Every year, many people across the globe recognize the 21st of September as World Alzheimer’s Day. It is a global endeavor to raise awareness and challenge the stigma around Alzheimer’s disease and other dementia. More than 55 million people around the world are
affected by the disease. In the United States alone, there are 6.7 million Americans age 65 and older with Alzheimer’s dementia in 2023. The estimated number of people age 65 and older comes from the latest data from the 2023 population projections from the U.S. Census Bureau and the Chicago Health and Aging Project (CHAP), a population-based study of chronic health conditions of older people. Researchers also believe although general studies of younger onset of dementia are limited, about 110 of every 100,000 people ages 30-64 years, or about 200,000 Americans in total, have a younger-onset dementia.

What are Alzheimer’s disease and dementia?

Dementia is an overall term for a particular group of symptoms. The characteristic symptoms of dementia are difficulties with memory, language, problem-solving, and other thinking skills. Dementia has several causes, and these causes reflect specific changes in the brain.

Alzheimer’s is one cause and the most common form of dementia. It’s a progressive brain disease that causes damage to nerve cells (neurons) in the brain. The brain’s neurons are essential to thinking, walking, talking, and all daily activities. In Alzheimer’s, the neurons damaged first are those in parts of the brain responsible for memory, language, and thinking. The first symptoms tend to be memory, language, and thinking problems.

Is Dementia Part of Normal Aging?

No. Dementia is not part of normal brain aging, according to the Centers for Disease Control and Prevention. Normal brain aging may mean slower processing speeds and trouble multitasking. Routine memory, skills, and knowledge are stable and may improve with age.

Some typical age-related changes are:

• Forgetting someone’s name sometimes but remembering them later.
• Misplacing things from time to time, retracing steps to find them.
• Occasionally needing help to use microwave settings or record a television.
• Making occasional errors when managing finances or household bills.
• Getting confused about the day of the week, but I will figure it out later
• Vision changes related to cataracts.
• Sometimes, having trouble finding the right word.
• Making a bad decision or mistake occasionally, such as neglecting to schedule an oil change for a car.
• Sometimes feeling uninterested in family and social obligations.
• Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Signs and Symptoms

Early signs and symptoms may vary from person to person. Difficulty remembering recent conversations, names, events, apathy, and depression are often early symptoms. Asking the same questions over and over, trouble finding words when conversing with another
person, and confusion with time or place are some other symptoms.

Read Alzheimer’s Association:
10 Early Signs and Symptoms of Alzheimer’s and Dementia

It’s important to note that there are dementia-like symptoms without the progressive brain changes of Alzheimer’s or other degenerative brain diseases. Causes of dementia-like symptoms include depression, untreated sleep apnea, delirium, side effects of medications, Lyme disease, thyroid problems, certain vitamin deficiencies, and excessive alcohol consumption. Unlike Alzheimer’s and other dementias, these conditions often may be reversed with treatment.

People experiencing cognitive changes should seek medical help to determine if the changes are normal for their age, are reversible, or maybe a symptom of Alzheimer’s or another dementia.

Alzheimer’s Disease Continuum

According to the Alzheimer’s Association, The progression of Alzheimer’s disease from brain changes that are unnoticeable by the person affected to brain changes that cause memory problems and eventually physical disability is called the Alzheimer’s disease continuum. On this continuum, there are three broad phases: preclinical Alzheimer’s disease, mild cognitive impairment (MCI) due to Alzheimer’s disease, and dementia due to Alzheimer’s disease, also called Alzheimer’s dementia (see Figure 1).The Alzheimer’s dementia phase is further broken down into mild, moderate, and severe dementia.

While we know the Alzheimer’s disease continuum starts with preclinical Alzheimer’s disease (no symptoms) and ends with severe Alzheimer’s dementia (severe symptoms), how long individuals spend in each part of the continuum varies. The length of each part of the continuum is influenced by age, genetics, biological sex, and other factors.

Risk Factors For Alzheimer’s

According to Alzheimer’s Association’s ‘Facts and Figures’ the vast majority of people who develop dementia are aged 65 or older. This is called late-onset Alzheimer’s. The greatest risk factors for late-onset Alzheimer’s are older age, genetics, and family history.

However, some risk factors can be changed or modified to reduce the risk of cognitive decline and dementia. The 2020 recommendations of The Lancet Commission suggest that addressing modifiable risk factors might prevent or delay up to 40% of dementia cases. A 2022 study found that nearly 37% of cases of Alzheimer’s and other dementias in the United States were associated with eight modifiable risk factors, the top being midlife obesity, followed by physical inactivity and low educational attainment. Other modifiable risk factors are smoking, hypertension, high cholesterol, diabetes, and brain injury.

Proactive Management of Dementia Due to Alzheimer’s Disease

Studies have consistently shown that proactive management of Alzheimer’s and other dementias can improve the quality of life of affected individuals and their caregivers.59-61.

Proactive management includes:

• Appropriate use of available treatment options.
• Effective management of coexisting conditions.
• Providing family caregivers with effective training in managing the day-to-day life of the care recipient
• Coordination of care among physicians, other health care professionals, and lay caregivers.
• Participation in activities that are meaningful to the individual with dementia and bring purpose to their life
• Maintaining a sense of self-identity and relationships with others.
• Having opportunities to connect with others living with dementia; support groups and supportive services are examples of such opportunities
• Becoming educated about the disease.
• Planning for the future.

Currently, there is no cure for Alzheimer’s disease, but treatments are available.

Seeking support from friends, family, and the local community is important not only for individuals with Alzheimer’s but also for their family caregivers. There are organizations like the Alzheimer’s Association that aim to spread awareness and provide resources to those with Alzheimer’s disease. Also, there are professional care providers for those with Alzheimer’s to help them with day-to-day activities.

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Source: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13016