What is Alzheimer’s disease?

By 2060, the number of people living with Alzheimer’s disease is expected to triple, making it likely that the disease will touch many families over the next few decades. Although there is no cure for the disease, treatments can help slow progression and improve quality of life. Because these treatments are most beneficial when started once early Alzheimer’s disease manifestations arise, it’s important to understand what the condition is and what the warning signs are.

Alzheimer’s disease is a progressive neurodegenerative disease that affects the brain and language, as well as memory and thinking abilities. The condition worsens with time, impairing one’s ability to speak, interact and carry out day-to-day activities independently. Most often, Alzheimer’s develops in people over the age of 65, but it can affect younger people as well if there is a genetic etiology. When it does, healthcare providers refer to the condition as early-onset Alzheimer’s.

Although scientists are still working to learn more about why people develop Alzheimer’s, a number of factors may contribute to the development of the condition. However, it is thought that a buildup of protein in the brain is likely the cause. As levels of these proteins rise, cells in the brain begin to die. In addition, the protein build-up may interfere with how remaining brain cells communicate with one another.

More research is necessary to determine why some people develop Alzheimer’s while others don’t. However, scientists have uncovered a link between abnormalities in the apolipoprotein E gene and Alzheimer’s. Individuals with this gene have an increased risk of Alzheimer’s, but it doesn’t guarantee they’ll develop the condition. Other risk factors for Alzheimer’s disease include:

• Depression
  
• Diabetes
• Trisomy 21 (Down’s syndrome)
• Heart disease
• High cholesterol
• Hypertension
• Obesity
• Smoking
• Traumatic brain injury

Signs and symptoms of Alzheimer’s disease can vary greatly from person to person, depending on the area of the brain affected, but may include:

• Memory difficulties that frequently interfere with daily activities
  
• Struggling with complex tasks, such as paying bills or handling money
• Inability to retrace your steps to find something you misplaced
• Poor judgment that interferes with decision-making
• Needing more time than usual to complete simple tasks
• Wandering or getting lost
• Changes in personality and mood
• Anxiety
• Aggression

Signs of Alzheimer’s typically start in people over the age of 65, but early-onset Alzheimer’s symptoms may begin in younger people.

Alzheimer’s disease is progressive and defined by three stages:

1. Early (Mild): During the early stage of Alzheimer’s, one begins showing symptoms of the disease. Memory problems are often the first warning signs.
   
2. Middle (Moderate): By the middle stage, Alzheimer's impacts more of the brain. At this point, a person with the disease may experience periods of confusion and struggle to recognize family members and familiar places.
3. Late (Severe): Once Alzheimer’s advances to the late stage, one may have difficulty communicating with others. People with late-stage Alzheimer’s usually need assistance performing most, if not all, daily living activities, such as bathing and toileting.

At this time, there is no cure for Alzheimer’s disease. Treatment for the condition typically involves attempting to slow the progression, addressing troubling symptoms and taking steps to help the person with the disease be as safe and comfortable as possible.

The FDA has approved three classes of drugs for the treatment of Alzheimer’s disease:

• Cholinesterase inhibitors: Used to control mild to moderate symptoms of Alzheimer’s, these drugs interfere with the actions of a substance that breaks down acetylcholine. This brain chemical helps cells communicate with one another. Cholinesterase inhibitor drugs include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon).
  
• NMDA antagonists: The memantine (Namenda) helps keep brain cells healthier and may allow people with moderate to severe Alzheimer’s to retain the ability to perform daily living activities more independently.
• Amyloid beta-directed antibodies: The FDA recently approved lecanemab (Leqembi) and donanemab-azbt (Kisunla) as infusion medications for the treatment of mild Alzheimer’s disease. These medications may help prevent protein buildup in the brain.

In some cases, healthcare providers may prescribe additional medications to treat the mood changes often seen in Alzheimer’s, such as:

• Antidepressants for depression, anxiety and aggression
  
• Anti-anxiety drugs for anxiety
• Anticonvulsant drugs for aggression
• Antipsychotic drugs for hallucinations, paranoia and agitation

While there is no surefire method for preventing Alzheimer’s, you may be able to lower your risk of developing the disease by making healthy lifestyle changes, such as:

• Exercising regularly
  
• Eating a healthy diet
• Reaching and maintaining a healthy weight
• Staying mentally active by learning new things
• Drinking alcohol only in moderation
• Quitting smoking

Your healthcare provider can give you personalized advice on how to minimize your risk for Alzheimer’s.

Updated August 2024.