Alzheimer’s… How does the disease start and progress?

Alzheimer’s is a type of dementia that affects memory, thinking and behavior. It is a neurodegenerative disease, which means there is progressive brain cell death that happens over a course of time. The total brain size shrinks with Alzheimer’s – the tissue has progressively fewer nerve cells and connections. Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.

Alzheimer’s disease slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. Memory loss is the key symptom of Alzheimer’s. Early signs include difficulty remembering recent events or conversations. As the disease progresses, memory impairments worsen and other symptoms develop. At first, a person with Alzheimer’s disease may be aware of having difficulty remembering things and organizing thoughts.

Over time, Alzheimer’s can lead to an inability to carry out daily activities, such as getting dressed, eating and taking care of himself. The patient needs complete care during the advanced stages of the disease.

The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly. 

Researchers trying to understand the cause of Alzheimer’s disease are focused on the role of two proteins: Beta-amyloid, which is a fragment of a larger protein. When these fragments cluster together, they appear to have a toxic effect on neurons and to disrupt cell-to-cell communication. Whereas tau proteins play a part in a neuron’s internal support and transport system to carry nutrients and other essential materials. In Alzheimer’s disease, tau proteins change shape and organize themselves into structures called neurofibrillary tangles. The tangles disrupt the transport system and are toxic to cells.

Caring for someone with Alzheimer’s

The Alzheimer’s patient mainly needs someone to be close to him, take care of him, without complaining, which is what the awareness campaigns focus on; they seek to educate the community about the disease and how to provide support and assistance to those people in order to improve their life by providing treatment and supportive devices in addition to offering support and advice to the patient’s family and to those who care for them. 

All family members should everyone know some basic information about the disease and its development and how to take care of the patient at home to prevent the deterioration of his medical condition.

Here are some tips and advice for people living with Alzheimer’s patients:

• The person who takes care of the patient on a daily basis must have some time to rest, otherwise they will not be able to carry out their assigned tasks alone. Rest is fundamental between daily tasks.
• Establish a daily schedule and routine for daily tasks such as bathing, medication, food and medical appointments.
• The person caring for the Alzheimer’s patient should be aware that routine tasks will take longer than they used to.
• Teaching the patient to participate in chores as much as possible, such as getting dressed or making his bed.
• Be specific when asking the patient about something, because multiple options confuse him, for example, do you prefer coffee or tea.
• Avoid napping or sleeping during daytime as this limits the patient’s ability to sleep at night.
• When eating or talking with the patient, the surrounding factors that distract him, such as watching television or talking on the phone, should be minimized, in order to boost his concentration.
• You should provide the patient with a safe environment in order to avoid injuries and promote general safety at home. Wires, carpets or any clutter must be removed, in addition to installing grab bars beside the toilet and in the shower. Closets containing toxic cleaning materials and dangerous tools must be locked.

Dementia or Alzheimer’s

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia. There are types of dementia other than Alzheimer’s disease, such as vascular dementia, frontotemporal dementia, mixed dementia and dementia due to both Parkinson’s disease and Huntington’s disease. An important part of diagnosing Alzheimer’s disease includes being able to explain your symptoms, as well as perspective from a close family member or friend about symptoms and their impact on daily life. Additionally, a diagnosis of Alzheimer’s disease is based on tests your doctor administers to assess memory and thinking skills. Laboratory and imaging tests can rule out other potential causes or help the doctor better identify the disease causing dementia symptoms.

Symptoms

Early signs and symptoms of Alzheimer’s disease can therefore be summarized as follows:

• Memory loss
• Trouble focusing and problem solving
• Inability to do simple things and daily chores
• Difficulty to remember times and places
• Changes in vision
• Poor judgment and decision-making
• Difficulty to think of common words during a conversation
• Mood changes such as depression

How does Alzheimer’s start?

The early signs of the disease include forgetting recent events or conversations. As the disease progresses, a person with Alzheimer’s disease will develop severe memory impairment and lose the ability to carry out everyday tasks.

At this stage, the patient becomes anxious and nervous because of his inability to carry out daily tasks; Here comes the role of the family in providing him with psychological support, urging him to do things by himself, encouraging him to do so, and not blaming him if he makes a mistake so that he feels valued.

Advanced Stage

As the disease progresses, the person will need more help and, at some point, will need a lot of support with daily living. The patient will forget names and places, his short-term memory deteriorates, and may fail to recognize people. He will get upset quickly because he feels frustrated and loses his self-confidence.

Individuals lose track of where they are, the day of the week or the season. They may confuse family members or close friends with one another or mistake strangers for family. They may wander, possibly in search of surroundings that feel more familiar. These difficulties make it unsafe to leave those in the moderate dementia stage on their own. An upset in the internal body clock will cause a biological mix-up between day and night in patients with Alzheimer’s. Visual hallucinations are also common in patients with Alzheimer’s.

Late Stage

In the late stage of the disease, mental function continues to decline, and the disease has a growing impact on movement and physical capabilities. People generally lose the ability to communicate coherently, the patient can no longer converse or speak in ways that make sense, although he or she may occasionally say words or phrases. Require daily assistance with personal care, this includes total assistance with eating, dressing, using the bathroom and all other daily self-care tasks. The patient will experience a decline in physical abilities, he will become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions.

Exercise

Exercise has many known benefits for both physical and mental health, including reducing the risk of cardiovascular disease and diabetes, strengthening the bones and muscles, and reducing stress. It also appears that regular physical activity benefits the brain. Studies show that people who are physically active are less likely to experience a decline in their mental function and have a lowered risk of developing Alzheimer’s disease. 

Physical activity is one of the known modifiable risk factors for dementia. Plus, regular exercise helps combat other Alzheimer’s disease risk factors, such as depression and obesity.

Obesity

There is a close association between obesity and the risk of Alzheimer’s disease, with one study showing that people with a BMI of 30 or more had a 31% risk of developing dementia.

Type II diabetes

People with type 2 diabetes have an increased risk of developing Alzheimer’s disease. Certain lifestyle choices, such as physical activity and diet, may help support brain health and prevent Alzheimer’s. Many of these lifestyle changes have been shown to lower the risk of other diseases, like heart disease and diabetes, which have been linked to Alzheimer’s.

In Alzheimer’s patients, there is a lack of insulin signals in the brain, which leads to a loss of energy in brain cells, and lead them to become without sufficient insulin signals. Hence, blood sugar won’t be transferred to brain cells.

There is still no radical treatment for Alzheimer’s disease, however, there are some lifestyle changes that can control the symptoms as much as possible. 

Some of the effective ways to prevent Alzheimer’s disease include being fit as weight loss is one of the best natural ways to prevent it, as a study has shown that obesity and overweight may lead to Alzheimer’s disease with age. Eating healthy foods rich in nutrients and minerals, especially foods containing omega-3 fatty acids, helps keep your brain cells healthy. 

Much of Alzheimer’s risk is related to nutrition and lifestyle factors that can be changed. Given that it is an irreversible condition, the best hope is prevention by encouraging positive diet and lifestyle changes that can impact cognitive function.