Alzheimer’s Disease

As we age, we become more susceptible to health complications. One chronic disease that is especially pertinent to the aging population is Alzheimer’s disease. According to the Alzheimer’s Association, there are 5.8 million Americans living with Alzheimer’s disease or other types of dementias. Among them, 5.6 million are older adults who are age 65 or older. This number translates to one in ten older adults diagnosed with some type of dementia (Alzheimer’s Association, 2019). Every 65 seconds, someone in the United States develops the disease (Alzheimer’s Association, 2019).

Japanese Americans and Japanese communities are not excluded from this population. However, the rate of those in Japan developing Alzheimer’s disease has been steadily increasing due to the increase in Japan’s elderly population as well as the increase in those with diabetes and high cholesterol (Drug Development Technology, 2017). With the changing age demographics and lifestyles, knowledge of what the disease is and how our lifestyles can contribute to it are key to protecting our loved ones and ourselves.

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What is Alzheimer’s disease?

The National Institute on Aging defines Alzheimer’s disease as “an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out simplest tasks.” Individuals with Alzheimer’s disease have lost neurons within their brain, which affects the brain’s ability to maintain its healthy brain functions (Alzheimer’s Disease International, 2018). Alzheimer’s disease is the most common type of dementia, affecting 60-80% of dementia cases (Alzheimer’s Association, 2019).

It is important to note that Alzheimer’s disease is not a natural progression of aging. However, risk factors such as older age, having a family history of Alzheimer’s, and carrying a certain gene can contribute towards the late-onset Alzheimer’s disease (Alzheimer’s Association, 2019). While there is currently no cure for the disease, there are options available to help treat its symptoms.

Is it memory loss from normal aging or Alzheimer’s disease/dementia?

What’s the difference?
Typical age-related changes Signs of Alzheimer’s disease/dementia
Making a bad decision once in a while Regularly showing poor judgement and decision-making
Missing a monthly payment occasionally Inability to manage a budget or follow a familiar recipe
Forgetting what day it is, then remembering it later Unable to correctly state the day or season
Sometimes forgetting which word to use Difficulty having a conversation
Losing things from time to time Misplacing things and being unable to retrace steps in order to find them on a regular basis

Stages and Symptoms of Alzheimer’s disease

Alzheimer’s disease is a progressive disease, meaning that the person’s cognitive abilities gradually decline. On average, life expectancy after diagnosis is 4-8 years, but depending on other factors, it can be 20 years or more (Alzheimer’s Association, 2019). In general, Alzheimer’s disease has three stages (Note: This is not the exhaustive list of symptoms in each stage.):

  1. Early Stage (Mild): Person may seem healthy but becomes noticeably forgetful to family and friends.
  2. Middle Stage (Moderate): Person becomes more confused and forgetful and will need intensive supervision along with help performing daily activities. They may not be able to recognize family members and friends and/or may be easily irritable.
  3. Late Stage (Severe): Person cannot communicate and is dependent on his/her caregiver for assistance with daily activities. They need help sitting up or walking, and eventually will have difficulty swallowing and controlling their bladder and bowel functions.

 Someone with Alzheimer’s disease or other dementia in the mild stage may experience:

  • Memory loss that affects daily activities, such as repeatedly asking for the same information, forgetting important events or dates, or relying heavily on memory aids or family members
  • Difficulty completing familiar tasks, such as forgetting how to go to an often-frequented restaurant or grocery store, or having trouble balancing a budget
  • Challenges in focusing, planning, and solving problems, such as having trouble following a familiar recipe or a list of instructions
  • Confusion with location and time, such as losing track of dates and seasons and sometimes forgetting where they are and how they got there
  • Vision problems, such as losing depth and color perception or having trouble reading
  • Difficulties in speaking, such as using the wrong word, making up words, or repeating themselves
  • Misplacing items and being unable to retrace steps in order to find them
  • Impaired judgment, such as making irresponsible, unreasonable, or inappropriate decisions that veer from their normal behavior, or dressing improperly for the weather
  • Withdrawing from social activities or favorite pastimes
  • Behavioral changes, such as feeling afraid, confused, fatigued, or overwhelmed which causes them to be anxious or agitated

How is Alzheimer’s disease diagnosed?

Please consult with a healthcare professional if you have concerns about memory loss, thinking skills, or behavioral changes regarding yourself or someone you know.

Individuals tend to be diagnosed when the disease is already in its advanced stages; therefore, early diagnosis is imperative to help your primary healthcare provider prescribe drugs that slow down the progression of Alzheimer’s disease. Medicare enrollees can take advantage of annual checkups through free Annual Wellness Visits which include a look into any cognitive impairments related to memory or thinking (Alzheimer’s Association, 2019).

Healthcare providers are currently developing options to identify Alzheimer’s disease to help with diagnosis. Current methods include brain scans, lumbar punctures, measurements of the retina layer, and memory tests like the Saint Louis University Mental Status Examination (Gould, 2018).

Risk Factors for Alzheimer’s disease

  • Age
    The risk of developing Alzheimer’s disease increases with age. Over 96% of those with the disease are age 65 or older.
  • Genetics
    A common gene linked to Alzheimer’s disease is said to be the APOE gene ε4. We receive APOE genes (ε2, ε3, or ε4) from each of our parents. Depending on the amount of gene ε4 we have, we may be at greater risk of developing the disease. However, certain racial and ethnic groups have shown contrary results in the relation between gene ε4 and Alzheimer’s (Alzheimer’s Association, 2019).
  • Family history
    Those who have a first-degree family member with Alzheimer’s disease are more likely to develop the disease, and the risk increases for those who have more than one first-degree family members with the disease. However, having a first-degree family member with Alzheimer’s does not necessarily mean that an individual will develop the disease (Alzheimer’s Association, 2019).
  • Exercise
    Lack of exercise can increase risk of Alzheimer’s as well. According to a study following 1,740 older adults in Seattle, those who exercised 3 times or more a week had an almost 40% reduced risk of developing Alzheimer’s disease (Larson et al., 2006).
  • Social Isolation
    Individuals who are socially isolated are at increased risk for Alzheimer’s disease.  The lack of social interactions decreases the number of opportunities to stimulate the creation of neurons within the brain (National Academies of Sciences, Engineering, and Medicine, 2017).
  • Head Injury
    Any concussions or hits to the head can raise the risk of cognitive decline and dementia. In fact, the risk of developing Alzheimer’s disease is 2.3 times greater in those with a history of moderate traumatic brain injury (a loss of consciousness or post-traumatic amnesia lasting over 30 minutes but less than 24 hours) and 4.5 times greater for those with a history of severe traumatic brain injury (loss of consciousness or post-traumatic amnesia lasting 24 hours or more) (Alzheimer’s Association, 2019).
  • Diet
    Studies show that 80% of those with Alzheimer’s disease also have cardiovascular diseases. Thus, those with diabetes and hypertension are also prone to developing Alzheimer’s disease (Alzheimer’s Association, 2019).
  • Sleep deprivation
    While we are awake, we accumulate excess waste in the brain which include waste that may increase your risk for Alzheimer’s disease. Sleep is essential for flushing out that waste (Konnikova, 2014).
  • Smoking
    Research conducted by the World Health Organization and Alzheimer’s Disease International state that smokers have a 45% higher risk of developing dementia than non-smokers.

Tips to Reduce Risk of Alzheimer’s disease

Studies show that Alzheimer’s disease begins to develop in the brain 20 years or more before diagnosis (Alzheimer’s Association, 2019). Making lifestyle adjustments can reduce your risk of Alzheimer’s disease by a third (Kametani & Hasegawa, 2018). Here are some tips to help you reduce your risk of Alzheimer’s disease:

  • Exercise at least 3-4 times a week for 30 minutes
    Exercise does not have to mean running a marathon. Whether it is gardening, a brisk walk around your neighborhood, or completing daily chores such as washing the dishes or cleaning the house, find an activity you enjoy that incorporates physical activity. This strengthens the brain’s ability to focus and maintain attention longer, increases long-term memory and the brain’s processing speed, and boosts mood by producing brand new brain cells.
  • Engage your brain in new activities and mentally challenging tasks
    Ways to keep your brain active include learning how to play a new game, taking a community class on a topic you are interested in, or joining a book club to stimulate your brain. When the brain is challenged, new channels of neuron to neuron connections form which keep the brain sharp. The additional support also helps give other pathways for neural transmission when parts of the brain are damaged by Alzheimer’s disease.
  • Maintain social connectedness
    We can lower our risk of developing Alzheimer’s disease by maintaining social connections with others. Attending an event at your local community center, going to a fitness class, and volunteering are all great opportunities for you to interact with people of all backgrounds.
  • Protect your head
    Look around your house to ensure that there are no areas where you could easily trip and fall. This includes curled edges on rugs, loose wires, or slippery floors. Installing lights around the house will help keep your rooms well lit, and as a rule of thumb, abide by general safety practices such as wearing seatbelts while traveling or wearing a helmet on a bicycle to prevent serious head injuries. For more tips on making your home fall proof, please refer to our fact sheet Reducing Risks of Falls at Home.
  • Eat a healthy diet
    Diets that promote consuming leafy greens, whole grains, dairy, nuts, seeds, and fruits—such as the Mediterranean diet—are shown in clinical studies to reduce blood pressure. Healthy dieting includes consumption of dietary fiber, monounsaturated fats, and lean meats in moderation, and avoiding overeating.
  • Sleep at least 7-8 hours
    The National Sleep Foundation recommends older adults ages 65 or older to have at least 7-8 hours of sleep. To improve your quality of sleep, keep your sleep schedule consistent. This means that the time you sleep and wake up should be consistent throughout the week. Try to avoid naps after 3:00 pm, avoid using screen-based devices 2 hours before sleeping, and avoid exercising right before sleeping. If sleep problems still arise, consult a healthcare professional to understand the cause behind your lack of sleep.
  • Cut down or quit smoking
    To decrease a smoking habit, identify internal and external cues such as stress or time frames that are associated with your desire for a cigarette. Once you identify this cue, try substituting your need for a cigarette with an alternative such as exercising or eating a healthy snack.

What are some resources available for someone with Alzheimer’s disease or wanting more information?

Alzheimer’s Association
https://www.alz.org/
Alzheimer’s Association offers information on the latest Alzheimer’s disease research, facts, and support groups in your area.

Alzheimer’s Association Los Angeles
AlzheimersLA.org
Alzheimer’s Los Angeles is increasing the awareness of Alzheimer’s disease and dementia by offering programs, services, support, and information on the disease.
Helpline 844.435.7529
A free 24/7 line offered by Alzheimer’s Los Angeles that provides information, emotional support, resources, and referrals.

LA Found
LAfound.com
Under the L.A. Found initiative, Project Lifesaver provides a free trackable bracelet for those living with the disease. If a loved one with Alzheimer’s disease goes missing, first responders can locate the person if he or she is wearing the bracelet.

 

References

  1. Alzheimer’s Association. (2019). 2019 Alzheimer’s Disease Facts and Figures. Alzheimers Dement. Retrieved from https://www.alz.org/media/Documents/alzheimers-facts-and-figures-2019-r.pdf
  2. Alzheimer’s Disease International. (2018, September). World Alzheimer Report 2018. Retrieved from https://www.alz.co.uk/research/WorldAlzheimerReport2018.pdf
  3. Drug Development Technology. (November, 2017). Japan will have the fastest growing prevalent cases of Alzheimer’s. Retrieved from https://www.drugdevelopment-technology.com/comment/japan-will-fastest-growing-prevalent-cases-alzheimers/
  4. Gould, J. (2018, November). Detecting Early Alzheimer Disease With Noninvasive Imaging Device. First Report Managed Care, 15, 26.
  5. Graves AB, Larson EB, Edland SD, et al. (1996). Prevalence of Dementia and Its Subtypes in the Japanese American Population of King County, Washington State. Retrieved from https://pdfs.semanticscholar.org/764e/039c6b5dc431cd7b9defc45757f74662784d.pdf
  6. Help for Alzheimer’s Families (2018, April). Tips for socializing with Someone Living with Dementia. Retrieved from https://www.helpforalzheimersfamilies.com/community-voices/live-chat-webinars/tips-socializing-someone-dementia/
  7. Kametani F., Hasegawa M. (2018, January). National Center for Biotechnology Information. Reconsideration of Amyloid Hypothesis and Tau Hypothesis in Alzheimer’s Disease. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797629/
  8. Konnikova Maria. (2014, January). Goodnight. Sleep Clean. The New York Times. Retrieved from https://www.nytimes.com/2014/01/12/opinion/sunday/goodnight-sleep-clean.html?_r=0
  9. Larson EB, Wang L, Bowen JD, et al. (2006, January). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16418406
  10. National Academies of Sciences, Engineering, and Medicine. (2017, September). Understanding Pathways to Successful Aging: Behavioral and Social Factors Related to Alzheimer’s Disease: Proceedings of a Workshop—in Brief. Retrieved from https://www.nia.nih.gov/sites/default/files/2017-11/alzheimers-workshop-in-brief.pdf