have dementia.2 With the shift towards an increasingly elderly population, there is nearly 30 million of new cases every year.1 The WHO predicts that the prevalence of dementia will almost double every 20 years, and by the year 2050, 152 million people will have the condition.1

Alzheimer’s disease is the most common cause of dementia, accounting for 60-80% of dementia cases.4

The total global societal cost of dementia is estimated to be USD 818 billion, rising to USD 2 trillion by 2030.1

Diagnosis and care

People who are concerned that they – or their loved ones – are experiencing symptoms of Alzheimer’s disease should see their doctor for help and advice. Alzheimer’s disease is diagnosed using patient and caregiver interviews; sometimes blood tests and brain imaging techniques are also performed. There are numerous assessment scales that can be used to identify the symptoms, and severity, of the disease.

Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.9

References

  1. World Health Organization. Dementia - A public health priority. 2017. (http://www.who.int/mental_health/neurology/dementia/infographic_dementia/en/).
  2. World Health Organization. Dementia fact sheet. 2017. (http://www.who.int/mediacentre/factsheets/fs362/en/)
  3. Georges J, Jansen S, Jackson J, et al. Alzheimer’s disease in real life – the dementia carer’s survey. Int J Geriatr Psychiatry 2008; 23 (5): 546–551.
  4. Alzheimer’s Association. Alzheimer’s Association Report. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12 (4): 459–509.
  5. Joubert S, Joncas S, Barbeau E, et al. Cognition. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
  6. Rainville C, Caza N, Belleville S, Gilbert B. Neuropsychological assessment. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
  7. Gélinas I. Functional autonomy. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
  8. Teng E, Cummings JL. Behaviour. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
  9. Alzheimer’s Association. Basics of Alzheimer’s disease:  http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
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