By Sam Fazio, PhD

Overview of Alzheimer’s Disease
It is estimated that every 70 seconds, someone develops Alzheimer’s disease. As many as 5.3 million people in the United States are currently living with Alzheimer’s. That number is expected to grow to a staggering 11-16 million by 2050.

Alzheimer’s disease is a progressive brain disease that results in impaired thinking, judgment and behavior. It is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 50 to 70 percent of dementia cases.

In Alzheimer’s disease, as in other types of dementia, increasing numbers of brain cells deteriorate and die. Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells. Plaques build up between nerve cells, and tangles form inside dying cells. Although scientists are not absolutely sure what role plaques and tangles play in Alzheimer’s, most experts believe they somehow block communication among nerve cells and disrupt activities that cells need to survive.

Currently, there is no cure for Alzheimer’s, but treatment for symptoms, combined with the right services and support, can make life better for the millions of Americans living with Alzheimer’s.

The Ten Warning Signs of Alzheimer’s Disease
Memory loss that disrupts daily life is not a typical part of aging. It may be a symptom of Alzheimer’s disease. Every individual may experience one or more of these signs in different degrees. If you notice any of them, it is important to see a doctor.

1) Memory loss that disrupts daily life
One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

2) Challenges in planning or solving problems
Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

3) Difficulty completing familiar tasks at home, at work or at leisure
People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

4) Confusion with time or place
People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

5) Trouble understanding visual images and spatial relationships
For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror.

6) New problems with words in speaking or writing
People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”).

7) Misplacing things and losing the ability to retrace steps
A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

8) Decreased or poor judgment
People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

9) Withdrawal from work or social activities
A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

10) Changes in mood and personality
The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

The Difference Between Alzheimer’s Disease and Typical Age-Related Changes

Signs of Alzheimer's	Typical age-related changes
Poor judgment and decision making	Making a bad decision once in a while
Inability to manage a budget	Missing a monthly payment
Losing track of the date or the season	Forgetting which day it is and remembering later
Difficulty having a conversation	Sometimes forgetting which word to use
Misplacing things and being unable to find them	Losing things from time to time

Diabetes and Alzheimer’s Disease
Doctors don’t know yet what causes Alzheimer’s disease or exactly how diabetes and dementia are connected. But they do know that insulin resistance, high blood sugar or diabetes can harm the brain in several ways:

• Insulin resistance and Type 2 diabetes increase the risk of heart disease and stroke. These conditions hurt the heart and blood vessels. Damaged blood vessels in the brain may contribute to Alzheimer’s disease.
• The brain depends on many different chemicals. Too much insulin may upset the balance of these chemicals. Some of these changes may help trigger Alzheimer’s disease.
• High blood sugar causes inflammation. This may damage brain cells and help Alzheimer’s to develop.

Scientists wonder whether Type 2 diabetes medicines can help prevent or treat Alzheimer’s. They are testing some of these drugs to see if they help. Preventing diabetes may not stop dementia, but diabetes causes many other health problems. So, preventing diabetes is a good idea in itself.

Brain-Healthy Life Choices
There’s a lot you can do to help keep your brain healthier as you age. These steps might also reduce your risk of Alzheimer’s disease or other dementia. Like other parts of your body, your brain may lose some agility as you get older. It can deteriorate even more if you don’t take care of it.

Stay mentally active
Mentally stimulating activities strengthen brain cells and the connections between them, and may even create new nerve cells.

Remain socially active
Social activity not only makes physical and mental activity more enjoyable, it can reduce stress levels, which helps maintain healthy connections among brain cells.

Stay physically active
Physical exercise is essential for maintaining good blood flow to the brain as well as to encourage new brain cells. It also can significantly reduce the risk of heart attack, stroke and diabetes, and thereby protect against those risk factors for Alzheimer’s and other dementias.

Adopt a brain-healthy diet
Research suggests high cholesterol may contribute to stroke and brain cell damage. A low fat, low cholesterol diet is advisable. And there is growing evidence a diet rich in dark vegetables and fruits, which contain antioxidants, may help protect brain cells.

Well-established risk factors for Alzheimer’s disease are genetics and aging – unfortunately, they are two risk factors you can’t control. These risk factors that you cannot change will set a starting point for you, but there is hope that adopting brain-healthy life habits might delay or prevent the appearance of Alzheimer’s disease.

About the Alzheimer’s Association:
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer care, support and research. For more information or to find a chapter near you, visit www.alz.org or call 1-800-272-3900.

Resources
1. 2009 Alzheimer’s Disease Facts and Figures, Alzheimer’s Association, www.alz.org/national/documents/report_alzfactsfigures2009.pdf, (As of Nov. 2, 2009)
2. 10 Warning Signs of Alzheimer’s Disease, Alzheimer’s Association, www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp, (As of Nov. 2, 2009)
3. Alzheimer’s Disease and Type 2 Diabetes: What Is the Link?, Alzheimer’s Association www.alz.org/national/documents/latino_brochure_diabetes.pdf, (As of Nov. 2, 2009)
4. Alzheimer’s Association website, www.alz.org

Sam Fazio, PhD, is Director of Special Projects in Medical and Scientific Relations with the Alzheimer’s Association. He oversees the international research conferences, scientific journal and social/behavioral research initiatives. Dr. Fazio is involved in several research projects with older adults in the Chicago area related to the persistence of self, person-centered care, and health and wellness. Additionally, Dr. Fazio is a part-time faculty member in the gerontology program at Northeastern Illinois University in Chicago. Dr. Fazio is also the author of The Enduring Self in People with Alzheimer’s: Getting to the Heart of Individualized Care and the co-author of the book Rethinking Alzheimer’s Care.

This article originally appeared in the December 2009 issue of Kidney Beginnings: The Magazine.

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