VA North Texas Health Care System
Know the Facts about Alzheimer’s Disease
Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer's disease, symptoms first appear after age 60. Estimates vary, but experts suggest that as many as 5.1 million Americans may have it - the most common cause of dementia among older people.
Dementia is the loss of cognitive functioning—thinking, remembering and reasoning—and behavioral abilities, to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage when it is just beginning to affect a person's functioning, to the most severe stage when the person must depend completely on others for basic activities of daily living.
There are two types of Alzheimer's disease, including early onset where symptoms appear before age 60. This type is much less common but tends to get worse quickly. Late onset is the most common type, occurring in people age 60 and older.
Early symptoms of Alzheimer’s can include:
- Difficulty performing tasks that take some thought, but used to come easily. Examples include balancing a checkbook, playing complex games (such as bridge) and learning new information or routines.
- Getting lost on familiar routes.
- Language problems, such as trouble finding the name of familiar objects.
- Losing interest in things previously enjoyed, flat mood.
- Misplacing items.
- Personality changes and loss of social skills.
Scientists don’t yet fully understand what causes Alzheimer's, but it has become increasingly clear that it develops because of a complex series of events that take place in the brain over a long period of time. It is likely that the causes include some mix of genetic, environmental and lifestyle factors. Because people differ in their genetic make-up and lifestyle, the importance of any one of these factors in increasing or decreasing the risk may differ from person to person.
Dr. Kevin Gray, neuro-psychiatrist at Dallas VA Medical Center, cites age as a prominent risk factor for developing Alzheimer's disease. His older patients often ask if there is any correlation between Alzheimer's and injuries they may have sustained in the military. According to a study performed in 2009 at San Francisco VA Medical Center, Veterans with post traumatic stress disorder (PTSD) are 77% more likely to develop Alzheimer's disease.
More recently, at the 2011 Alzheimer's Association International Conference in Paris, France, this same VA group, after studying more than 280,000 older Veterans, concluded that Veterans with traumatic brain injury (TBI) are twice as likely to develop the disease. Even after controlling for factors such as age, medical history and cardiovascular health, the authors found that a TBI diagnosis still doubled the risk of dementia. Of course, studies of large groups can show these important associations but cannot predict what will happen to any specific person. So someone can "do everything right" and still have serious health problems or seemingly "do everything wrong" and live to be 100.
Dr. Gray said, "We serve a unique group of patients, and it is important for all of us to be aware of these emerging risks as our Veterans age."
Although we still don't know how the Alzheimer's process begins, it seems likely that damage to the brain starts a decade or more before problems become evident. During the preclinical stage, people are free of symptoms but destructive changes are taking place in the brain. Abnormal deposits of protein form plaques throughout the brain, and once-healthy neurons begin to work less efficiently. Over time, neurons lose their ability to function and communicate with each other and eventually they die, leaving only tangles.
There is no proven way to prevent Alzheimer's, but there are some practices that may be worth incorporating into your daily routine, particularly if you have a family history of dementia.
Some key ingredients of a brain-healthy lifestyle include regular exercise, healthy diet, mental stimulation, adequate sleep, stress management and maintaining an active social life. Clinical trials and early testing of a vaccine against Alzheimer's disease are underway. However, it could still be many years before there are any proven "cures" for this heartbreaking illness.
If you are experiencing memory loss or any of the early symptoms of Alzheimer's disease listed above, contact your primary care provider to learn more.