What is Alzheimer’s Disease? Causes, Symptoms, Treatment
“The Notebook” is famous for the immortal love story of Noah and Allie, but it also deals with the trials and tribulations that come with dealing with a person suffering from memory loss. Amnesia is also a form of memory loss, so then what makes amnesia different from Alzheimer’s? Amnesia is the condition where a person has lost a part or all of their memories due to some or the other reason, and while this condition can be both curable and incurable, what is important to remember is that a person can still have intact cognitive functions and ability to make new memories. On the other hand, Alzheimer’s is a degenerative disease which has no cure, it progresses over, causing memory loss, speech and other cognitive functions. Today, we will try to understand Alzheimer’s disease, its causes, symptoms and treatments, along with how it is different from Dementia and which came first, dementia or Alzheimer’s. Having elaborated the intent of this piece, let us begin with the fundamental question:
- What is Alzheimer’s Disease
- Alzheimer’s and Dementia Basics:
- Alzheimer’s and the Brain:
- What Causes Alzheimer’s Disease:
- Symptoms of Alzheimer’s Disease:
- Treatment of Alzheimer’s Disease:
- Alzheimer’s Disease Prevention:
- Link Between Heart Disease and Alzheimer’s:
- World Alzheimer’s Day:
- News on Alzheimer’s Disease:
What is Alzheimer’s Disease
Alzheimer’s disease is an age related disease, however, it is not a normal part of aging. Alzheimer’s as a disease is caused because of the presence of plaques and tangles in the brain which affects cognitive function. The first thing a person loses is his/her memory, the person may also exhibit behavioral changes and suffer from mood swings including violent bouts, as the disease increases, the person may lose all sense of self and be completely dependent on the caregiver, near the last stages of the disease, the person may even forget speech and locomotor memory. However, the surprising bit about Alzheimer’s is that a person may have moments of absolute clarity where they remember everything, followed by episodes of confusion and disorientation.
The brain images of Alzheimer’s patients show a gradual decline in the brain size, which in turn affects memory and cognitive behaviour. Once a person is diagnosed with Alzheimer’s disease, there is no stopping or reversing the disease, it progresses, though the speed of its progress may be monitored. Alzheimer’s is also a self terminal disease, which is to say, it will cause death of the body in time. A person is generally expected to survive for 10 years, maximum, after Alzheimer’s has set.
Alzheimer’s and Dementia Basics:
Dementia has been known to human civilization since the ancient Greeks and their counterparts. Thus, for the ancient Greeks and Romans, Dementia was a part of aging. The Greek God for aging was “Geras”, age was also considered a virtue, thus, people acquired Geras. The more Geras they acquired, the more they would attract fame and respect. The Roman version of Geras is known as Senectus. In fact, several other famous philosophers and medicine practitioners saw dementia as an unavoidable part of growing old.
In pythagorean division of human life cycle, the last two stages describe the decay of the physical form as well as mind. Similarly, Hippocrates believed that “paranoia” or what we now know as Dementia was a normal part of aging. This view was also upheld by philosophers like Aristotle, Plato, Cicero, Galen and others.
Even William Shakespeare, in his monologue from “As You Like It”, describes the seven stages of a man’s life. The last stage is described as “second childishness and mere oblivion, sans teeth, sans eyes, sans taste, sans everything”. This part in isolation is known as “The seven ages of man”.
No observable biological change was defined until this point in history, to mark as the onset of dementia. In fact, not many people knew what exactly happened to the human brain for it to go senile this way. However, as the world emerged from the dark ages to the age of scientific temperament, more and more breakthroughs were made in understanding, treating and preventing several diseases.
In 1907, a young German psychiatrist called Alois Alzheimer was handed the case of Auguste Deter. Her husband had admitted her because of her strange behavior which had made life difficult for the couple. Dr Alzheimer’s notes are still saved and readable. A small translation of those notes describe Augusta as a woman who was often disoriented. She had difficulty remembering her own name or the fact that she was married, at times, she would display amnesia one moment and then display clear memory the next moment. Sometimes, she wouldn’t recognize what she was eating, couldn’t remember eating at all, moments after finishing her meal.
Upon Augusta’s death, Dr. Alzheimer procured permission to dissect her brain and discovered plaques and tangles in her brain, leading him to conclude that her affliction was caused because of these plaques and tangles. The disease was ultimately named after him and to this day the questions healthcare providers ask patients showing signs of early onset Alzheimer’s are similar to what Dr. Alzheimer himself asked Augusta.
For the longest time, people believed that Dementia and Alzheimer’s were one and the same thing and thus, these terms were used interchangeably. However, we need to remember that Dementia is an umbrella term to describe a range of diseases which lead to a loss of brain functioning. Alzheimer’s, on the other hand, is a form of dementia which is marked by symptoms like confusion, memory loss, and so on.
Alzheimer’s and the Brain:
The most basic and important question to ask is what happens to the brain with the onset of Alzheimer’s disease. Alzheimer’s is caused because of the presence and growth of plaques and tangles in the brain. This means that the brain doesn’t get enough blood or oxygen which leads to brain decay. The neurons are the first to get affected, damaged neurons lead to other issues like the brain starts shrinking in size leading to corrosion in parts of the brain, mostly the hippocampus. This decay is gradual and it starts affecting the daily functions, as well as the social life of the patient. While Alzheimer’s is treated as a disease which affects the elderly, however, early onset Alzheimer’s can be detected in patients as old as 45-50 years of age. In one exceptional case, a 30 year old man has been diagnosed with early onset Alzheimer’s.
Researchers have wondered if genetics play a role in the onset of Alzheimer’s, while family history makes a person more susceptible to Alzheimer’s, however, the presence of apolipoprotein E is more indicative of the risks of developing Alzheimer’s. Some researchers also believe that being addicted to our screens and apps for taking care of all our tasks and setting reminders for every task allows the brain to filter everything which is deemed not worthy of attention. This means that less and less people are exercising their brains to retain information, and some experts in the field believe that exercising and stimulating the brain is important for preventing and controlling Alzheimer’s and Dementia.
What Causes Alzheimer’s Disease:
There are several hypotheses attributed to the development of Alzheimer’s disease in an individual. Some of these have been debunked as tests for the disease for more and more sophisticated. The probable causes of Alzheimer’s include heredity, head injuries, Down’s syndrome, diseases or activities that may affect blood vessels like smoking, diabetes, hypertension and most importantly age We have broadly divided causes into four categories:
- Genetic: As the word suggests, these deal with not just familial explanations but also explore how having a pair of extra chromosomes or gender affect the risks of developing Alzheimer’s.
- Environmental: Environmental factors look at the environment the human body survives and which kind of environmental exposure may trigger the risks of developing Alzheimer’s Disease.
- Lifestyle: Lifestyle factors look at the loopholes in modern lifestyle which leads to Alzheimer’s disease.
- Others: This category examine causes which are arguably beyond our control but have a hand in the development of Alzheimer’s disease.
These categories have been explored in detail in the following table:
[table id=49 /]
Symptoms of Alzheimer’s Disease:
Generally, symptoms of Alzheimer’s Disease are confused with those of old age and mostly go unnoticed or treated with disdain and frustration. We have talked about the more common symptoms like forgetfulness but one needs to understand that while forgetfulness can be caused due to a lot of reasons Alzheimer’s is caused because of brain cell death.
- Inability to retain new information
- Inability to make new memories, including remembering the sequence of one’s daily tasks
- Disorientation like inability to wear clothes in the correct order.
- Inability to remember faces, names, and common objects
- Mood swings along with other psychological issues like Obsessive Compulsive Disorder, Social Withdrawal, Inappropriate Behaviour and so on.
- Loss of Empathy
In a previous post, we have also discussed, ten early signs of Alzheimer’s that you must not ignore. Additionally, the table below describes symptoms in categories.
[table id=50 /]
There are probably two diagnostic approaches that the primary healthcare provider may opt for before confirming Alzheimer’s Disease.
Under behaviour analysis, your doctor will speak with the patient first. He/she will conduct multiple interviews with the patient to test their memory retention and so on. The doctor would then interview members from the individual’s immediate environment to check if one of them has noticed any significant changes in the behaviour of the patient.
Since Alzheimer’s is a disease which causes changes in the structure of the brain, the doctor may then opt for either one or more than one of the following tests.
- MRI scan: MRI machines use magnets and radio waves to create an image of the brain.
- CT scan: CT scan is an X-ray scan of the brain.
- PET scan: PET scans use certain chemicals to point out any changes, a recent development is that now a new chemical has been developed which could detect the presence of plaques in the brain.
Treatment of Alzheimer’s Disease:
Alzheimer’s Disease is a chronic disease which is irreversible as well as self terminating. However, some medicines can prevent the erosion of certain chemicals in the brain. These medicines can help delay the effects of Alzheimer’s disease and elongate an individual’s life, however, all these medicines have severe side effects which include nausea, diarrhea, headaches, even depression.
On the other hand, researchers have also introduced some mind games for at risk individuals, which could stimulate their brain cell activity, delaying the start of the disease.
In fact, now it is believed that Yoga and Meditation can not only help manage the symptoms of Alzheimer’s and delay its progress, they can also be used to prevent the development of the disease in the first place.
In traditional Indian medicine, it is widely believed that Ashwagandha is an ayurvedic herb which could help with the symptoms of Alzheimer’s.
Alzheimer Disease Treatment in Ayurveda:
As we discussed the fundamentals of the ayurvedic approach to healing the body in detail in a previous article. We would only recap the key points here. The ayurvedic approach has divided the human body into forms of energy, dhatus, as well as, elements and so on which exist by balancing each other. Ayurveda believes that a human body is healthy when all the said forms are holding each other in critical balance, any disbalance in any dhatus, dosh, energy and so on leads to the development of diseases both acute and chronic. By this logic, ayurvedic practitioners, do not focus on controlling the symptoms but eliminating the root cause of the disease by correcting the human body to reach the right balance. To reach this critical balance, practitioners may ask the patient to alter their diets, as well as consume some herbs which are naturally rich in enforcing the balance.
In 2012, Alzheimer’s Research and Therapy1, published a study conducted by Rammohan V Rao et al, who studied herbs like Ashwagandha, Turmeric, Brahmi, Shankhpushpi, Gotu Kola, Jyotishmati, Jatamansi, and Guggulu in labs via various experiments and concluded that all these herbs in some form or the other not only help prevent the development of Alzheimer’s Disease but also help in slowing down the growth of the disease. Extracts in various doses of the said herbs are available in the market.
Medlife has launched a range of single herb ayurvedic products known as Medlife Essentials, which are created by co-joining the wisdom of over 5000 years with the precision of cutting edge technology. Of the herbs mentioned above Medlife has either launched or is planning to launch them in the near future, they are available online and can be accessed here: Ashwagandha, Turmeric (Curcumin), and Brahmi.
Alzheimer’s Disease Prevention:
Unfortunately, there are no proven or verified means of preventing Alzheimer’s Disease. It is one of those diseases which will develop if it has to develop in a person and cannot be reversed. However, some research has proved that a Mediterranean diet, along with some physical exercise and meditation, may be able to help delay the process of the development of Alzheimer’s disease. Having established the same, it is also believed that there are some vitamins as well as home remedies to help deal with the disease.
Vitamin Supplements Alzheimer’s Disease:
Since, we have already established that nothing can help prevent, cure or reverse Alzheimer’s disease, you must be wondering what good would vitamins do? Well, the disease may be unstoppable, but it can always be slowed down. Here are some vitamin supplements to help manage Alzheimer’s:
- Vitamin D: While research has shown that people with Alzheimer’s Disease have low Vitamin D, and one research study also proved that people with low vitamin D were twice at the risk of developing Alzheimer’s disease, it hasn’t been concretely established that lack of vitamin D causes Alzheimer’s. However, it is also known that Vitamin D contributes to brain health. Most people can get Vitamin D from direct exposure to sunlight,
- Resveratrol: Resveratrol is an antioxidant found in red wine, red grapes and chocolate. Research has proved that resveratrol has some anti-aging properties.
- Antioxidants: While people believe that antioxidants can help maintain brain health, however, more research needs to be done in this area.
Home Remedies For Alzheimer:
Alzheimer’s is not a disease which could have a remedy at home. It is not even treatable, however, here are a few things an individual can do at home to prevent the growth of Alzheimer’s:
- Adopting a healthy lifestyle
- Eating more fresh fruits and vegetables
- Regular physical exercise and yoga
- Regular meditation
- Regular mind exercise
To understand the link between heart disease and Alzheimer’s disease23, one needs to understand the common binding factor the ApOE gene. This gene strand contains instructions for producing three variants of cholesterol absorbing proteins, these variants are e2, e3, and e4. Out of these, e2, and e3 remain unaffected, however, the variant factor e4, increased amounts of which have been recognised as the leading cause for elevated LDL cholesterol which in turn causes the development of plaques and blockages in the heart. The same e4 is also believed to be responsible for the development of plaques in brain cells. A recent study with over 250 participants revealed that all who underwent the ApOE gene test for confirming risk for Alzheimer’s also showed increased risk of cardiovascular diseases. Over the years, more and more proof is being accumulated that Alzheimer’s may very well be linked to the high blood pressure and heart diseases.
Is Alzheimer’s Disease Hereditary?
Alzheimer’s disease is caused because of genetic mutations, that much is true but there has been reasonable debate on it being hereditary. Although, early onset Alzheimer’s is said to be hereditary and can be passed on between generations it amounts to only 5% of all Alzheimer’s cases. There are several other major factors which end up causing Alzheimer’s in a human mind, all of which have been listed above.
World Alzheimer’s Day:
September 21, is celebrated globally as the World Alzheimer’s Day. There is little information on the origins and history of how the months September came to be celebrated as Alzheimer’s Month, with September 21 being World Alzheimer’s Day. Although, one month a year is dedicated to generating more knowledge about Alzheimer’s as a disease as well as eradicating the stigma attached to it. Alzheimer’s is often termed as a family disease, as the pressure and stress of handling a person with Alzheimer’s falls on the shoulders of the primary caregiver and Alzheimer’s as a disease comes with its own set of restrictions, making it a difficult disease to cope with.
Having learnt enough about Alzheimer’s it should be emphasised that while the disease is distressing for the patient, it is even more disconcerting and stressful for the primary caregiver who has to dedicate his/her entire life to the care of the patient. Most commonly it is the spouse, hence, it is necessary to provide support to the caregivers. The most important support could be in the form of tricks and tips on handling mood swings or memory lapses of the patient. This World Alzheimer’s Day take a pledge to pay more attention to your loved ones and support them with the disease.
News on Alzheimer’s Disease:
1. Accurate Diagnosis of Alzheimer’s With the Help of This New Method
– 26th Sept 2018
The Journal of the American Medical Association recently published a study report conducted by researchers from Sweden, San Francisco and Seoul. The study was conducted with 700 participants, with Oskar Hansson of the Lund University of Sweden being the first and last author of the study. The study reveals that a new brain scan can conclusively determine the presence of tau protein which causes tangles in brain cells. The process of administering this test involves a tau marker which is introduced to the system of a patient intravenously.
The patient will be then be asked to take a PET Scan test. The tau marker would highlight the presence of tau protein in the brain, which can be easily mapped in the PET scan images of the brain. The development of Alzheimer’s depends on two chemicals, beta-amyloid which can be present in the patient’s brain much before the onset of Alzheimer’s and is responsible for causing plaques. However, it is the presence of tau protein, which causes tangles, which is a clear indication of the onset of Alzheimer’s in a patient. This study report is considered path breaking as the general symptoms of Alzheimer’s can also indicate various other diseases, which always lead to the possibility of wrong diagnosis. However, this new approach, which specifically marks tau protein, can be used to conclusively determine the development of Alzheimer’s disease in a patient.
2. Biotherapy For Alzheimer’s?
– 21st Sept 2018
In recent reports, the Rockefeller University Press announced the publishing of a new research report which may a new potential treatment for Alzheimer’s. This research report would be published in the Journal of Experimental Medicine and was conducted by researchers of University of Florida. The researchers have discovered that an altered version of immune cell protein can, in fact, lead to the prevention of the formation of amyloid plaques in the brain. Researchers believe that a soluble variant of a protein called TLR5 can help produce desired results. This conclusion was reached after researchers were able to produce definitive results on mice. Researchers assert, that since the protein has worked on mice, it is bound to work on human beings the same way. It is yet left to be seen how this new protein can help prevent as well as treat Alzheimer’s Disease in the long run.