When you hear someone talking about dementia, you may instantly think of Alzheimer’s disease. That’s not surprising as it is the most common cause of dementia in the UK. In fact there are over 520,000 people with Alzheimer’s in the UK alone.
Related: What is dementia?
We don’t yet know exactly what causes Alzheimer’s disease, but we do know some factors that can increase your chances of developing it:
- getting older – the most important risk factor for Alzheimer’s and other forms of dementia. It is very unusual to develop Alzheimer’s under the age of 65
- having a family history of Alzheimer’s – the risk of developing this disease is higher if a close relative has the disease
- having had severe a head injury or whiplash
- having an increased risk of cardiovascular disease
- slightly increased risk if you are a woman - 67% in women, 44% in men
- smoking increases your risk of developing dementia
- drinking over the recommended level of alcohol increases your risk, however, drinking moderate amounts of alcohol may help protect your brain against dementia
What happens when you have Alzheimer’s disease?
This condition has a physical effect on the brain. If you have Alzheimer’s disease, your brain shrinks, and the amount of nerve fibres in your brain slowly decline. Brain chemicals, known as neurotransmitters, also reduce in number.
Clusters of protein fragments, known as plaques, develop between the nerve cells. Tangles – twisted strands of protein – develop inside dying cells.
The result of these changes is that we lose connections in the brain. As the brain becomes more damaged through this process, Alzheimer’s disease becomes worse.
Symptoms and signs of Alzheimer’s disease
You’re unlikely to notice much difference in the very early stages of Alzheimer’s disease, as the symptoms develop gradually. The first symptoms most people have are memory lapses. (However, new research suggests that people aged under 65, may be more likely to have other symptoms first. These may include difficulties with language and problem-solving.)
In the early stages someone with Alzheimer’s may not remember recent trips out, the names of items they see often, and the names of people they know. They may ask the same question repeatedly, and get lost in a place they know well.
As time goes on, and the disease has an increasing effect, their memory loss will become worse, and they will find it harder to make good decisions, or any decision at all. This will make day-to-day living steadily more difficult.
As Alzheimer’s disease progresses, the existing memory problems will grow worse, so the person may have trouble remembering the names of those close to them, and may have difficulty recognising family members and friends. Other symptoms will appear. These are likely to include:
- problems with concentration and planning – for instance, organising tasks that have to be done in a certain order, like cooking a meal.
- trouble judging distances, or seeing items in three dimensions – walking up or down the stairs, and parking a car (if they are still driving) will become more difficult.
- difficulty following a conversation, or taking part in a conversation without saying the same thing over and over again.
- not knowing where they are, or where they should go, which means that they can easily become lost
- increased difficulty in finding the right words to express what they want to say
Other symptoms that can appear include:
- obsessive and repetitive behaviour
- sudden mood swings
- becoming anxious, confused, depressed and frustrated
Poor eyesight can also become a problem, as can disturbed sleep.
The symptoms can vary from person to person – different people can have slightly different symptoms, or the same symptoms, but to different degrees.
By the time they are having these symptoms, people with Alzheimer’s disease are unlikely to be coping with normal daily life, and will need help to look after themselves. This can even include washing, getting dressed, and feeding themselves.
Unfortunately, in the later stages of Alzheimer’s disease the symptoms of the disease become much worse for the person who has the condition. Their memory, ability to communicate and to know where they are will continue to decline.
Your relative or friend with Alzheimer’s disease may have increasingly bad hallucinations, and delusions. When this happens they can be convinced that something has happened, or someone has said something, when they haven’t.
People with later stage Alzheimer’s can become very agitated and may become quite aggressive. Their sleeping pattern can also become disturbed. This can be very hard for the person with Alzheimer’s, and for those close to them. By the time their Alzheimer’s has become this severe, most people are likely to need a lot of help.
Mixed dementia, where you have both vascular dementia and Alzheimer’s disease, affects at least 10 percent of people with dementia. The symptoms you have can be like Alzheimer’s, or like vascular dementia. However, they may include elements of both conditions.
Related: Find out about vascular dementia
Treatment for Alzheimer’s disease
At the moment there is no treatment that will cure Alzheimer’s disease. There are some medicines that can help to slow the condition down in some people, and there is medication that can reduce some of the symptoms on a temporary basis.
When you or your relative or friend has been diagnosed with Alzheimer’s disease, your GP, specialist Alzheimer’s team, and psychiatrist, and members of the local social care services, will develop a care plan.
This will cover the health needs of the person with Alzheimer’s, and other areas where they need help.
Someone may be concerned about their ability to cope, or feel they haven’t had their care plan explained to them. If this is the case ask the person’s GP and their specialist medical team to go through it with them and you, if you are their carer.
The GP may also be able to give information about the help available locally through the NHS and social services. These are likely to vary from area to area, so you need to find out what is available.
Some services may be provided by the NHS, or through the local authority social services.
Having regular sight tests is important, as having the right glasses could help someone with dementia feel less confused. People with Alzheimer’s who are over 60 qualify for free NHS eye tests. Some people who are under 60 and have dementia can also have free eye tests.
Hearing tests can also help. Anyone who has trouble hearing can feel left out, and isolated. Hearing tests are free through the NHS.
Foot care is also important as it helps us all stay mobile. Ask your GP about having access to podiatry through the NHS.
The Alzheimer’s Society provides some local services, as do Age UK. You can call the Alzheimer’s Society’s National Dementia Helpline on 0300 222 11 22. You could also look online for local services by going to www.nhs.uk .
The full range of help available locally will vary, but may include:
- Group cognitive stimulation programmes that may help to slow down the decline of mental abilities, and help Alzheimer’s sufferers cope with day-to-day tasks
- Cognitive behavioural therapy sessions for people with Alzheimer’s disease, who are struggling with anxiety or depression (this may include carers too)
- Aromatherapy and/or massage therapy, to help with relaxation
- Music and dance therapy
- Reminiscence therapy
- Exercise – such as walking, gardening, dancing and sport – can help people with dementia by increasing their strength, flexibility and balance, and reducing stress. Some people may only be able to exercise sitting down, but these can still build muscle strength and improve balance.