What is it?
Alzheimer's (alls-hi-mers) disease (AD) is a long term brain disease. With AD, brain cells die and do not come back. There are also fewer amounts of the normal chemicals in the brain. These chemicals carry messages back and forth between the nerve cells throughout the body. This causes problems with how you think, behave, and remember things. The disease cannot be stopped or reversed. There is no cure for Alzheimer's disease.
The disease usually starts about 65 to 70 years, but can start earlier. In its later stages, a person may need 24-hour care for feeding, personal care, and bathroom needs. AD usually lasts 2 to 10 years, but it can take 20 years before a person dies from AD.
It is not known what causes AD. The risk of getting AD increases with age but AD is not a normal part of aging. AD is probably not caused by any one factor by itself. People who have one or more of the following factors may have a greater risk of getting AD.
- Environmental factors. Scientists have found metals like aluminum and zinc in the brain tissue of people with AD. They are studying these metals to see if they caused the AD. They are also looking to see if the metals build up in the brain because of the disease.
- Genetic (inherited) factors (something you are born with). Scientists believe that more than half of the people with AD inherited it. A protein called ApoE, which normally carries cholesterol in the blood, may cause AD. Everyone has ApoE, but one type of ApoE seems to protect a person from getting AD. Another type of ApoE seems to make it more likely to get the disease. Scientists are learning more about ApoE and other genetic factors that increase your chance of getting AD. Scientists are also studying how having high cholesterol increases your risk of getting AD. Brain cells affected by AD often have high levels of a protein. This causes plaques (plaks) and tangles in the brain.
- Injuries like a head injury or a heart attack.
- Viruses. Scientists have found changes in the brain tissue of people with AD. They are studying different viruses to see if they cause changes in brain tissue that might cause AD.
- Women seem to get AD more than men.
Signs and Symptoms:
AD is a slow disease and is different for each person. Some people may only have the disease for 5 years while others may have it for 20 years. Early signs may be missed because they look like normal aging signs. The following are the 3 stages of Alzheimer's disease.
- Stage 1 lasts from 1 to 3 years. Memory loss is the most common sign. You may be able to remember what happened years ago, but may not remember things from yesterday. Things that happen seem to be happening for the first time. You may be confused about what month or season it is. You may forget to brush your teeth or comb your hair. You may not remember the names of common things or people. You may feel like you have to make up stories to hide your forgetfulness. Walking may become harder for you. It may be hard to work on your checkbook or to take care of your house. You may find it hard to make decisions that were once easy. You may not be as interested in doing things. You may feel depressed, angry, or confused about the changes you notice.
- Stage 2 lasts up to 10 years. You may have problems choosing what clothes to wear or doing simple jobs. Feeding yourself, brushing your teeth, or shaving may be hard. Taking care of your body may no longer seem important. You may not know familiar people. Things that happen seem to be happening for the first time. You may become loud, violent, and hard to control. Sleeping, pacing, or wandering off may cause problems because you are confused. You may seem anxious, restless, and agitated at night. This is often called "sundowning." It may be hard to find words to say what you mean. Talking in normal sentences may give you problems. Your speech may be hard to understand. You may quickly change topics when you are talking. You may seem depressed or worried. You may be happy at unusual times. You may put things in strange places and not remember where you put them. You may be unable to make choices and decisions. It may be hard to reason or solve problems. Or, you may be unable to plan and follow through with activities. You may find it hard to control your emotions. Sometimes you may act like a child because you cannot control your anger. You may not be able to wait to get what you want. You may get more tired because everything takes more effort and energy. You may think that something is true even though it is not. You may see things that are not actually there. Sometimes you may not be able to control your urine.
- Stage 3 lasts from 8 to 12 years. You will completely lose your memory and speech. Groups of your muscles will stop working, including those used for urinating and having a bowel movement (BM). It will be very hard to walk. Your behavior will change and you may become very angry and out of control. You may be aggressive and destroy things. With time, you will not be able to care for yourself and will need someone to take care of you.
Eating healthy food, exercising, being with and talking to people, and keeping a routine are important. Regular walking can actually improve thinking for patients with AD. Aspirin may lower the risk of AD and heart disease.
There is no cure for AD. The disease cannot be stopped or turned around. Treatment involves trying to keep a good quality of life for as long as possible. Medicine may be used to try to slow the early stages of the disease. It may also be used to treat anxiety, nervousness, sleep problems, or depression.
Aluminum, a metal, may play a part in AD. Do not eat food or use products that have a high amount of aluminum.
Herbs and Supplements:
Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.
- Ginkgo (Ginkgo biloba) is helpful in AD when taken every day. Ginkgo should not be taken with aspirin (or anything else that thins the blood) as it can increase the risk of bleeding problems. When buying, be sure the label on the bottle says the product is a standardized extract containing 24% ginkgoflavonglycosides (ginkgosides) and 6% terpenes.
- Ginseng (Panax ginseng) may improve thinking, but has not been studied in people who have AD.
- Huperzine A (Huperzia serrata) , an extract from club moss, may be helpful.
- 5 - HTP (5-hydroxy tryptophan) has been used, but has not been studied in people who have AD.
- Acetyl L-carnitine may be helpful in AD.
- B vitamins (vitamin B12 which is cyanocobalamin and folic acid) have been used, but have not been studied in people who have AD. If you are already taking a multivitamin or B complex supplement then it is not necessary to take additional B vitamins.
- DMAE (dimethylaminoethanol) has been used, but has not been studied in people who have AD.
- Inositol has been used, but has not been studied in people who have AD.
- Phosphatidylserine may be a little helpful in AD.
- Tyrosine , an amino acid, has been used, but has not been studied in people who have AD.
- Vitamin E may slow AD.
Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.
Talk to your caregiver if:
- You would like medicine to treat AD.
- Your symptoms have not gone away or improved by these self-help measures.
- You have questions about what you have read in this document.
SEEK CARE IMMEDIATELY IF :
- You are so depressed you feel you can not cope with your illness.
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment
1. Barak Y, Levine J, Glasman A et al: Inositol treatment of Alzheimer's disease: a double blind, cross-over placebo controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 1996; 20(4):729-735.
2. Bhattacharya SK, Kumar A & Ghosal S: Effects of glycowithanolides from Withania somnifera on an animal model of Alzheimer's disease and perturbed central cholinergic markers of cognition in rats. Phytother Res 1995; 9:110-113.
3. Brooks JO III, Yesavage JA, Carta A et al: Acetyl L-carnitine slows decline in younger patients with Alzheimer's disease: a reanalysis of a double-blind, placebo-controlled study using the trilinear approach. Int Psychogeriatr 1998; 10(2):193-203.
4. Bush AI, Pettingell WH, Multhaup G et al: Rapid induction of alzheimer A8 amyloid formation by zinc. Science 1994; 265:1464-1465.
5. Cherny RA, Legg JT, McLean CA et al: Aqueous dissolution of Alzheimer's disease Abeta amyloid deposits by biometal depletion. J Biol Chem 1999; 274(33):23223-23228.
6. Colodny L & Hoffman RL: Inositol-clinical applications for exogenous use. Altern Med Rev 1998; 3(6):432-447.
7. Crook T: Effects of phosphatidylserine in Alzheimer's disease. Psychopharmacol Bull 1992; 28:61-66.
8. Cuajungco MP & Lees GJ: Zinc and Alzheimer's disease: is there a direct link? Brain Res Brain Res Rev 1997; 23(3):219-236.
9. Cuajungco MP & Lees GJ: Zinc metabolism in the brain: relevance to human neurodegenerative disorders. Neurobiol Dis 1997; 4(3-4):137-169.
10. Cucinotta D: Multicenter clinical placebo-controlled study with acetyl-L-carnitine (LAC) in the treatment of mildly demented elderly patients. Drug Development Res 1988; 14:213-216.
11. D'Angelo L & Grimaldi R: A double-blind, placebo-controlled clinical study of a standardized ginseng extract on psychomotor performance in healthy volunteers. J Ethnopharmacol 1986; 16:15-22.
12. de la Torre JC: Cerebromicrovascular pathology in Alzheimer's disease compared to normal aging. Gerontology 1997; 43(1-2):26-43.
13. Dhuley JN: Effect of ashwagandha on lipid peroxidation in stress-induced animals.
J Ethnopharmacol 1998; 60(2):173-178.
14. Exley C: Does antiperspirant use increase the risk of aluminium-related disease, including Alzheimer's disease? Mol Med Today 1998; 4(3):107-109.
15. Ferris SH, Sathananthan G, Gershon S et al: Senile dementia. Treatment with Deanol. J Am Ger Soc 1977; 25:241-244.
16. Fisman M, Mersky H & Helmes E: Double-blind trial of 2-dimethylaminoethanol in Alzheimer's disease. Am J Psych 1981; 138:970-972.
17. Flood JF, Smith GE & Cherkin A: Memory retention: potentiation of cholinergic drug combinations in mice. Neurobiol Aging 1983; 4(1):37-43.
18. Gindin J: The effect of plant phosphatidylserine on age-associated memory impairment and mood in the functioning elderly. Geriatric Institute for Education and Research and Department of Geriatrics, Kaplan Hospital, Rehovot, Israel, 1995.
19. Heiss WD, Kessler J, Mielke R et al: Long-term effects of phosphatidylserine, pyritinol, and cognitive training in Alzheimer's disease. A neuropsychological, EEG, and PET investigation. Dementia 1994; 5(2):88-98.
20. Hofferberth B: The efficacy of EGb 761 in patients with senile dementia of the Alzheimer type: A double-blind, placebo-controlled study on different levels of investigation. Human Psychopharmacol 1994; 9:215-222.
21. Holford NH & Peace K: The effect of tacrine and lecithin in Alzheimer's disease. A population pharmacodynamic analysis of five clinical trials. Eur J Clin Pharmacol 1994; 47(1):17-23.
22. Kanowski S, Herrmann WM, Stephan K et al: Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatr 1996; 29:47-56.
23. Khalsa DS: Integrated medicine and the prevention and reversal of memory loss. Altern Ther Health Med 1998; 4(6):38-43.
24. Le Bars P, Velasco F, Ferguson J et al: Influence of the severity of cognitive impairment on the effect of the Ginkgo biloba extract Egb 761 in Alzheimer's disease. Neuropsychobiology 2002; 45:19-26.
25. Le Bars PL, Katz MM, Berman N et al: A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA 1997; 278(16):1327-1332.
26. Leibson CL, Rocca WA, Hanson VA et al: Risk of dementia among persons with diabetes mellitus: a population-based cohort study. Am J Epidemiol 1997; 145(4):301-308.
27. Lione A: The prophylactic reduction of aluminum intake. Food Chem Toxicol 1983; 21(1):103-109.
28. Lovell MA, Xie C & Markesbery WR: Protection against amyloid beta peptide toxicity by zinc. Brain Res 1999; 823(1-2):88-95.
29. Meyer JS, Welch KMA, Deshmuckh VD et al: Neurotransmitter precursor amino acids in the treatment of multi-infarct dementia and Alzheimer's disease. J Am Ger Soc 1977; 7:289-298.
30. Miller JW: Homocysteine and Alzheimer's disease. Nutr Rev 1999; 57(4):126-129.
31. Nippoldt TB & Nair KS: Is there a case for DHEA replacement? Baillieres Clin Endocrinol Metab 1998; 12(3):507-520.
32. Notkola IL, Sulkava R, Pekkanen J et al: Serum total cholesterol, apolipoprotein E epsilon 4 allele, and Alzheimer's disease. Neuroepidemiology 1998; 17(1):14-20.
33. Panda S & Kar A: Evidence for free radical scavenging activity of Ashwagandha root powder in mice. Indian J Physiol Pharmacol 1997; 41(4):424-426.
34. Pasinetti GM: Cyclooxygenase and inflammation in Alzheimer's disease: experimental approaches and clinical interventions. J Neurosci Res 1998; 54(1):1-6.
35. Pettegrew JW, Klunk WE, Panchalingam K et al: Clinical and neurochemical effects of acetyl-L-carnitine in Alzheimer's disease. Neurobio Aging 1995; 16:1-4.
36. Podhaisky HP, Abate A, Polte T et al: Aspirin protects endothelial cells from oxidative stress-possible synergism with vitamin E. FEBS Lett 1997; 417(3):349-351.
37. Priest ND: Satellite symposium on Alzheimer's disease and dietary aluminium. Proc Nutr Soc 1993; 52:231-240.
38. Sano M, Ernesto C, Thomas RG et al: A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease: the Alzheimer's Disease Cooperative Study. N Engl J Med 1997; 336(17):1216-1222.
39. Satoh T, Sakurai I, Miyagi K et al: Walking exercise and improved neuropsychological functioning in elderly patients with cardiac disease. J Intern Med 1995; 238(5):423-428.
40. Schliebs R, Liebmann A, Bhattacharya SK et al: Systemic administration of defined extracts from Withania somnifera (Indian Ginseng) and Shilajit differentially affects cholinergic but not glutamatergic and GABAergic markers in rat brain. Neurochem Int 1997; 30(2):181-190.
41. Shimamura K, Takatsuka N, Inaba R et al: Environmental factors possibly associated with onset of senile dementia. Nippon Koshu Eisei Zasshi 1998; 45(3):203-212.
42. Somova LI, Missankov A & Khan MS: Chronic aluminum intoxication in rats: dose-dependent morphological changes. Methods Find Exp Clin Pharmacol 1997; 19(9):599-604.
43. Sorensen H & Sonne J: A double-masked study of the effects of ginseng on cognitive functions. Curr Ther Res 1996; 57:959-968.
44. Sparks DL: Coronary artery disease, hypertension, ApoE, and cholesterol: a link to Alzheimer's disease? Ann NY Acad Sci 1997; 826:128-146.
45. Stefanov AV, Pozharov VP, Miniailenko TD et al: Biological effect of liposomes in hypoxic conditions of various etiologies. Vestn Akad Med Nauk USSR 1990; (6):47-51.
46. Stewart R & Liolitsa D: Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med 1999; 16(2):93-112
47. Stewart WF, Kawas C, Corrada M et al: Risk of Alzheimer's disease and duration of NSAID use. Neurology 1997; 48(3):626-632.
48. Thal LJ, Carta A, Clarke WR et al: A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's disease. Neurology 1996; 47(3):705-711.
49. Veld BA, Launer LJ, Hoes AW et al: NSAIDs and incident Alzheimer's disease. The Rotterdam Study. Neurobiol Aging 1998; 19(6):607-611.
50. Xu SS, Gao ZX, Weng Z et al: Efficacy of tablet huperzine-A on memory, cognition, and behavior in Alzheimer's disease. Acta Pharmacol Sinica 1995; 16(5):391-395.
Last Updated: 1/4/2011