Alzheimer Disease

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Overview and Definition of Alzheimer's disease

Alzheimer’s disease is a progressive brain disorder that slowly destroys memory and thinking skills, eventually leading to an inability to perform simple tasks. It is the most common cause of dementia worldwide.
Damage begins years before symptoms appear, driven by the buildup of toxic proteins called amyloid plaques and tau tangles. These interfere with nerve cell communication, causing cell death and brain shrinkage.
Early signs include forgetting recent events or difficulty finding words. The disease inevitably progresses, causing severe confusion and increasing the need for full-time care.

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Chronic Neurodegenerative Disease

GERIATRICS
  • The Alzheimer’s disease definition is a chronic neurodegenerative disease. It is characterized by the irreversible degeneration and death of nerve cells in the brain. This loss of neurons causes the progressive decline of cognitive functions.

    The disease is named after the German psychiatrist and pathologist, Dr. Alois Alzheimer. In 1906, he first described the condition after noticing peculiar changes, plaques, and tangles in the brain tissue of a woman who had died from an unusual mental illness. The disease is complex, and research continues to fully unravel its causes.

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What It Is and Is Not

GERIATRICS

It is crucial to understand the difference between Alzheimer’s disease and dementia. Dementia is a general term, while Alzheimer’s is a specific disease.

  • Dementia: A syndrome defined by the loss of memory, reasoning, and thinking abilities severe enough to interfere with daily life. It is not a normal part of aging.
  • Alzheimer’s disease: The most common cause of dementia, accounting for 60-80% of all cases. It is the biological process, the specific plaques and tangles, that cause the dementia symptoms.

Finding the exact cause of dementia is the first step in diagnosis. Other diseases like strokes or tumors can cause dementia, but only the presence of specific protein aggregates confirms Alzheimer’s.

Main Categories Covered

Alzheimer’s disease is categorized primarily by the age of onset, which often relates to the underlying cause (genetic or sporadic).These types of Alzheimer’s disease guide diagnostic urgency and genetic testing.

Late-Onset Alzheimer’s 

This is the most common form of the disease. Symptoms first appear after age 65. The cause is likely a combination of genetic, environmental, and lifestyle factors, but a single causative gene has not been identified.

  • Prevalence: It accounts for the vast majority of all Alzheimer’s cases.
  • Risk: Age is the single greatest risk factor; the likelihood of developing the disease doubles every five years after age 65.

Early-Onset Alzheimer’s 

This is a rare form where symptoms appear in people younger than age 65, often in their 40s or 50s.

  • Familial Link: Up to 5% of all cases are early-onset. Many of these are linked to a strong family history and inherited gene defects (on chromosomes 1, 14, or 21).

The Biology of Protein Buildup

The disease is defined by the abnormal accumulation of two proteins in the brain. These buildups block communication between nerve cells, leading to their death and eventual brain shrinkage.

  • Amyloid Plaques: These are clusters of beta-amyloid protein fragments. They collect outside the nerve cells (neurons) and disrupt cell function. Recent drugs target the removal of these plaques.
  • Neurofibrillary Tangles: These are abnormal accumulations of the protein tau. They form twisted threads inside the neurons, blocking the cell’s transport system and causing cell death.

Common Atypical Symptoms Related Organ Systems

  • While Alzheimer’s disease originates in the brain, it eventually impacts the body’s entire functioning because the brain controls all other systems. It is a disease of the Central Nervous System (CNS).

    • Central Nervous System (CNS): Directly affected by plaque and tangle accumulation, leading to the death of neurons, particularly in areas controlling memory (hippocampus).
    • Autonomic Nervous System: The disease indirectly affects the systems that control involuntary functions (heart rate, digestion). This can lead to problems with blood pressure and bladder control.
    • Digestive/Respiratory System: As the disease progresses, swallowing ability declines. This increases the risk of malnutrition and aspiration pneumonia (food or liquid entering the lungs).
    Muscular System: Loss of brain control leads to impaired balance, coordination, and eventual loss of motor abilities, often requiring the patient to be bedridden in late stages.

Importance in Medicine

  • Alzheimer’s disease is at the forefront of biomedical research due to its massive societal and economic impact. It is one of the leading causes of death worldwide, and its prevalence continues to rise as the population ages.

    Scientific breakthroughs in identifying biomarkers (indicators in the blood or spinal fluid) have transformed diagnosis. The development of new disease-modifying drugs that target and reduce amyloid plaques offers the first real hope of slowing the progression of the disease.

Subspecialty Areas

  • Treatment for Alzheimer’s requires a collaborative approach from several specialized medical fields.

    • Neurology: The primary specialist who diagnoses the disease and manages medication aimed at cognitive and behavioral symptoms.
    • Geriatrics: Specialists focused on the comprehensive health care needs of older adults, including managing the complex non-cognitive symptoms of dementia.
    • Neuropsychology: Specialists who perform detailed testing to measure cognitive function (memory, reasoning, language) and track the progression of the disease.
    • Neurorehabilitation: Therapists who use physical, occupational, and speech therapy to help the patient maintain daily living skills and manage physical decline.

The Role of Specialists

  • What do Alzheimer’s Specialists do? Neurologists or geriatricians specialize in identifying the underlying cause of memory loss. They use advanced imaging and biomarker testing to distinguish Alzheimer’s from other forms of dementia.

    When should I see an Alzheimer’s disease Specialist? You should see one if you or a family member notices persistent memory loss or changes in thinking, reasoning, or behavior that begin to interfere with daily life and activities. Early diagnosis is key for starting available treatments.

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FREQUENTLY ASKED QUESTIONS

What is Alzheimer's disease, and what do Alzheimer's Specialists do?

It is a neurodegenerative disease causing memory loss and cognitive decline due to protein buildup in the brain. Specialists diagnose the disease and manage symptoms with medication.

While there is no cure, current treatments manage the cognitive and behavioral symptoms (like memory loss, depression, and agitation) associated with the disease.

The main types are Late-Onset (most common, starting after age 65) and Early-Onset (rare, starting before age 65), often linked to specific genetic mutations.

See a specialist if memory loss affects daily functioning, or if you have difficulty making decisions, planning, or recognizing familiar places or people.

Dementia is the general term for memory loss and cognitive decline. Alzheimer’s disease is a specific brain disease (caused by plaques and tangles) that is the most common cause of dementia.

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