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Saturday, 31 May 2025

Alzheimer's Disease: Symptoms, Causes and Care

 


*Key Points -

- Alzheimer's disease is a common brain disorder causing memory loss and thinking problems, mostly in older adults.

- Research suggests it involves brain changes like amyloid plaques and tau tangles, with age as a key risk factor.

- It seems likely that genetics and lifestyle, such as family history and heart health, also play a role.

- Treatments can help manage symptoms, with recent advances like donanemab and lecanemab slowing early decline.

- Support resources, like the Alzheimer's Association, are available for patients and families.

 

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### Overview

**What is Alzheimer's Disease?** 

Alzheimer's is a progressive brain disorder that slowly impairs memory, thinking, and behavior, mainly affecting those over 65. It's the leading cause of dementia, impacting daily life as it worsens.

 

**Symptoms and Stages** 

It starts with mild memory issues, like forgetting recent conversations, and can progress to severe stages where individuals lose the ability to communicate or care for themselves. Symptoms include confusion, language problems, and mood changes.

 

**Causes and Risk Factors** 

The evidence leans toward brain changes, such as amyloid plaques and tau tangles, causing neuron damage. Age is the biggest risk, but genetics (like the APOE-e4 gene) and lifestyle factors, such as heart health and smoking, may contribute.

 

**Treatments and Recent Advances** 

While there's no cure, medications like donanemab and lecanemab can slow early cognitive decline by targeting amyloid. Other treatments manage symptoms, and research is exploring new therapies, including preventive pills.

 

**Support and Resources** 

Organizations like the Alzheimer's Association offer helplines, online tools like ALZNavigator™, and support groups.

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### Detailed Survey Note on Alzheimer's Disease

 

This note provides a comprehensive overview of Alzheimer's disease, covering its definition, symptoms, causes, treatments, recent developments, and resources, based on authoritative sources and current research as of May 31, 2025. It aims to inform and support those affected, reflecting the latest understanding and advancements.

 

#### Definition and Prevalence

Alzheimer's disease is a neurodegenerative disorder that progressively destroys memory and thinking skills, eventually impacting the simplest tasks. It is the most common cause of dementia, accounting for 60-80% of cases. In the United States, 6.9 million people aged 65 and older have Alzheimer's, with over 70% being 75 and older. Globally, of over 55 million people with dementia, 60% to 70% have Alzheimer's, highlighting its significant public health impact.

 

The disease is named after Dr. Alois Alzheimer, who in 1906 identified abnormal brain changes, including amyloid plaques and tau tangles, in a patient with memory loss and behavioral issues. These changes are now understood to disrupt neuron communication and lead to cell death, beginning years before symptoms appear.

 

#### Symptoms and Stages

Alzheimer's progresses through mild, moderate, and severe stages, each with distinct symptoms:

 

- **Early Symptoms (Mild Stage):** Individuals may struggle with remembering recent information, such as conversations or events, and face challenges with planning or problem-solving, like managing finances. They might experience mild confusion about time or place and mood changes, such as increased anxiety or apathy.

- **Middle Symptoms (Moderate Stage):** Memory loss worsens, particularly for recent events, and confusion increases, even in familiar settings. Patients may have difficulty recognizing family and friends, struggle with language (e.g., finding words), and exhibit behavioral changes like impulsiveness or agitation.

- **Late Symptoms (Severe Stage):** Severe memory loss includes forgetting personal history, with a loss of communication ability and dependence on others for basic activities like eating and dressing. Physical decline, such as difficulty walking or swallowing, is common, leading to significant challenges in daily life.

 

Memory issues alone do not confirm Alzheimer's, as other conditions can mimic these symptoms, necessitating a medical evaluation for diagnosis.

 

#### Causes and Risk Factors

The exact cause of Alzheimer's remains poorly understood, but research suggests a combination of genetic, environmental, and lifestyle factors. Key aspects include:

 

- **Brain Changes:** The disease is characterized by amyloid plaques (clumps of protein) and tau tangles (twisted fibers) that impair brain function. Neuron loss and reduced levels of neurotransmitters like acetylcholine are also involved, leading to cognitive decline.

- **Genetic Factors:** Early-onset Alzheimer's, rare and affecting those in their 30s to mid-60s, is linked to specific genetic mutations. For late-onset Alzheimer's, the APOE-e4 gene is a significant risk factor, though not a definitive cause, indicating a complex genetic influence.

- **Risk Factors:** Age is the primary risk, with prevalence doubling every five years after 65. Other factors include family history, cardiovascular issues (e.g., high blood pressure), diabetes, head injuries, and lifestyle choices like smoking or physical inactivity. These factors suggest a multifaceted interplay, with ongoing research exploring their roles.

 

#### Treatments and Management

There is currently no cure for Alzheimer's, but treatments can alleviate symptoms and, in some cases, slow progression:

 

- **Medications:** 

  - **Disease-Modifying Treatments:** Recent approvals include donanemab (Kisunla™) and lecanemab (Leqembi®), which target amyloid plaques to reduce cognitive decline in early Alzheimer's. These are not cures but can delay progression.

  - **Symptom Management:** Cholinesterase inhibitors (e.g., donepezil) and memantine help improve memory and cognition temporarily. Medications for mood or behavior, such as antidepressants, may address agitation or depression.

- **Non-Pharmacological Approaches:** Cognitive therapy, exercise, and social activities can maintain mental function and well-being. Supportive care, including occupational therapy or home modifications, assists with daily living, enhancing quality of life.

- **Emerging Research:** Clinical trials are investigating anti-tau therapies, anti-inflammatory drugs, and lifestyle interventions to reduce risk or slow progression. For example, recent studies show anti-amyloid drugs can reduce cerebral plaque burden, and focused ultrasound trials demonstrate safety and potential benefits.

 

#### Recent Developments in Treatment (2025)

As of May 31, 2025, significant advancements have been made, reflecting a "new era" in Alzheimer's treatment:

 

- **Approved Drugs:** Donanemab and lecanemab have been approved, with evidence showing they slow cognitive decline in early stages by targeting amyloid. The FDA's full approval of donanemab (Kisunla) in early 2025 marks progress in anti-amyloid immunotherapy.

- **Preventive Measures:** An international clinical trial found an anti-amyloid drug can delay cognitive decline if given years before symptoms, suggesting a shift toward prevention.

- **New Therapies:** Research from Case Western Reserve University indicates a potential new drug for Alzheimer's and other neurodegenerative conditions, expanding treatment options.

- **Focused Ultrasound:** A clinical trial published in January 2025 showed repeated, extensive focused ultrasound treatments are safe and may offer clinical benefits, opening new avenues for non-invasive interventions.

- **Future Treatments:** Experts suggest pills to prevent or blunt Alzheimer's effects are on the horizon, with ongoing research into oral medications and other innovative approaches.

 

These developments highlight a growing focus on early intervention and disease modification, offering hope for improved outcomes.

 

#### Conclusion

Alzheimer's disease presents significant challenges, but advancements in treatment and robust support systems offer hope. Early diagnosis, access to medications like donanemab and lecanemab, and utilization of resources from organizations like the Alzheimer's Association can improve quality of life. Ongoing research continues to explore new therapies, aiming for prevention and better management, reflecting a dynamic field with promising future directions.

 

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