Did you know that there are an estimated 5.3 million Americans living with Alzheimer’s disease right now? Although this represents a very small portion of the U.S. population (less than 2% according to 2014 numbers), Alzheimer’s stands out because it is one of the very few diseases that cannot be prevented, cured, or slowed down. Even if it does not impact a majority of Americans directly, the nature of the disease is such that it has a huge impact on both the person suffering, and their family and friends. But what is Alzheimer's disease? Let’s take a closer look at this disease in-depth to better understand what it is, what can be done, and how to care for those living with Alzheimer’s.
What is Alzheimer’s disease?
Alzheimer’s disease falls under the category of dementias, which is a general term for issues that affect cognitive function and memory loss. Of the dementias, Alzheimer’s is one of the most common, according to the Alzheimer’s Association. Unfortunately, Alzheimer’s is a progressive disease; while the initial symptoms might look like normal memory loss, eventually they rob a person of his/her ability to carry on conversation, care for themselves, or respond to their environment.
Risk factors for developing Alzheimer’s include having a family history of the disease, and the chances of getting it increase with age. If more than one close relative has the disease, it may be a function of genetics, environment, or both. As far as genes go, you can be tested to see whether a person has either risk or deterministic indicators. Risk genes are those that indicate a higher likelihood of developing the disease, but are not a guarantee. Deterministic genes, as the name suggests, directly cause the disease to develop.
“When Alzheimer’s disease is caused by these deterministic variations, it is called “autosomal dominant Alzheimer’s disease (ADAD)” or “familial Alzheimer’s disease,” and many family members in multiple generations are affected. Symptoms nearly always develop before age 60, and may appear as early as a person's 30s or 40s. Deterministic Alzheimer's variations have been found in only a few hundred extended families worldwide. True familial Alzheimer’s accounts for less than 5 percent of cases.” (read more from the Alzheimer’s Association here)
What’s happening to the brain of an Alzheimer’s patient?
You may remember the term synapses from your high school biology classes. These are the spaces between nerve cells that allow information to pass. Many scientists believe that synapses are negatively impacted (or otherwise disrupted) by plaques and tangles. Plaques occur when a certain protein (beta-amyloid) builds up in these spaces, and can interrupt signals attempting to pass among cells. This interferes with cognitive ability.
Another protein in the brain that is affected by Alzheimer’s disease is called tau. Tau stabilizes strands of protein that transport nutrients to cells. In the brain of an Alzheimer’s patient, these strands become tangled, and thus cells in the brain do not receive enough nutrition and eventually die. As more and more cells die, a person’s ability to function decreases and they progress from early- to late-stage Alzheimer’s.
How does Alzheimer’s disease progress?
The different stages of Alzheimer’s (early, middle, and late) are distinct, but the transitions from one to the next can occur gradually, and may be hard to notice because they can overlap. Each person will progress through the disease in their own way.
Those with early-stage Alzheimer’s may start to notice difficulty remembering small things (which can easily be confused for normal memory loss). An important indicator is whether a person has difficulty remembering things they have recently learned because the part of the brain affected by the disease impacts learning centers. Someone in the early stages is likely still able to function independently, but they may be noticing things gradually changing (similar to Julianne Moore’s portrayal of an Alzheimer’s patient in the movie “Still Alice”).
Middle-stage Alzheimer’s will start manifesting in ways that are noticeable to others. This stage can last for years, and can include personality changes, confusion, changes in sleeping and eating patterns, and increases in forgetfulness (including things that have been known for a whole lifetime, not just recently learned material).
Late-stage Alzheimer’s is almost completely debilitating. A person will eventually lose the ability to communicate effectively, respond to their environment, take care of themselves, and more. Someone at this stage of Alzheimer’s generally needs round-the-clock care or assistance.
Is In Home Care appropriate for Alzheimer’s patients?
As we’ve learned, the different stages of Alzheimer’s require different levels of care and involvement. Someone in the early stage is probably functioning independently, and may not even know that they have Alzheimer’s. In these cases, the need for care is pretty much non-existent. Once someone begins progressing through the disease, however, care levels will continue to increase. Some of the options available are assisted living facilities, In Home Care, and nursing homes.
There is definitely an appropriate place for Alzheimer’s patients and families to utilize In Home Care, especially while a person can remain at home in a familiar environment. This might be especially important for those living with Alzheimer’s - as memory loss and confusion become more prevalent, it can be comforting to stay somewhere familiar and recognizable. To learn more about In Home Care for Alzheimer's, please visit our Services page.
Resources for caregivers:
Alzheimer’s undoubtedly has a massive impact on the person living with it. But this disease also affects friends and family in important ways. It can be emotionally and physically draining to watch a loved one mentally deteriorate and eventually become unable to care for themselves.
With that in mind, here are some resources for caregivers working with Alzheimer’s (whether as family members or professional caretakers):
While the number of people living with Alzheimer’s represents a very small portion of the U.S. population, the actual number of people affected by this disease is much larger. We hope you enjoyed this primer, where we covered the basics of Alzheimer’s, how it progresses, types of care, and resources for caregivers. To learn more, please visit our blog or contact us to see how Pennsylvania Agency of Nurses can assist your loved ones with Alzheimer’s.