Diseases & Conditions
What is Alzheimer’s disease?
Alzheimer’s disease is a non-reversible, progressive brain disorder that develops over a period of years destroying memory and other important mental functions. In this disease, the brain cells degenerate and die leading to changes in behavior and personality and a decline in cognitive abilities such as decision-making and language skills. Alzheimer’s disease ultimately leads to a severe loss of mental function and the inability to carry out the simplest tasks. It is the most common cause of dementia among people age 65 and older. 1
In the Kingdom of Saudi Arabia, there are no official statistics on the spread of Alzheimer's disease, but experts estimate that there are at least 50,000 patients living with this disease in the country. The Saudi Alzheimer's Disease Association indicates that the chances of getting the disease double every 5 years among individuals aging more than 65 years, while that half of those aging over 85 years were found affected by the disease.2
What causes Alzheimer's disease?
The causes of Alzheimer's are not yet fully understood, although people with Alzheimer's disease have been found to have abnormal amounts of protein (amyloid plaques) and fibers (neurofibrillary tangles) in the brain:3
Amyloid plaques and tangles will lead to a loss of connections between neurons, which will be responsible for memory and learning decline. Neurons cannot survive when they lose their connections to other neurons. This loss of connection is strongly implicated in the shrinkage of the affected brain regions. People in the final stages of the disease have a widespread damage with significant shrinkage of their brain tissue.
Who is at risk for getting Alzheimer's disease?
Although it is still unknown what triggers Alzheimer's disease, several factors are known to increase the risk of developing the condition. These risk factors are of two types: unavoidable risk factors and modifiable factors (someone can reduce his risk of getting Alzheimer’s disease by keeping these conditions under control).4
What are the signs and symptoms of Alzheimer’s disease?
Alzheimer’s disease affects people in different ways. The most common initial symptom is a gradually decreasing ability to remember new information. This occurs because the first neurons to malfunction and die are usually neurons in brain regions involved in forming new memories.
The following are common symptoms of Alzheimer’s disease:5
A person in the earlier stages of Alzheimer's will often have changes in their mood. They may become anxious, irritable or depressed. Many people become withdrawn and lose interest in activities and hobbies.
How is Alzheimer’s disease diagnosed?
Alzheimer disease is usually diagnosed on physical and neurological exams, and checking for signs of intellectual impairment through standard tests of mental function. For a diagnosis of Alzheimer’s disease, new criteria were published in 2011.6 In this guideline, the physician obtains a medical and family history, including psychiatric history and history of cognitive and behavioral changes. The deficits should include impairment in learning and recall of recently learned information, deficits in word-findings and visuospatial cognition and impaired reasoning, judgment, and problem solving.
In addition, the physician conducts cognitive tests and physical and neurologic examinations. Moreover, he may request that the individual undergo computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to rule out other possible causes for symptoms.
What treatment and management options are available for Alzheimer's disease patients?
There is currently no cure for Alzheimer’s disease, and drug therapy is still in its early stages. Approved medications help control the symptoms of Alzheimer’s disease but do not slow down the progression or reverse the course of the disease itself. At present, only drugs that target neurotransmitter systems in the brain are used for treating Alzheimer’s disease.7
Doctors can offer pharmacological treatment and non-pharmacological interventions:8
As discussed above, there is currently no medical treatment to stop or reverse the progression of Alzheimer’s disease. However, six drugs have been approved by the U.S. Food and Drug Administration that temporarily improve symptoms of Alzheimer’s disease by increasing the amount of chemicals called neurotransmitters in the brain. These medications have been shown to improve quality of life through all stages of the disease for individuals with Alzheimer’s disease.8
The primary goals of non-pharmacological interventions are to maximize the patient’s ability to function in daily life, maintain quality of life, slow the progression of symptoms, and treat depression or disruptive behaviors. Such interventions comprise physical therapy and reminiscence therapy (therapy in which photos and other familiar items may be used to help the patient remembers). It is important to note that this kind of therapy does not alter the course of the disease but it can help the brain compensate for impairments and enhance the patient’s quality of life.