What is Alzheimer's disease?
Alzheimer's disease is type of dementia
that causes a progressive decline in the mental functions that affect memory,
thinking, language and behaviour. It is most common in people aged 65 and
older, although it can also affect younger people. However, Alzheimer’s disease
is not a normal or inevitable part of ageing – the symptoms are more severe
than the mild memory loss that many people may experience as they grow older.
Nearly 40,000 people in Ireland suffer
from Alzheimer’s disease or some related form of dementia, and with our ageing
population, this figure is expected to grow even higher over the coming years.
What are the symptoms?
Symptoms vary from person to person, and
may at first go by unnoticed. However, symptoms gradually worsen as the disease
progresses. They may include:
- Memory loss
- Difficulty performing familiar tasks
- Problems with language – forgetting
- Disorientation – confusion about what day
or time it is, or where you are
- Poor or decreased judgment
- Changes in mood or behaviour
- Changes in personality
Alzheimer’s disease progresses through
three main stages: mild, moderate and severe. In mild Alzheimer’s disease,
there may be slight lapses of memory and altered mood. Later on however, more
obvious problems may develop – for instance the person may not recognise once
familiar people or places, they may become confused or agitated, and may
wander. The person may also eventually start to develop physical symptoms, such
as losing bladder or bowel control – and eventually they may become incapable
of caring for themselves.
What causes Alzheimer's disease?
In Alzheimer’s disease, certain changes
take place in the brain, which means that the brain cells no longer function
properly. ‘Plaques’ made up of a protein called amyloid and ‘tangles’ of
twisted fibres develop in the brain of affected people, which
gradually damage and eventually destroy the brain cells. People with
Alzheimer’s disease also have a reduction in the level of a chemical messenger
(or ‘neurotransmitter’) in their brain called acetylcholine – which is
necessary for the brain cells to function properly.
It is not fully understood what causes
these changes in the brain. However, it is thought that a combination of
factors is most likely, including age, genetic factors, environmental factors,
diet and overall general health. Age, however, is the most important risk
How is it diagnosed?
The first step if you think that you or
somebody else is experiencing symptoms of Alzheimer’s disease, is for the
person affected to visit their GP. The GP may conduct screening tests that
involve asking simple questions to assess the person’s mental ability. The GP
may then refer the person to a specialist, who will conduct a full assessment.
This may include a detailed assessment of memory, a full history of the
person’s medical and family background, and other tests – such as a brain scan
and blood tests.
It is also important that other treatable
diseases that may resemble the symptoms of Alzheimer’s disease – such as
thyroid problems, infections, vitamin deficiencies and depression – are also
How is it treated?
There is no medication available at
present that can cure or prevent the development of Alzheimer's disease. The
focus is therefore on managing the symptoms of the disease and on trying to
help the person affected to live as independently as possible, for as long as
There are medications available in Ireland
that can help to manage the symptoms and delay the progression of Alzheimer’s
disease. Cholinesterase inhibitors, which are only suitable for people with mild to
moderate Alzheimer’s disease, act to increase the level of the chemical
messenger acetylcholine in the brain. This can slow the progression of some of
the symptoms, such as memory loss and changes in thinking and
judgement. However, these drugs can only ease symptoms temporarily, and
not all people respond to them. They should not be considered as a cure for the
Ebixa (memantine) is another type of drug
which may be given to people in later stages of the disease. Again, this drug
can only treat symptoms and delay progression of the disease temporarily.
Research into a treatment or preventive
strategy for Alzheimer’s disease continues.
Caring for someone with Alzheimer’s
As the disease progresses, ensuring that
the person has enough assistance to meet their everyday needs will become the
most important aspect of therapy. A person with severe Alzheimer’s disease may eventually
become totally incapable of caring for themselves.
It is also important that the relatives /
carers themselves have appropriate support – caring for someone with
Alzheimer’s disease can be very demanding. Counselling, support groups and day
or respite care can help to relieve the burden on carers and may make it
possible for the sufferer to be cared for at home for longer than would
otherwise be possible. In advanced cases of Alzheimer’s, however, inpatient
care may be necessary.
What can I do to help my friend/relative
with Alzheimer's disease?
- Be supportive — talk to your
friend/relative in the early stages of the disease about the type of care they
would like to receive in the later stages. Loss of independence is a major
issue for most people with Alzheimer’s, so be reassuring and involve your
friend/relative in any decisions that will affect them.
- Be practical — although it is distressing,
it is important that your friend/relative addresses legal issues such as power
of attorney and a living will while they are still competent.
- Find support for yourself — join a support
group and find out what forms of community support (for example, home help or
respite care) are available. For more information, contact the Alzheimer
Society of Ireland at 1800 341 341 or visit the Society's website at: www.alzheimer.ie
Visit the irishhealth.com Alzheimer's Clinic for more information on symptoms of Alzheimer's disease, treatments and advice for carers.