Am Fam Physician. 1998;58(7):1589-1590
See related article on Alzheimer's disease.
What is Alzheimer's disease?
Alzheimer's disease is a condition that damages several parts of the brain. Usually, the first sign is a poor memory or having trouble doing things that the person used to do, like balancing a checkbook, grocery shopping or finding the right words when talking. The disease may get worse slowly, so it isn't unusual for someone to have the disease for 10 years or more before it's diagnosed.
What causes Alzheimer's disease?
We don't know what causes the damage in the brains of people with Alzheimer's disease. We do know that you can't catch it from someone. We also know that this kind of damage isn't caused by strokes or “hardening of the arteries.” People as young as 40 can get Alzheimer's, but it usually affects people over age 75.
The leading risk factor for Alzheimer's disease is old age. The chance of getting Alzheimer's is about 1 in 3 after age 85. It may run in the family. Unknown triggers in the environment may also bring on the disease in some people.
What's it like to have Alzheimer's disease?
Very early in the disease, some people with Alzheimer's don't even know that anything is wrong. Instead, their families may notice that the person doesn't remember as well or can't think as clearly, or has different emotional reactions. Sometimes people with Alzheimer's become frustrated, fearful or depressed.
As time passes, people with Alzheimer's lose more abilities. They often lose their train of thought while speaking. Later on, they may become unable to speak in sentences. In addition, eventually they need help with daily activities such as housework or bathing. Many people with Alzheimer's eventually lose the ability to walk or feed themselves. By this time, people with the disease usually aren't aware of what's the matter, but they may still feel frustrated, sad or afraid.
How is Alzheimer's disease diagnosed?
There is no one test for Alzheimer's disease. Instead, doctors make the diagnosis on the basis of the symptoms and the course of the disease, the results of a physical exam and laboratory tests that rule out other causes of brain disease.
What should we expect from our family doctor?
Your doctor will do a careful exam, with blood tests and maybe a CT scan or MRI scan. Your doctor will explain the results and tell you about possible treatments, including new medicines. Your doctor should be there to help you during the illness.
How is Alzheimer's disease treated?
There's no cure for Alzheimer's disease, but many things can be done to help the person with this condition. First of all, it's important to have the right diagnosis and to treat other diseases. There are some medicines that give a little help to some people, but not to everyone. It's important to be sure that medicines don't add to problems with memory or behavior. You can help your loved one cope by minimizing stresses and hazards at home. People with Alzheimer's should be helped to do as much by themselves as they can. Sometimes, hard decisions must be made, such as not allowing the person to drive anymore. Your doctor can help with the difficult decisions. You'll need support, advice and assistance.
Where can we get more support and advice about Alzheimer's disease?
The Alzheimer's Association provides information and support for people with Alzheimer's disease and their families. The association sponsors support groups for families in many cities and gives out information about Alzheimer's disease.
A book you may find helpful is The 36-Hour Day: A Family Guide to Caring for Persons with Alzheimer's Disease, Related Dementing Illnesses, and Memory Loss in Later Life, by Nancy L. Mace and Peter V. Rabins, published in 1991 by Johns Hopkins University Press.