Memory impairment is often the first problem which people notice but as the illness progresses, other brain functions are affected and people have increasing difficulty managing everyday tasks. There is currently no cure for Alzheimer's type dementia but there is treatment, including medication, which can help.
The disease attacks the cells, nerves and transmitters in the brain, causing tangled clumps and bundles (known as plaques and tangles) of certain proteins to develop inside and outside the brain cells. This gradually destroys the connections between the brain cells that are essential for normal mental activity.
Alzheimer's disease typically begins with minor memory problems, mood swings, and difficulty finding the correct words. Later, there may be confusion, and changes in personality and behaviour.
Most cases of Alzheimer's develop in those aged 65 or over. Below the age of 65, Alzheimer's is rare, affecting about 1 person in 1000. Over the age of 65 it affects about 1 in 20. The risk of developing Alzheimer's continues to increase with age, so those aged 80 have a higher risk of developing it than those aged 65. By the age of 85 nearly 1 in 2 will have the disease.
Women have a slightly greater chance of developing Alzheimer's than men. About 500,000 people in the UK are believed to have the disease.
Further information and leaflets can be found on the Alzheimer's Society website and on the Alzheimer's Scotland website. Although these organisations have the word "Alzheimer's" in their title, they deal with a wide range of memory problems, not just Alzheimer's disease.
For information on power of attorney, guardianship and adults with incapacity act, visit the Mental Health Legislation section of elament.
Alzheimer's disease is a progressive disease, which means that it gets worse over time.
The symptoms of Alzheimer's disease can vary greatly, but those with the disease often have one or more of the following:
It is not known exactly what causes Alzheimer's disease. Scientists think there is unlikely to be a single cause, but a number of factors that come together to trigger the disease. However, they have identified certain risk factors that increase the likelihood of developing Alzheimer's:
Environmental factors are being studied as possible causes for Alzheimer's, but so far there is no conclusive evidence that any environmental factor increases the risk of Alzheimer's. The concerns regarding aluminium causing Alzheimer's disease have largely been discounted.
Alzheimer's disease cannot be diagnosed with complete certainty during someone's lifetime. It is only after death that the plaques and tangles that are characteristic of the disease can be identified in the brain. As a result, there is no specific test for diagnosing Alzheimer's.
The disease is normally diagnosed initially from the most common symptoms, such as memory loss. Standard diagnostic tests include a full medical history, careful physical examination, and simple memory and mental ability tests that check things such as the ability to read, write or calculate.
Other tests, such as a CT or MRI scan of the brain, may be used to make sure that the person does not have a condition which can produce symptoms similar to Alzheimer's, such as other forms of dementia, or depression.
After eliminating other causes, a diagnosis of Alzheimer's disease can be made with an accuracy of about 90 per cent.
There is no cure for Alzheimer's disease, so treatment focuses on reducing and slowing down the progress of the symptoms.
There are some medicines that seem to delay the progress of the disease. The National Institute for Clinical Excellence (NICE) has reviewed three drugs - donepezil, rivastigmine and galantamine - and has decided that they are of some value in certain people with moderate Alzheimer's disease. They should be continued only if the person improves, or at least does not become worse, and the person must be reviewed every six months.
A new medicine called memantine may have the same effect for some people who have moderate or severe Alzheimer's disease. However, NICE has not yet completed its review of memantine. NICE is currently proposing that this medicine should not be available on the NHS in England and Wales as a treatment option for those with Alzheimer's disease, although no final decision has yet been taken.
Medical researchers are currently investigating other medical treatments, including anti-oxidants, brain stem cell therapy and a vaccination to stop the build up of plaques in the brain (a hallmark of Alzheimer's disease).
Mood-controlling drugs (tranquillisers) and other forms of medication can reduce the behaviour problems that often develop in those with Alzheimer's, including sleeplessness, wandering, anxiety, agitation and depression.
There is limited evidence that the herbal remedy Ginkgo biloba can delay the progression of dementia for some of those with Alzheimer's disease, and even make a small improvement in symptoms such as forgetfulness and confusion. However, more research is needed.
It is thought that mental activity can help to slow the progress of Alzheimer's, so you should encourage someone with the disease to stay mentally and physically active and ensure their environment is stimulating. Puzzles, games (particularly memory games), reading and simple mental arithmetic are good choices, but its important not to overwhelm them with too many demands, or unrealistic demands, as this may only frustrate them.
A technique called reality orientation may help some people with Alzheimer's. It uses repetition to help the memory and involves regularly reminding the person of information such as the time, date, where they are and important information for that day, such as a visit to see a friend. The information could be given verbally by a carer, or be written on a board in their home where they will see it regularly. The aim of reality orientation is to help people understand their situation by reminding them or telling them about what's going on.
Many of those with Alzheimer's in the early and intermediate stages are able to cope well in their own home, due to the familiar surroundings. Others may need more frequent supervision, full time care in the home, or care in a residential or nursing home. Those with severe Alzheimer's disease can do little on their own and will normally need full-time care
Support and care is the most important part of treatment for Alzheimer's disease. Many people with the condition are cared for in the community, often by a relative or friend. However, caring for a person with Alzheimer's can be very difficult. Support and advice for those caring for someone with the disease is available from the following sources:
The information shown here is Crown copyright and has been reproduced with the permission of NHS Direct. Last updated June 2007