Dementia is a loss of brain function that occurs with certain diseases. Alzheimer disease is one form of dementia. It affects memory, thinking, and behavior.
Senile dementia – Alzheimer type (SDAT); SDAT; Dementia – Alzheimer
The exact cause of Alzheimer disease (AD) is not known. Research shows that certain changes in the brain lead to AD.
You are more likely to develop AD if you:
Are older. Developing AD is not a part of normal aging.
Have a close relative, such as a brother, sister, or parent with AD.
Have certain genes linked to AD.
The following may also increase the risk:
Having heart and blood vessel problems due to high cholesterol
History of head trauma
There are two types of AD:
Early onset AD. Symptoms appear before age 60. This type is much less common than late onset. It tends to get worse quickly. Early onset disease can run in families. Several genes have been identified.
Late onset AD. This is the most common type. It occurs in people age 60 and older. It may run in some families, but the role of genes is less clear.
AD symptoms include difficulty with many areas of mental function, including:
Emotional behavior or personality
Thinking and judgment (cognitive skills)
AD usually first appears as forgetfulness.
Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging, and the development of AD. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They are often aware of the forgetfulness. Not everyone with MCI develops AD.
Symptoms of MCI include:
Difficulty performing more than one task at a time
Difficulty solving problems
Forgetting recent events or conversations
Taking longer to perform more difficult activities
Early symptoms of AD can include:
Difficulty performing tasks that take some thought, but used to come easily, such as balancing a checkbook, playing complex games (bridge), and learning new information or routines
Getting lost on familiar routes
Language problems, such as trouble remembering the names of familiar objects
Losing interest in things previously enjoyed and being in a flat mood
Personality changes and loss of social skills
As AD becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include:
Change in sleep patterns, often waking up at night
Delusions, depression, and agitation
Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, and driving
Difficulty reading or writing
Forgetting details about current events
Forgetting events in one’s life history and losing self-awareness
Hallucinations, arguments, striking out, and violent behavior
Poor judgment and loss of ability to recognize danger
Using the wrong word, mispronouncing words, or speaking in confusing sentences
Withdrawing from social contact
People with severe AD can no longer:
Recognize family members
Perform basic activities of daily living, such as eating, dressing, and bathing
Other symptoms that may occur with AD:
Problems controlling bowel movements or urine
Exams and Tests
A skilled health care provider can often diagnose AD with the following steps:
Performing a complete physical exam, including a nervous system exam
Asking about the person’s medical history and symptoms
Mental function tests (mental status examination)
A diagnosis of AD is made when certain symptoms are present, and by making sure other causes of dementia are not present.
Tests may be done to rule out other possible causes of dementia, including:
Intoxication from medicines
Increased fluid on the brain (normal pressure hydrocephalus)
CT or MRI of the brain may be done to look for other causes of dementia, such as a brain tumor or stroke. Sometimes, a PET scan can be used to rule out AD.
The only way to know for certain that someone has AD is to examine a sample of their brain tissue after death.
There is no cure for AD. The goals of treatment are:
Slow the progression of the disease (although this is difficult to do)
Manage symptoms, such as behavior problems, confusion, and sleep problems
Change the home environment to make daily activities easier
Support family members and other caregivers
Medicines are used to:
Slow the rate at which symptoms worsen, though the benefit from using these drugs may be small
Control problems with behavior, such as loss of judgment or confusion
Before using these medicines, ask the provider:
What are the side effects? Is the medicine worth the risk?
When is the best time, if any, to use these medicines?
Do medicines for other health problems need to be changed or stopped?
Someone with AD will need support in the home as the disease gets worse. Family members or other caregivers can help by helping the person cope with memory loss and behavior and sleep problems. It is important to make sure the home of a person who has AD is safe for them.
Having AD or caring for a person with the condition may be a challenge. You can ease the stress of illness by seeking support through AD resources. Sharing with others who have common experiences and problems can help you not feel alone.
How quickly AD gets worse is different for each person. If AD develops quickly, it is more likely to worsen quickly.
People with AD often die earlier than normal, although a person may live anywhere from 3 to 20 years after diagnosis.
Families will likely need to plan for their loved one’s future care.
The final phase of the disease may last from a few months to several years. During that time, the person becomes totally disabled. Death usually occurs from an infection or organ failure.
When to Contact a Medical Professional
Call the provider if:
AD symptoms develop or a person has a sudden change in mental status
The condition of a person with AD gets worse
You are unable to care for a person with AD at home
Although there is no proven way to prevent AD, there are some measures that may help prevent or slow the onset of AD:
Stay on a low-fat diet and eat foods high in omega-3 fatty acids.
Get plenty of exercise.
Stay mentally and socially active.
Wear a helmet during risky activities to prevent brain injury.
Dementia – what to ask your doctor
You are caring for someone who has dementia. Below are questions you may want to ask your health care provider to help you take care of that person.
What to ask your doctor about dementia; Alzheimer disease – what to ask your doctor; Cognitive impairment – what to ask your doctor
Are there ways that I can help someone remember things around the home?
How should I talk with someone who is losing or has lost their memory?
What type of words should I use?
What is the best way to ask them questions?
What is the best way to give instructions to someone with memory loss?
How can I help someone with dressing? Are some clothes or shoes easier? Will an occupational therapist be able to teach us skills?
What is the best way to react when the person I am caring for becomes confused, hard to manage, or does not sleep well?
What can I do to help the person calm down?
Are there activities that are more likely to agitate them?
Can I make changes around the home that will help keep the person calmer?
What should I do if the person I am caring for wanders around?
How can I keep them safe when they do wander?
Are there ways to keep them from leaving the home?
How can I keep the person I am caring for from hurting themselves around the house?
What should I hide?
Are there changes in the bathroom or kitchen I should make?
Are they able to take their own medicines?
What are the signs that driving is becoming unsafe?
How often should this person have a driving evaluation?
What are the ways I can lessen the need for driving?
What are the steps to take if the person I am caring for refuses to stop driving?
What diet should I give this person?
Are there hazards I should watch for while this person is eating?
What should I do if this person starts to choke?
Alzheimer – resources
Alternative NamesResources – AlzheimerInformationThe following organizations are good resources for information on Alzheimer disease: