What we do and don’t know about Alzheimer’s disease

Published Dec 25, 2016 at 9:00am

You may be worried that you or someone you love is beginning to have Alzheimer’s disease, which is a type of dementia, or loss of intellectual functioning that occurs in old age.

The most common early symptom is loss of short term memory. The problem is, everyone occasionally forgets things. Some memory loss is not unusual for all of us, such as forgetting names of people, restaurants, cars, etc.

Your doctor can do a simple mental test to help decide if your memory loss is due to early Alzheimer’s disease. Then a specialist can do more complex tests. Sometimes there is no clear answer, and you or the loved one will just need to wait and see what develops.

In many cases, we can understand the cause of a disease and the way that it develops, which is the pathophysiology of the disease. For instance, we know that sun exposure over many years causes damage to skin cells, which causes skin cancer. This kind of information is not available for Alzheimer’s disease. 

For years, it has been noted that Alzheimer’s patients had material in their brain called amyloid plaques. Although we did not know how the plaques developed, it was speculated that they were the cause of the disease. Now a drug has been developed for people with mild Alzheimer’s disease to prevent amyloid plaques. This drug has been tested on humans, and although fewer plaques developed in persons given the medication, there was no change in the onset of dementia. 

In the last few years, new information about risk factors has come forward. As a result of large, long-term studies scientists have found that risk factors for Alzheimer’s and for heart attacks are very similar. These factors include high cholesterol, high blood sugar, and high blood pressure. Smoking is a very strong risk factor for Alzheimer’s and obesity may actually not be a risk. Confusing as this might be, it suggests that behavioral factors to prevent heart attacks will help prevent Alzheimer’s disease.

Another bit of recent information is that fewer new cases of Alzheimer’s disease are occurring than occurred in the past 20 or 30 years. Statistics are sometimes hard to understand, but experts can show that there are fewer patients getting the disease and those who do, get it at an older age.

It will be some time before we see a dramatic effect of this decline, since Alzheimer’s patients usually survive for many years, in nursing homes. Given the fact that there is also a decline in heart attacks and strokes, experts have suggested that as we gradually improve our general health, all three of these diseases will become less common.

At this time, there is no medical treatment to halt dementia and bring back someone’s intellectual functioning. That is very sad, if your family member is disabled and unable to communicate with you. Perhaps eventually we will develop a medication or some other treatment to help people who have Alzheimer’s disease improve. 

In the meantime, all of the guidance for maintaining good health seems to apply to preventing Alzheimer’s disease. You should keep regular appointments with your doctor. Discuss your blood pressure, cholesterol, and blood sugar levels. Strive to bring them down into the normal range. Stop smoking. Get lots of exercise, aiming for a minimum of a 20 minute walk every day. Take classes. Watch less television. Read the newspaper every day and get a good night’s sleep every night.

As you begin to make these changes, you will feel the benefits of being healthier. And your chances of developing devastating illness will decrease.