Alzheimer’s disease

What is Alzheimer’s disease?

Alzheimer’s disease (AD) is a degenerative disease of the brain, which is the most common form of dementia. Alzheimer’s disease is a serious brain disorder which seriously affects a person’s ability to have a normal life and their ability to carry out their activities each day.

Alzheimer’s disease normally starts after after age 65, but the symptoms normally start slowly and can often be disregarded as a normal part of ageing (slowed thinking, confusion and forgetting things) before this age.

Alzheimer’s disease is characterised by the increased amounts of abnormal clumps (amyloid plaques) and tangled fibres of proteins (neurofibrillary tangles) – basically abnormal deposits of substances in and around the neurons. Some of these changes normally occur with ageing, but not anywhere near the level that they do in a person with Alzheimer’s disease.

Scientists believe that the communication between the neurons (nerve cells) becomes disconnected, especially in the parts of the brain which rule memory and learning. Some of the nerve cells die. In addition to this, levels of some of the neurotransmitters in the brain appear to be low, which may also play a role in this disease.

It is known that Alzheimer’s affects brain cells by progressively making them fail to work properly, but scientists do not yet know what causes the brain cells to fail in such a way.

Facts about Alzheimer’s disease

• Alzheimer’s disease is not a normal part of the ageing process
• Scientists still do not know exactly what causes Alzheimer’s disease, but have a few theories which are currently being investigated (including researching specific genes which seem to be associated with Alzheimer’s disease)
• Alzheimer’s disease will progress over time in the individual, with a deterioration of their condition in the long term
• Since Alzheimer’s is a progressive disease, this means it will continue to cause deterioration for anywhere from 5-20 years
• The most common cause of death in people with Alzheimer’s disease is serious infection
• Alzheimer’s disease is named after Dr. Alois Alzheimer, a German doctor who first diagnosed this disease in a patient in 1906
• Age is the most common risk factor for Alzheimer’s disease, with most people diagnosed being over 65
• There is currently no cure for Alzheimer’s disease (as at 2007), but some drugs (and alternative treatments) may help keep symptoms from getting worse for a short time

Symptoms of Alzheimer’s disease

Alzheimer’s disease is characterised by a progression of symptoms, which start slowly and steadily become worse and worse in time.

Early symptoms (mild to moderate)

The early symptoms are normally not noticed at first, as they can be quite mild and signal a normal part of ageing (occasionally forgetting some things). Once the symptoms increase and worsen, they are noticed by other people.

• Difficulty in calculating simple maths problems
• Difficulty in retaining information
• Inability to recall people’s names or familiar words
• Inability to perform complicated mathematical calculations (or do any analytical or critical thinking)
• Less ability to organise or carry out complicated plans
• Mild to moderate memory lapses
• Performance difficulties at work
• Socially withdrawn

Later symptoms (severe)

At this stage, the symptoms are starting to be noticed by other people.

• Some help is needed for many daily activities (dressing, washing, eating, cooking) – which deteriorates until full time assistance is necessary for all daily activities
• Inability to remember address, phone number and date – this decline in cognition will progress until there is an in ability to remember anything
• Incontinence
• Insomnia
• Major decline in cognition
• Major gaps in memory
• Personal history will still be recalled, but symptoms will progress until this is also forgotten
• Personality changes – depression, anxiety, anger, hallucinations, suspicion and paranoia

Late-stage symptoms (very severe)

This is the final stage of Alzheimer’s disease, where the disease progresses to such a point where the person loses all body movement and finally dies due to inability to control their bodily functions (including breathing).

• Difficulty swallowing
• Inability to cook and eat – feeding is achieved through tubes
• Inability to go to the toilet – require assistance
• Inability to speak
• Inability to walk without assistance – then inability to sit or hold the head up without assistance (can only lie down)
• Incontinence
• Loss of control of body movement
• Loss of control of reflexes

Causes of Alzheimer’s disease

Currently there is no answer for the cause of Alzheimer’s disease, but there are a number of theories which have been proposed (but have not yet been proven):

Family history / genetics

There is some strong evidence that within certain families, there is a definite connection between developing Alzheimer’s disease and family history of the condition. Other research shows that people who have family members with Alzheimer’s disease have a greater risk for developing this condition than people without any family members who have this condition. Research in this area continues to search for the definite link between heredity and this condition in order to understand how Alzheimer’s disease develops in certain people and not in other people (even in the same family).

Environmental factors

There are a number of theories about the different types of environmental factors that could cause Alzheimer’s disease, but there is no consensus about any of these theories.

Some of the theories proposed about environmental factors are:

• Aluminium – a number of studies (including a long term, 15 year follow up study) suggest that long term or chronic exposure to aluminium (from drinking cans, pans, pots, food tins or other cooking items) may be responsible for some of the beta-amyloid accumulations and neurodegenerative damage which occurs in the brain of people with Alzheimer’s disease. There are also a number of studies which suggest that aluminium is not related to development of Alzheimer’s disease

Other internal factors

Some research suggests that there could be a number of other, yet unknown factors which could cause Alzheimer’s disease. Some of the theories proposed in this area are:

• Imbalanced body chemistry – it could be hormones, neurotransmitters or any other body chemicals that are not in a normal level
• Immune system problems – the immune system may be faulty and this could cause Alzheimer’s disease to develop
• Virus – some researchers are looking into whether a very slow-acting virus is responsible for causing Alzheimer’s disease

Prevention of Alzheimer’s disease

Scientists have not yet discovered what causes Alzheimer’s disease, although they do have a list of risk factors, which means people in these groups are at higher risk for this disease.

Non-preventable risk factors

There is very little that can be done to prevent known risk factors that are either genetic or in some other way unpreventable. The main ones are:

• Age – people over 65 have a much higher risk of developing Alzheimer’s disease than younger people. People who are over 85 have a very significant risk of developing this disease
• Cold sores – the latest research also shows that the cold sore virus (herpes simplex) is linked to development of Alzheimer’s disease in 30% of people who also have the apoliprotein E-e4 (APOE-e4)
• Family history – research shows that people who have a close family relative have a higher risk of also developing Alzheimer’s disease when they get older
• Genetics – research has shown that certain genes play a definite role in the development of this disease:
  • Risky genes – apoliprotein E-e4 (APOE-e4) gene provides the mechanism that allows proteins to carry cholesterol in the blood (lipoproteins). Inheriting this gene (1 or more copies of it) increases the likelihood of developing Alzheimer’s disease but does not guarantee it
  • Deterministic genes – inheriting some very rare genes are known to directly cause Alzheimer’s disease, this type of the disease is called familial Alzheimer’s disease and is responsible for less then about 5% of all cases of Alzheimer’s disease

Preventable risk factors

There are ways to possibly reduce the risk of developing Alzheimer’s disease in the first place. Or at least reduce some of the symptoms associated with Alzheimer’s disease:

• Acetylcholine – the neurotransmitter acetylcholine is very low in people with Alzheimer’s disease. This neurotransmitter is associated with good memory and if it is in deficit this can present as poor memory symptoms, which are associated with Alzheimer’s disease
• Alcohol in moderation – limiting alcohol consumption may help brain health in a number of ways: it reduces the number of brain cells that are killed through excessive alcohol consumption, enables better circulation and reduces risk of heart problems
• Aluminium – current research has shown that higher than normal deposits of aluminium in the brain could be a risk factor for developing Alzheimer’s disease. Studies show that aluminium causes malfunction of the neurons (especially in the brain) and ultimately in cell death. If aluminium gets into the brain, it can disrupt normal brain cell function, cause free radical production and excessive excitation of the neurons in the brain (excitotoxicity) and all of this ultimately causes death of the brain cells. People who are deficient in magnesium are especially at risk, because aluminium competes with magnesium for absorption and usage
• Dopamine – studies show that the neurotransmitter dopamine is very low in people with Alzheimer’s disease. Dopamine is associated with normal mood function and is synthesised from the amino acid tyrosine. Researchers do not know if people with Alzheimer’s disease become deficient in dopamine due to the disease or they were first deficient in this neurotransmitter which led to the progression of Alzheimer’s, but getting adequate amounts of tyrosine in the diet may significantly reduce the risk of developing Alzheimer’s disease
• Engage your brain – keeping the brain stimulated is one key way to prevent the memory and cognition problems associated with Alzheimer’s disease. The best ways to keep the brain active and young are through: learning a new skill, playing games that stimulate the mind, doing puzzles and crosswords most days
• Essential fatty acids – there is some research which suggests that a deficiency in the essential fatty acids DHA/EPA and GLA (gamma linolenic acid) are associated with a high risk of developing Alzheimer’s disease and this is because much of the membranes of the brain cells need the essential fatty acids to function properly and behave normally
• Exercise regularly – there is a link between heart health and brain health, with good circulation being a major factor in reducing ill health to both. Regular exercise enables the circulatory system and the heart to be healthy
• Head injury – research shows that people who sustain a serious head injury at any point in their life are at higher risk for developing Alzheimer’s disease. Always wear protective head gear when cycling, riding or engaging in any activity which could cause accidental head injury
• Healthy ageing – research suggests that overall health as people age has some implications on the risks of developing Alzheimer’s disease. The main recommendations now are – stay within a healthy weight range, perform mental calculations every day (crosswords, maths problems, reading, writing), socialise, exercise and eat nutritious, unprocessed food
• Healthy diet – a healthy diet for life, which consists of lots of fresh fruit (2-3 per day) and vegetables (5-7 per day), some nuts and seeds, low fat dairy, legumes, wholegrains, oily fish (especially salmon, mackerel, sardines, trout and tuna), some poultry and red meat helps to keep the brain healthy by providing lots of antioxidants which may reduce any build up of plaque in the brain
• Heart health – much research shows that an unhealthy vascular system (heart and blood vessels) is a definite risk factor for Alzheimer’s disease. The brain is the body’s most important organ and requires about 25% of the blood pumped from the heart, so if it is not getting the correct nutrients (oxygen, vitamins, minerals, glucose) every day, then it may be more vulnerable to Alzheimer’s disease
• Heavy metal exposure – there is some research that suggests people who have had exposure to heavy metals (especially mercury) may have a higher risk for developing Alzheimer’s disease. The research suggests that the mercury fillings in some sensitive people can adversely affect their brain and increase risk of development of Alzheimer’s disease, especially if their diet is deficient in certain vitamins, minerals and other nutrients
• Homocysteine – high levels of the homocysteine, which is an by-product of a number of metabolic processes, is implicated as a risk factor for Alzheimer’s disease. The higher the level of homocysteine in the blood, the more significant the memory, mood and concentration problems
• Keep the brain active – research shows that keeping the brain active well into old age helps to improve brain health and may even prevent Alzheimer’s disease. Activities which promote an active brain are those which stimulate the mind to think and process new information and learning a new activity is a great way to achieve this
• Stress – excessive amounts of stress, with elevated cortisol levels are associated with a higher risk for developing Alzheimer’s disease
• Stop smoking – people who smoke are putting their brain in danger, as smoking is associated with a number of health conditions, such as stroke, which may put the brain at further risk of Alzheimer’s Disease

Complications of Alzheimer’s disease

The ultimate complication of Alzheimer’s disease is death, but most people with Alzheimer’s disease normally pass away from other illness (such as pneumonia) before the ultimate end from Alzheimer’s disease.

The most common complications of having advanced Alzheimer’s disease are:

• Losing control of bodily functions – the most common complications in people with later stage Alzheimer’s disease is the inability to control any of their bodily functions, from eating, to being incontinent and to soiling their undergarments due to inability to control the emptying of the bowels. Some people with Alzheimer’s disease may be at such a late stage that they require a respirator to help them breath, because their lungs are not able to function properly
• Injuries from falls – people who have later stage Alzheimer’s disease often fall as they are starting to lose control of their bodily function and/or become easily disorientated. Falls are a common cause of serious head injuries, hip fractures and arm or leg injuries. Falls can also cause bleeding in the brain (if serious enough)

• Pneumonia – this is one of the most common infections in people with Alzheimer’s disease. When this conditions is in the advanced stage, it may be difficult for the person to swallow properly, as the muscles in their throat are not able to function properly. Due to this disability, it means they may inhale a tiny portion of the food or drink they are being fed and this may cause a pneumonia infection. Very often people with Alzheimer’s disease pass away from a pneumonia infection when they are in the late stage of the disease, as their body cannot cope with this type of infection
• Serious infections – many people with later stage Alzheimer’s disease become incontinent, so require the insertion of a catheter which may become infected, causing a urinary tract infection. An untreated urinary tract infection could have really serious consequences. In addition to this, there are other infections that a person with late stage Alzheimer’s disease could develop, that could easily become very serious and life threatening

When to see a doctor about Alzheimer’s disease

A family doctor should be consulted if one of your family members has any of the symptoms of Alzheimer’s disease (or even if you suspect you may be developing it). It is better to get diagnosis early, so that treatment can start early before symptoms really degenerate to a late stage and when it is not possible to do much, but give palliative care.

People with existing Alzheimer’s disease need to see their doctor on a regular basis, to check that the dosage of their treatment is working well, or to adjust it, to check on their symptoms (if there is any deterioration or if there is no change) and to discuss any other experimental or alternative or complementary treatments which may provide benefit to some.

Scientists are constantly finding new information about Alzheimer’s disease, so the earlier it is diagnosed, the earlier it can be treated.

Diagnosis of Alzheimer’s disease

Alzheimer’s disease is initially diagnosed through the following tests:

• Medical history – the doctor will ask a number of questions about symptoms, when they started, the duration, the severity and how often they occur. If the condition is at a moderately severe stage, the person affected with the Alzheimer’s disease will need a family member (or carer) to answer these questions and follow up with other diagnoses and treatments
• Physical examination – the doctor may do a routine check of the heart and lungs with a stethoscope (to listen to the heart and lungs) as well as a blood pressure test, to determine if blood pressure is normal
• Blood test – a blood test can be requested as part of the initial diagnosis to rule out any other reasons for the dementia symptoms, such as nutrition deficiencies (especially vitamin B3, but also others) and to also rule out conditions of the thyroid, which may cause some psychological symptoms such as forgetfulness

The only way to definitively diagnose Alzheimer’s disease is at death, when the brain can be thoroughly examined for the plaque deposits which are associated with Alzheimer’s disease. Not every case of this disease will ever be properly diagnosed as the symptoms may be too mild, or onset may occur just prior to death of another condition.

Diagnostic tests

There are also a number of other diagnostic tests which can be done to help with diagnosis of Alzheimer’s disease:

• CAT scan – a CAT (computerised tomography) scan uses low level x-rays to produce cross-sectional images of the brain which may help to diagnose Alzheimer’s disease
• MRI – an MRI (magnetic resonance imaging) machine uses radio waves an a magnetic field to produce images of the brain which may be able to give an indication of the progression of the Alzheimer’s disease
• Neuropsychological testing – this is a special test which is used in some cases to get a clearer picture of the damage to the brain and cognitive functioning at the early stage of Alzheimer’s disease (and other dementia). In this test, which may last 2-3 hours, an assessment is made of thinking, memory and analytical skills to provide a better diagnosis of Alzheimer’s disease
• PET scan – a PET scan (positron emission tomography) is similar to an MRI or CAT scan, except in the PET scan, you are first injected with a special, low level radioactive isotope into your veins, which travels to the brain, while you lie on a table and the PET scanner overhead transmits the images of your brain to the technician. This test is most useful in determining the type of dementia in the brain

Conventional treatment of Alzheimer’s disease

Conventional treatment for Alzheimer’s disease consists of a combination of a number of treatments, with quite a few drugs that are prescribed to try to halt or at least slow down symptoms and prevent further cognition decline.

Memory and cognition symptoms

There are a few drugs which are approved to help with the memory problems:

• Acetylcholinesterase inhibitors – these drugs block the activity of acetylcholinesterase, which is an enzyme that destroys acetylcholine, a very important neurotransmitter involved in memory. These drugs are used for people with mild to moderate Alzheimer’s disease (these drugs are available on the PBS in Australia for a small fee, but to continue being prescribed the drugs after 6 months of treatment, the patient must show some improvement in symptoms)
• Memantine – this drug blocks the neurotransmitter glutamate and prevents too much calcium moving into the brain cells and causing damage. This drug is used for people with moderate to severe Alzheimer’s disease (this drug is not available on the PBS in Australia and must be privately prescribed)

Behavioural and psychological symptoms

There are a variety of different classes of drugs used to treat the behavioural and psychological symptoms that start to appear once the disease progresses

• Anti-psychotics – these drugs are used to treat symptoms such as delusion, aggression, hallucination and agitation in people with moderate to severe Alzheimer’s disease. These drugs can cause side effects which some people cannot tolerate well, so alternatives may be advised (or lowered dosages)
• Anti-depressants – these drugs are used to treat depression symptoms that are often present in people with Alzheimer’s disease. Anti-depressants medications help to reduce the depressive feelings that often occur in people with Alzheimer’s disease
• Anti-anxiety medications – benzodiazepine drugs are used as a short-term treatment for anxiety, fear and agitation that may occur in people with Alzheimer’s disease. The reason these drugs are only used for a short term, is because the effect of these drugs may lessen over time and cause a number of side effects
• Sedating medications – these drugs (usually tranquilisers) are used to help with the sleeping problems experienced by people with Alzheimer’s disease. Care needs to be taken with sedating medications as they can cause an addiction, so should only be used on a short term or “as required” basis

Alternative / complementary treatment of Alzheimer’s disease

People who have Alzheimer’s disease (or their family member) must talk to their doctor about any alternative / complementary strategies that they are thinking about undertaking, before doing so. Your doctor will be in the best position to advise you if these strategies will help you.

Vitamins, herbs, minerals and other nutrients can have major adverse effects if taken in combination with some medications. Aways be careful and consult your doctor for advice before taking them

Use these strategies here as a guide and work with your doctor (and possibly alternative health specialist) to find the best combination of medication and alternative/complementary therapy that can work the best for you.

Herbs

There are a few herbs which show much promise in delaying onset of the more serious symptoms of Alzheimer’s disease and preventing the illness from getting worse for a longer duration:

• Ginkgo biloba – this is a herb used in traditional Chinese medicine (and also Western herbal medicine) which is known to have beneficial effects on circulation of the blood. Ginkgo biloba is also used to improve memory and other cognitive functions which means it could be especially beneficial for people with Alzheimer’s disease. One trial showed no improvement in cognitive function, while other trials have shown some improvement; to determine if ginkgo biloba has any ability to slow or prevent the onset of dementia (specifically Alzheimer’s disease), the National Centre for Complementary and Alternative Medicine (NCCAM) USA is conducting a large trial to test this theory
• Huperzine A – this is a type of moss used in Traditional Chinese medicine, which has a potent alkaloid substance that is the active component. The active component in the moss is thought to provide the beneficial memory and learning benefits, especially in people with Alzheimer’s disease. Studies show that Huperzine A has strong neuroprotective effects that are even more beneficial than the acetylcholinesterase inhibitor type drugs. In April 2004, the National Institute of Ageing (USA) launched a clinical trial to determine the effect of Huperzine A on improving cognitive function in people with Alzheimer’s disease – this trial was completed in December 2006 and the results are yet to be released (as at March 2009). This study is being conducted to confirm (or reject) previous research which showed the benefits of Huperzine A on cognitive functions

Vitamins

There are a number of other vitamins which could be beneficial for people to either possibly reduce the risk of developing Alzheimer’s disease in the first place or to reduce symptoms:

• Choline (or phosphatidylcholine) – this B vitamin co-factor is used by the body to make the fatty substance in the membranes of healthy cells and to ensure the membranes of cells can be repaired when necessary; one study showed that increased plasma levels of phosphatidylcholine were associated with a reduction of the risk of Alzheimer’s disease by almost 50%. Other studies have shown that people with Alzheimer’s disease have a deficit of phosphatidylcholine in cerebral-spinal fluid
• Folic acid – the B vitamin, folic acid is often in deficient levels in people who have Alzheimer’s disease and studies show when the levels of folic acid are supplemented to normal, there was an improvement of cognitive symptoms
• Vitamin A – the antioxidant vitamin A may be required to reduce the amount of oxidative damage to the neurons, neurotransmitters and cells in the brain, which may reduce risk of worsening of symptoms
• Vitamin B1 – studies show that a possible deficiency in Vitamin B1 (thiamin) may result in increased accumulations of the beta-amyloid plaque in the brain, which is associated with Alzheimer’s disease
• Vitamin B3 – studies show that a possible deficiency in all the B vitamins, including vitamin B3 (niacin) may increase the risk for cognitive impairment associated with Alzheimer’s disease. Studies also show that vitamin B3 helps to balance levels of the neurotransmitter, dopamine, which may reduce some symptoms
• Vitamin B6 – studies show that a possible deficiency in all the B vitamins, including vitamin B6 (pyridoxine) may increase the risk for cognitive impairment associated with Alzheimer’s disease
• Vitamin B12 – studies show that a possible deficiency in all the B vitamins, including vitamin B12 (cyanocobalamin) may increase the risk for cognitive impairment associated with Alzheimer’s disease
• Vitamin C – the antioxidant vitamin C may be required to reduce the amount of oxidative damage to the neurons, neurotransmitters and cells in the brain, which may reduce risk of worsening of symptoms. Vitamin C may be also beneficial when there has been heavy metal poisoning, to help excrete the metals from the body
• Vitamin E – the antioxidant vitamin E may be required to reduce the amount of oxidative damage to the neurons, neurotransmitters and cells in the brain, which may reduce risk of worsening of symptoms. Vitamin E is also necessary as a vasodilator, which means it opens up the blood vessels to allow proper blood flow, which is vital for the heart and brain. Vitamin E also thins the blood, preventing blood clots from forming. Vitamin E is vital for heart health and for the health of the whole cardiovascular system

Minerals

There are a number of other minerals which could be beneficial for people to either possibly reduce the risk of developing Alzheimer’s disease in the first place or to reduce symptoms:

• Calcium – the mineral calcium, may be effective in people whose dementia symptoms are due to heavy metal poisoning or who have been exposed to chronic and prolonged levels of aluminium
• Selenium – the antioxidant mineral selenium, may help to reduce free radical damage, that may damage the membranes of the brain cells
• Zinc – the antioxidant mineral zinc, may help to reduce free radical damage, that may damage the membranes of the brain cells

Living with Alzheimer’s disease

Living with Alzheimer’s disease is focused mainly on managing symptoms, to prevent them from getting worse in order to get a better quality of life:

• Avoid antacids containing aluminium – this is to ensure that the brain does not accumulate any more aluminium which is one of the possible risk factors for the development this disease
• Avoid aluminium cookware – this is because the food cooked in the aluminium pots / pans may absorb some of the aluminium and it is absorbed by the body, which may put a greater burden on the person with Alzheimer’s disease which is not necessary
• Avoid aluminium cans – it is recommended to avoid fluids in aluminium cans that contain citric acid, oxalic acid, malic acid or lactic acid, as they can cause the aluminium to be more easily absorbed by the body. This means, all soft drinks, all cola drinks and even milk drinks are banned
• Calendar – people with Alzheimer’s disease need to help boost their memory function and a simple way to do this is with a calendar that can be carried around. The calendar is best if it is started before memory problems become too severe, as it may not work so well in that stage of the disease. A calendar can be used to note certain events, people’s birthdays, daily activities, to do lists and to even jot down what happened during the day and use it as a memory exercise to go over those events the next day, to try to recall them
• Eat more eggs – the latest scientific advise is that eggs are safe to eat, even for people who have high blood levels of LDL (“bad”) cholesterol. The yolk of eggs is especially packed full of omega-3 fatty acids, choline and antioxidants, especially if the chickens that have laid the eggs have been fed organically and raised in a free range environment. Choline is vitally important for brain health, as it is needed to synthesise the neurotransmitter, acetylcholine, which appears to be very low in people with Alzheimer’s disease. People without any cholesterol problems can eat one egg each day, but people who have cholesterol problems should seek their doctor’s advice about how many eggs they can eat
• Exercise regularly – the brain requires proper circulation, to enable the nutrients that the blood supplies to be delivered properly and efficiently. People who exercise usually have a better circulatory system, which significantly decreases the risk of Alzheimer’s disease from developing, or reduces the progression of the disease in people with existing Alzheimer’s
• Filter all drinking/cooking water – this should be done through a reverse osmosis process to remove as much of the heavy metals from the water and reduce any further stress on the brain
• Healthy diet – a diet which is rich in fresh fruit and vegetables and little red meat, is the optimal diet for someone who has Alzheimer’s disease. At least two pieces of fruit should be eaten each day, plus around 5-7 portions of vegetables, with some of them raw. Leafy green vegetables are especially full of antioxidants and nutrients. The diet should also include adequate amounts of healthy fats (cold pressed olive oil, avocado, nuts, seeds), legumes (chickpeas, beans), wholegrains, some cold water fish (mackerel, salmon, sardines, trout, tuna), some poultry (1-2 times a week)
• Limit sugar and processed foods – any type of sugar, including both white and brown should be strictly limited in the diet, as several studies show that excessive amounts of sugar may be linked to cognitive (memory) decline, especially in people with any type of glucose or insulin problems
• Limit saturated fat – studies show the type of fat that is eaten, has a big impact on the health of not just the heart, but also the brain and excessive intake of saturated fat is linked to heart disease and poor circulation (through blocked blood vessels. Saturated fats from red meat, full fat dairy (especially butter, sour cream, and cream) as well as processed and junk foods, should be strictly limited in the diet to maintain better brain (and cardiovascular) health
• Regular medical check-ups – people with Alzheimer’s disease should ensure they are visiting their doctor on a regular basis, to check on progress of the disease and symptoms, as well as to to monitor medication (or supplements) being taken and to adjust dosage if required

There are always new breakthroughs that occur all the time in the study of Alzheimer’s disease, but the cure is not yet available.

Caring for someone with Alzheimer’s disease

Partner / family

People who have a partner with Alzheimer’s disease can help them through the following strategies:

• Asking other family members to help – one person is not enough to take care of someone with Alzheimer’s disease, especially when the disease progresses to the late stages, which may require 24 hour care for your partner. If you have other family members, you should ask them to also provide some assistance, when they can, to give you a break and to share the care
• Medical care – it is highly recommended that you (or another close family member) go to the doctors with your partner, to make sure that the appointments are being made on a regular basis, that they have a good duty of care, that their medications are being monitored and that the doctor understands the progression of their disease and can you give the best advice based on this
• Reduce noise and pressure in the home – people with Alzheimer’s disease tend to get more agitated, confused and anxious when they are surrounded by a lot of noise or are being pressured or are being pushed to rush anything or even are surrounded by too many people (loud, noisy shopping centres are a very bad idea for people with Alzheimer’s disease). Try to be gentle with your partner and let them feel comfortable at home, because when they become upset or very agitated, their ability to think clearly deteriorated even more rapidly
• Support – people with Alzheimer’s disease can often experience a wide range of emotions and behaviours, which they may not be able to control. Emotions ranging from rage, anger, irritation, depression, anxiety, fear, uncertainty and confusion. You can help your partner cope somewhat better (at least in the early stages) by reassuring them that you are there to help them, to listen to them and to let them know that they can still enjoy their life. Your partner needs your unconditional love and commitment to treating them with dignity and respect

Friends

People who have a friend with Alzheimer’s disease can help them through the following strategies:

• Helping the family – if you are a close friend, you may be able to reduce the burden on the family at times, by helping to take care of your friend, or take your friend on an outing somewhere they enjoy or to an activity they enjoy. This is a good way to spend some time with your friend and to let their family relax a little
• Support – people with Alzheimer’s disease can often experience a wide range of emotions and behaviours, which they may not be able to control. Emotions ranging from rage, anger, irritation, depression, anxiety, fear, uncertainty and confusion. You can help your friend cope somewhat better (at least in the early stages) by reassuring them that you are there to help them, to listen to them and to let them know that they can still enjoy their life. Your friend needs your unconditional love and commitment to treating them with dignity and respect

References

Last reviewed and updated: 14 May 2024