All About Alzheimer’s Disease

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The Good News About Alzheimer’s Disease

There’s a lot of good news about Alzheimer’s disease and its treatment these days. Medical researchers all around the world are eagerly searching for better treatments and for a cure. We’ve gained a huge understanding about the causes of Alzheimer’s from the many drug companies that have been searching. The many compounds that were found not to be effective have produced a wealth of information about what might work and what doesn’t work. We are encouraged that the road ahead is getting clearer even though we wish it weren’t taking so long. The top academic experts believe that we’re closer than ever to Alzheimer’s treatments that will stop or greatly slow disease progression. As always, our website provides unbiased information. We praise what works, debunk anything that doesn’t work, and keep you informed about what’s on the horizon.

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What is Alzheimer’s Disease?

Alzheimer’s disease is a medical condition, a brain disorder, that causes a loss of the ability to think. The famous 17th century philosopher René Descartes said, “I think, therefore I am.” (See our free page on Your Mind & Your Brain.) The fact that we are thinking creatures confirms our existence. We need to think to live life, to learn new things, be it phone numbers or driving directions. We have to be able to prioritize which tasks to do first. And we have to think to do things, like make a sandwich, use a mobile phone, or find a web page. To have a successful social life we need to keep up, recognize people, remember names, and understand social situations. For all of these areas we need to think. Alzheimer disease slowly destroys the ability to think.

A Reader Asks:

What goes wrong in Alzheimer’s? I don’t get it. What’s the problem?

Wow, you have hit the bullseye of the target with this question. That’s exactly the problem. The world’s greatest scientists have been trying for years to understand what exactly is wrong in Alzheimer’s. It has stumped them all. Medical science still does not know. Dr. Alzheimer first described the disease in 1906. Putting the brain of a person who died of Alzheimer’s under a microscope he saw abnormal lumpy proteins which he called amyloid plaques and neurofibrillary tangles. But we now have drugs that remove these lumpy proteins but the drugs still don’t slow Alzheimer’s. No one can understand what’s wrong. We think we know all the parts and pieces of Alzheimer’s disease but we don’t. We’re missing something and we don’t know what.

What Are the Earliest Warning Signs of Alzheimer’s?

What signs to watch for? What’s the first symptom you see? These questions are not as straightforward to answer as one might hope. Here’s the problem. Everyone, as they get older, develops minor quirks and wrinkles in thinking. Most of the time these never become Alzheimer’s or any other medical condition. So how can one tell if simple forgetfulness in recalling someone’s name is Alzheimer’s? You can’t. That’s because an important part of identifying Alzheimer’s is time. So the question is, as time goes by does this minor thinking glitch get worse? And there’s another hurdle. How can you keep track over time of your ability to think if your thinking keeps getting worse? You won’t be able to remember.

Solving the “First Sign of Alzheimer’s” Problem

There are at least a couple of ways to solve knowing whether you see the first early signs of Alzheimer’s. One needs a friend or relative you trust. If you don’t have such a trusted person in your life, or you just want to be private about it, get a little book to use as a diary. Whether you tell a person or make a diary note, once a week mark the way you feel your thinking, along with the date. Every two or three months note how you’re doing. In less than a year your trusted person or your diary will give you a good idea if things are really getting worse or are actually just staying about the same. It’s gradual continued thinking loss as time goes by that answers the question about whether something more serious is going on, like Alzheimer’s.

A Fork in the Alzheimer’s Road : An Important “First Sign”

One can have a few mental hiccups, problems with losing some thinking ability, but continue to chug along with life. The bills get paid, the medicines are taken, you call your daughter once a day. These mental hiccups are not Alzheimer’s. It might be normal aging or it could be “pre-Alzheimer’s”, but it’s not Alzheimer’s. To tell the difference you need to wait and see, track changes over time. If a few years go by and nothing’s different, it’s probably not Alzheimer’s. If it’s worse than this, if the person really can’t live independently anymore, that’s more like Alzheimer’s. It’s when the bills don’t get paid, the medicines get mixed up, and the milk gets put in the cabinet and the cereal in the refrigerator. That’s more like Alzheimer’s.

Are the First Signs Different in Women and Men?

The shortest and best answer to this question is no, there are no differences. But there’s a lot of research on this question. Different groups find different things, and so the findings are not consistent. There is some thought that men might keep the ability to name things and recall lists better than women, and that women might have memory impairment sooner than men. It might be that depressed men are more likely to develop Alzheimer’s than depressed women. It does seem that once the dementia of Alzheimer’s is there, it seems to worsen more quickly in women. Finally, any gender differences have not been helpful in diagnosing or treating Alzheimer’s. For now, the most useful answer that there are no differences.

An Important Point Before We Continue on the Symptoms of Alzheimer’s?

Alzheimer’s disease affects thinking. Thinking is a central activity of life. The result is that all kinds of things can go wrong. We’ll list some of them, but actually, that’s not the most important point. The most important point is this: It starts very mild and it worsens very slowly over a long time, years and years. So if your situation, whatever it is, came on suddenly or got worse quickly, it’s not Alzheimer’s. Strokes happen quickly. Brain injury with bleeding into the brain worsens quickly or over hours or days. Alzheimer’s if very slow. Everyone has time to watch what’s happening and make decisions.

The Symptoms of Alzheimer’s Disease

Memory problems are the most obvious and irritating symptom. You’ve looked up and memorized a phone number 4 times and still can’t remember it. So, you wrote it down and now you can’t find the piece of paper. Making plans and completing tasks are other problem areas. For example, you can’t plan a small social gathering or you get confused playing a familiar card game. Other dilemmas are a poor ability to get ideas across in a conversation, misjudging distances, or walking somewhere and not being able to find the way back. Poor judgment can creep in, like bad financial decisions or worse personal hygiene (tooth brushing, taking a shower, hair combing). As life becomes generally confusing, there’s a likelihood of stopping social activities. It all just gets to be too much. There also might be changes in personality, with moodiness and irritability.

What causes Alzheimer’s Disease?

As we said above in answering the reader’s question, nobody knows what causes Alzheimer’s. Here’s a link to the National Institute on Aging on What Causes Alzheimer’s Disease? Drug companies thought they knew, spending a vast fortune (about $100 billion or 75 billion£) during the past 20 years to find an effective medication. They failed completely. Age is part of the cause. Alzheimer’s risk goes up as one gets older. There’s a genetic, family inheritance risk gene, but it’s not a sure thing. A healthy lifestyle lessens the risk, a good diet, regular exercise, a good night’s sleep on most nights, staying socially active, and doing hard things that need difficult thinking that make your brain work harder. One’s early life experiences play a role. More education lessens your risk. Poor medical health increases risk, like obesity, diabetes, heart disease, untreated high blood pressure, and stroke.

Alzheimer’s Is Common

Many, many people have Alzheimer’s. It’s the most common cause of memory loss and inability to think severe enough to make it difficult to live independently. During the year that people are age 65 there is about a 1% chance of getting Alzheimer’s. That means for every 100 people age 65, one of them will probably have it. During the year that people are age 85 the percentage increases to about 6%, so six people out of every 100 will have it.

More Alzheimer’s Statistics

While that’s the number that show up as a new diagnosis in the year one is age 65, the number of people that have it now in a room full of people age 65 is higher, about 8%. So if you thumb through the photos in your high school or college yearbook (if you’re one of those rare individuals that still has your yearbook), when everyone in your class is age 65, about eight classmates out of every 100 will have Alzheimer’s. When everyone is age 80, the number jumps to about 40%, that is, for every 100 photos in that yearbook, about forty of those classmates will have it.

So, Where’s The Alzheimer’s Cure?

This really is THE problem. If we had a cure Alzheimer’s wouldn’t be much of a problem. We don’t yet have a cure. As we said above, billions of dollars and euros and British pounds are spent each year looking for a cure, or even just a treatment that’s a lot better than what we have. But we don’t have one yet. Dr. Daniel Skovronsky, the President of Lilly Research Labs, has said that the complexity of Alzheimer’s disease poses one of the most difficult medical challenges of our time.

What’s Coming to Treat Alzheimer’s?

The media coverage on Alzheimer’s treatments is far too exaggerated. Medicines are described and promised and it’s just not true. Given what has been learned during the past twenty years, it’s most likely that no one drug now in development is going to work by itself. The most probable eventual better treatment will likely be a combination of two or three of these soon-to-come medications.

Two or Three Medicines to Treat Alzheimer’s?

Yes, and here’s why. The cause of Alzheimer’s seems to be more than one broken part in the brain’s machinery. It’s probably two or three missing links in a necessary chain of events. There likely are proteins likely involved, beta-amyloid, beta-secretase, and tau. There might be receptors involved, those little catcher’s mitts for signal molecules, with names like serotonin 2A and serotonin-6. It seems unlikely that one medication can fix enough of the parts to fix Alzheimer’s. There’s more. The medications will likely work in “pre-Alzheimer’s” or very early Alzheimer’s, but not in severe, advanced Alzheimer’s. The neuron damage in severe Alzheimer’s probably cannot be fixed. Once a nerve cell is dead it can’t be brought back to life.

About the Aducanumab Controversy

On June 7, 2021, the FDA approved aducanumab for the treatment of Alzheimer’s disease. A controversy immediately erupted. The FDA’s independent Advisory Committee had evaluated all the data on aducanumab and, in their opinion, it had failed its clinical trials. Based on this failure all ten members of the Advisory Committee voted against approval. They were shocked, therefore, when the head of the FDA overruled all ten of these expert scientists and approved it anyway. Three members of the Committee were so upset about the approval of a drug that didn’t work and had problem side effects that they resigned. But did the FDA really get it wrong? We’ll have to wait and see. Aducanumab is now approved and on the market. It appears that Medicare will pay for it. If it works as hoped we’ll all be jumping for joy. If it doesn’t work the FDA should be in trouble.

For Alzheimer’s, Back to Those Ounces of Prevention…

So severe Alzheimer’s probably cannot ever be successfully treated? Why? Because once Alzheimer’s has progressed to even moderate severity too many nerve cells are dead. Once too many nerve cells are dead, once too many brain circuits and nerve pathways are interrupted, there’s no way with today’s science and methods to regrow these parts of the brain. So, just what are we supposed to do? Sit and wait for it to get us? Nope. Pursuing all activities that avert or delay the onset of Alzheimer’s is the key. We mentioned a few above, and see our page on Treating Alzheimer’s. Such preventative activities are worth their weight in gold, worth every bit of energy you can put into them.

For Now, Successful Coping is the Final Key to End-Stage Alzheimer’s

People with early to mild to moderate Alzheimer’s can see a path laid out in front of them. As time goes by and as abilities decline there are choices to make. As with all of life’s situations, people can make good choices or poor choices. Most people do make good choices and set down one final life’s success by coping well and living the end of life to its fullest. Sometimes family and friends are the first to notice the changes and are willing to be supportive. The final choice is, do I want to go out with an ordinary death or do I want to die with success to the end. If you are diagnosed with Alzheimer’s connect with family, with friends, and stay connected as best you can for as long as you can.

Alzheimer’s Caregivers Help

As a person with Alzheimer’s moves through time, at some point along the way those who know and love them, who care about them, step up and begin helping them more and more. These remarkably kind and caring individuals are called “caregivers”, and they must be the earth’s most wonderful people. Usually over time they themselves need help and support. The gradually increasing behavioral confusion of Alzheimer’s and the resulting increasing care needed weigh heavily on these caregivers. If you know someone caring for a person with Alzheimer’s, lend them a hand now and then. Help them to have a bit of a break. They need it.

Success in Treating/Curing Alzheimer’s Will Come

Medical science will conquer Alzheimer’s. Brain scientists are a clever bunch. The solutions to the Alzheimer’s puzzle will come. It’s a difficult puzzle to understand and solve but we will get there. When? “When?” is indeed the big question. Major pharmaceutical companies and rich and powerful governments have spent decades and hundreds of billions of dollars, euros, and British pounds pushing for a cure. Time after time they have hit a dead end. But they’ve learned along the way. The younger you are now the greater your chance of never having Alzheimer’s or having your Mild Cognitive Impairment treated and cured.

Helpful links:

A discussion of Alzheimer’s by the Alzheimer’s Association

Events and information by the Alzheimer’s Foundation of America

The National Institute on Aging about Alzheimer’s Disease

Center for Disease Control and Prevention CDC) on Alzheimer’s Diseas

The Mayo Clinic on Alzheimer’s Disease

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