Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die, often resulting in symptoms such as impaired memory, thinking and behavior.
According to the National Institute of Neurological Disorders and Stroke, Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die. The disease often results in the following behaviors:
Impaired memory, thinking, and behavior
Personality and behavior changes
Inability to follow directions
Impaired thought processes that involve visual and spatial awareness
With Alzheimer's disease, motor function is often preserved.
When Alzheimer's was first identified by German doctor Alois Alzheimer in 1906, it was considered a rare disorder. Today Alzheimer's disease is recognized as the most common cause of dementia (a disorder in which mental functions deteriorate and break down). An estimated 5.3 million Americans have Alzheimer's disease. According to the Alzheimer's Association, this number includes 5.1 million people over the age of 65, as well as 200,000 to 500,000 people younger than 65 who have early-onset Alzheimer's and other types of dementias.
Alzheimer's disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy. Brains affected by Alzheimer's disease often show presence of the following:
Fiber tangles within nerve cells (neurofibrillary tangles)
Clusters of degenerating nerve endings (neuritic plaques)
Another characteristic of Alzheimer's disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and somatostatin.
Although intense investigation has been underway for many years, the causes of Alzheimer's disease are not entirely known. The National Institute on Aging says that suspected causes often include the following:
Age and family history
Abnormal protein deposits in the brain
Other risk and environmental factors
Immune system problems
According to the Alzheimer's Association, the following are the most common symptoms of Alzheimer's disease. However, each individual may experience symptoms differently. Symptoms may include:
Memory loss that affects job skills, especially short-term memory loss
Difficulty performing familiar tasks
Problems with language
Disorientation to time and place
Poor or decreased judgment
Problems with abstract thinking
Changes in mood or behavior
Changes in personality
Loss of initiative
Loss of ability to recognize who people are, even people well known to the individual, such as his or her child or spouse, when the disease progresses to a severe stage
The symptoms of Alzheimer's disease may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
There is not a single, comprehensive test for diagnosing Alzheimer's disease. By ruling out other conditions through a process of elimination, doctors, or other specialists, can obtain a diagnosis of probable Alzheimer's disease with approximately 90 percent accuracy. However, the only way to confirm a diagnosis of Alzheimer's disease is through autopsy.
Examination and evaluation are essential in determining whether the dementia is the result of a treatable illness. In addition to a complete medical history and extensive neurological motor and sensory exam, diagnostic procedures for Alzheimer's disease may include the following:
Mental status test. This is a brief and simple test of memory and some other common cognitive or thinking skills; it is usually part of a complete neurological exam
Lumbar puncture (spinal tap). A procedure performed by inserting a hollow needle into the lower back (lumbar spine)
Urinalysis. Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein
Chest X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film
Electroencephalogram (EEG). A procedure that records the brain's continuous electrical activity by means of electrodes attached to the scalp
Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body
Genetic testing. Some genetic testing is available, especially in some research settings. Because there is no cure or effective treatment for Alzheimer's, the decision to undergo genetic testing is one that requires careful consideration and counseling with a specialist in genetics.
Because the cause of the disease is unknown, there are no prevention protocols to follow at this time. And, because the controllable risk factors for Alzheimer's disease are unknown, it is not yet possible to reduce the chances of developing the disease.
Specific treatment for Alzheimer's disease will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
At this time, there is no cure for Alzheimer's, no way of slowing down the progression of this disease, and no treatment available to reverse the deterioration of Alzheimer's disease. New research findings give reason for hope, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time.
There are some medications available to assist in managing some of the most troubling symptoms of Alzheimer's disease, including the following:
In managing the disease, physical exercise and social activity are important, as are proper nutrition, health maintenance, and a calm and well-structured environment.
The rehabilitation program for people with Alzheimer's differs depending on the symptoms, expression, and progression of the disease, and the fact that making a diagnosis of Alzheimer's is so difficult. These variables determine the amount and type of assistance needed for the Alzheimer's individual and family.
With Alzheimer's rehabilitation, it is important to remember that, although any skills lost will not be regained, the caregiving team must keep in mind the following considerations:
To manage the disease, plan a balanced program of physical exercise, social activity, proper nutrition, and health maintenance activities.
Plan daily activities that help to provide structure, meaning, and accomplishment for the individual.
As functions are lost, adapt activities and routines to allow the individual to participate as much as possible.
Keep activities familiar and satisfying.
Allow the individual to complete as many things by himself or herself as possible. The caregiver may need to initiate an activity, but allow the individual to complete it as much as he or she can.
Provide "cues" for desired behavior (for example, label drawers, cabinets, and closets according to their contents).
Keep the individual out of harm's way by removing all safety risks (for example, car keys and matches).
As a caregiver (full-time or part-time), understand your own physical and emotional limitations.
The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.
MGH Hotline 07.31.09 Eleven national leaders in medical research, including Rudolph Tanzi, PhD, of the MGH, exchanged their lab coats for designer duds in the June issue of GQ magazine.
Leveraging Alzheimer’s Genome Project™ data, geneticist Rudy Tanzi, PhD, completes research to discover all gene variants that increase a person’s risk of Alzheimer’s disease.
Representatives of the Alzheimer’s Association Massachusetts/New Hampshire Chapter visited the Charlestown Navy Yard Dec. 8 to present four investigators with $680,000 on behalf of the national organization.
Mass General received a $20 million grant to establish a nationwide clinical coordinating center for testing drugs that can help people with diseases of the brain such as Alzheimer’s disease.
A panel of experts convened by the Alzheimer’s Association and the Society of Nuclear Medicine and Molecular Imaging have issued new guidelines on the use of amyloid PET imaging in diagnosing Alzheimer's disease.
Neurofibrillary tangles - largely composed of tau protein- are one of the two pathological hallmarks of Alzheimer’s disease.
Can anti-amyloid antibody treatment reverse Alzheimer’s disease pathology before memory loss sets in?
Mark Albers, MD, PhD, is developing a set of simple but powerful tools to screen for the very earliest stages of preclinical Alzheimer’s Disease.
Mark Albers, MD, PhD, of the Department of Neurology, was named the first incumbent of the Frank Wilkens, Jr. and Family Endowed Chair in Alzheimer’s Disease Research.
Caroline Murray is hoping to make a difference. The 9-year-old has been collecting funds for MGH Alzheimer’s research to help her grandmother and others who suffer from the disease.
Lisa Genova, PhD, a neuroscientist and New York Times bestselling author of “Still Alice,” visited the MGH on June 16 to discuss her journey into the world of Alzheimer’s disease.
Harvard neurologist, Dr. Marie Pasinski, MD will talk about keeping your brain healthy.