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Every year, September 21 marks World Alzheimer’s Day, encouraging people to pay closer attention to changes in memory, thinking, and behavior in themselves or their loved ones. Alzheimer’s disease does not present only as forgetfulness. A person may begin asking the same questions repeatedly, get lost in familiar places, struggle with routine tasks they once performed easily, or experience changes in personality and mood.
Today, treatments are becoming available that may improve symptoms, but treatment should begin in the early stages. Recognizing abnormalities early and seeking medical evaluation can help doctors develop a treatment and care plan that is appropriate for each patient.
Causes of Alzheimer’s Disease
Alzheimer’s disease is a brain disorder that gradually affects memory, thinking, language, decision-making, and the ability to carry out daily activities. Symptoms usually develop gradually and become more noticeable as the disease progresses. Alzheimer’s disease is the most common cause of dementia, although not everyone with dementia has Alzheimer’s disease.
The exact cause of Alzheimer’s disease is still not fully understood. However, it is associated with changes in the brain, particularly the accumulation of amyloid-beta proteins and abnormalities in tau proteins, which interfere with the function of nerve cells and gradually lead to deterioration of brain cells. These changes may begin many years before noticeable symptoms appear.
Several factors are also associated with the likelihood of developing the disease, including age, genetics, health conditions, and lifestyle.
Factors That May Increase the Risk of Alzheimer’s Disease
- Age: The risk increases with age, but Alzheimer’s disease is not a normal part of aging that every older adult will experience.
- Genetics and family history: Having a family member with the disease may increase the risk, but it does not mean that a person will definitely develop Alzheimer’s disease.
- Cardiovascular health: High blood pressure, diabetes, abnormal blood lipid levels, obesity, and smoking can affect the blood vessels supplying the brain and may increase the risk of dementia.
- Lifestyle and environment: Physical inactivity, lack of social interaction, excessive alcohol consumption, untreated hearing problems, and long-term exposure to air pollution may also affect brain health.
10 Signs of Alzheimer’s Disease to Watch For
Early symptoms of Alzheimer’s disease can vary from person to person and are not limited to memory problems. The disease can also affect thinking, communication, decision-making, and behavior. These changes usually develop gradually and become more noticeable over time.
The followings are the signs of Alzheimer’s disease:
- Forgetting conversations or appointments and frequently asking the same questions.
- Finding familiar routines increasingly difficult, such as cooking, using equipment, or completing tasks that involve familiar steps.
- Becoming confused about dates, time, or places, including getting lost in familiar locations.
- Having difficulty planning and solving problems, such as managing expenses, planning tasks, or completing activities in the correct sequence.
- Having communication difficulties, such as struggling to find words, using incorrect words, or being unable to follow a conversation continuously.
- Frequently misplacing items and being unable to retrace steps to remember where they were placed.
- Showing poorer judgment than before, particularly regarding finances, personal care, or safety.
- Withdrawing from social activities or hobbies because these activities have become more difficult to perform.
- Experiencing changes in mood and personality, such as irritability, anxiety, suspicion, or other behavioral changes.
- Having difficulty with vision and spatial judgment, such as difficulty judging distance or depth, which may make walking, using stairs, or driving more difficult.
An important factor when identifying early symptoms is whether changes in memory, thinking, or behavior persist and begin to interfere with daily life, such as work, traveling, managing finances, or self-care. If these changes occur, a medical evaluation is recommended.
Forgetfulness or reduced thinking ability may also result from other causes, including medication side effects, sleep problems, depression, thyroid disorders, or certain vitamin deficiencies. Appropriate medical evaluation can therefore help identify the cause and determine the most suitable care for each patient.
What Is the Difference Between Alzheimer’s Disease and Dementia?
Many people assume that dementia and Alzheimer’s disease are the same condition, but they have different meanings.
Dementia is a general term describing impaired brain function that affects memory, thinking, communication, or the ability to perform daily activities. Alzheimer’s disease is one of the diseases that can cause dementia and is its most common cause.
Dementia can also result from other conditions, including stroke, Lewy body dementia, and frontotemporal dementia. Therefore, when memory or thinking abilities change from normal, medical evaluation is important to determine the underlying cause and establish an appropriate care plan.
What Are the Stages of Alzheimer’s Disease?
Alzheimer’s disease can be divided into three main stages: early, moderate, and severe. Each stage affects a person’s ability to live independently and care for themselves differently. The rate of disease progression can also vary considerably between individuals.
Early Stage
Patients can generally continue living independently and caring for themselves. However, certain activities may become more difficult, particularly tasks involving planning or multiple steps. Family members or people close to the patient may begin noticing changes even though the patient remains capable of performing most daily activities independently.
Moderate Stage
Patients begin to require more assistance with daily activities, such as preparing meals, taking medication, managing finances, or getting dressed. Changes in sleep, mood, and behavior may also occur. Family members therefore play an increasingly important role in providing care and maintaining the patient’s safety.
Severe Stage
Patients become dependent on caregivers for most daily activities. Their ability to communicate and move may decline, and difficulties with eating and swallowing may occur. Care at this stage therefore focuses on safety, nutrition, preventing complications, and maintaining the patient’s quality of life.
Although categorizing Alzheimer’s disease into stages helps doctors and families plan appropriate treatment and care, the stage of the disease cannot determine exactly how quickly the condition will progress or how long a patient will live.
Diagnosis of Alzheimer’s Disease Diagnosed
Diagnosing Alzheimer’s disease involves more than evaluating forgetfulness. Doctors assess memory, thinking, behavior, and the patient’s ability to perform daily activities. They also investigate other conditions that could cause similar symptoms.
The assessment may include:
- Medical history and assessment of changes: This may include determining when memory problems began, how symptoms have changed, and how much they affect daily life. Doctors may also obtain additional information from family members or caregivers.
- Cognitive testing: To evaluate memory, concentration, language, planning, and decision-making abilities.
- Physical and neurological examinations: To identify abnormalities that may be related to the symptoms.
- Blood tests: To identify other conditions that may affect memory and thinking, as well as testing for amyloid-beta in the blood.
- Brain imaging: MRI, CT, or PET scans may be used to evaluate the structure of the brain and help rule out other causes of similar symptoms.
For some patients, doctors may recommend additional testing for biomarkers associated with Alzheimer’s disease, such as blood tests or cerebrospinal fluid testing. The decision depends on the patient’s symptoms, stage of disease, and individual suitability.
Seeking medical evaluation as soon as abnormalities are noticed can help identify the cause and allow care planning to begin earlier. It can also help patients and their families prepare for treatment, safety considerations, and future daily living needs.
Dr. Duangkamol Singwicha, neurologist specialized in Cognitive and Behavioral Neurology at Vejthani International Hospital, recommends seeking medical evaluation when a person experiences changes in memory, thinking, or behavior that begin to interfere with daily life. Forgetfulness can result from many different conditions, and identifying the cause early can help ensure proper and effective treatment.
Treatment of Alzheimer’s Disease
Treatment options are now becoming available that may improve the condition, although suitability must be assessed individually. Medications are also available to slow symptoms and help patients maintain their ability to care for themselves and perform daily tasks for longer.
Medications may be used to support memory and thinking. For some patients in the early stages, treatments that may slow disease progression may also be considered. Doctors will assess whether these treatments are appropriate and closely monitor the patient.
In addition to medication, maintaining overall health and healthy daily habits is important. Appropriate exercise, sufficient sleep, nutritious food, and activities suited to the patient’s abilities can help patients live safely and maintain a better quality of life.
How to Care for a Person With Alzheimer’s Disease Safely
Patients should be encouraged to do as much as possible independently according to their abilities, while maintaining safety and adapting their environment according to the stage of the disease.
Families can begin with practical measures such as:
- Maintain a consistent daily routine: Keep waking, mealtimes, medication, exercise, and bedtime at approximately the same times each day to help reduce unnecessary confusion.
- Make the home safe and easy to navigate: Ensure adequate lighting, keep walkways clear, remove obstacles and potential tripping hazards, and keep essential items in consistent locations.
- Prevent wandering and getting lost: If patients begin having difficulty remembering routes, home entrances and exits should be appropriately secured, and patients should carry family contact information.
- Assist with medication and finances: When patients begin having difficulty managing these responsibilities, family members should provide support while continuing to involve patients in tasks and decisions they are still able to handle.
- Communicate with understanding: Use short, clear sentences, allow sufficient time for the patient to respond, and avoid arguing when the patient remembers events differently. If mood or behavior changes occur, observe possible triggers and help the patient feel calm and safe.
Caregiver health is equally important. Family members should share caregiving responsibilities, allow themselves time to rest, and seek advice from healthcare professionals when necessary to ensure that care can be maintained over the long term.
Reducing the Risks of Alzheimer’s Disease
There is currently no guaranteed way to prevent Alzheimer’s disease. However, taking care of overall health and addressing modifiable risk factors may help reduce the risk of dementia and support long-term brain health.
Ways to support brain health include:
- Exercise regularly: Choose activities appropriate for your age and health, such as brisk walking, swimming, or cycling, to support cardiovascular and brain health.
- Manage underlying health conditions: Particularly high blood pressure, diabetes, high blood lipid levels, and vascular conditions, while undergoing health checkups according to your doctor’s recommendations.
- Eat a nutritious diet: Focus on vegetables, fruits, whole grains, fish, and appropriate sources of protein while reducing foods high in sugar, saturated fat, or sodium.
- Stay mentally and socially active: Read, learn new things, pursue hobbies, and spend time talking with family and friends to keep the brain actively engaged.
- Get sufficient sleep: Address sleep problems appropriately. If you regularly experience insomnia, severe snoring, or symptoms that may indicate sleep apnea, consult a doctor.
- Avoid smoking and protect your brain health: Reduce the risk of head injuries by wearing a seat belt when traveling by car and a helmet when riding a motorbike.
Brain health should be maintained consistently beginning in middle age rather than waiting until memory problems appear, as many factors associated with brain health can be addressed early.
Alzheimer’s disease affects memory, thinking, and the ability to perform daily activities, with symptoms gradually changing as the disease progresses.
Frequently Asked Questions
What Are the Early Symptoms of Alzheimer’s Disease?
A common early symptom is reduced memory for recent events, such as forgetting something that just happened, repeatedly asking the same question, or having difficulty remembering new information. Patients may also begin experiencing problems with planning, language, decision-making, or orientation to time and place. If these changes persist and begin interfering with daily life, medical evaluation is recommended.
Can Alzheimer’s Disease Be Cured?
There is currently no treatment that can completely cure Alzheimer’s disease, but treatment can help improve the condition.
What Are the Symptoms of Late-Stage Alzheimer’s Disease?
In the severe stage, patients generally require increasing assistance with daily activities. Their ability to communicate and move may decline, and they may also experience difficulties with eating and swallowing. Care therefore focuses primarily on safety, comfort, and quality of life.
How Is Alzheimer’s Disease Treated?
Treatment depends on the patient’s symptoms and stage of disease. Treatments are now becoming available that may improve the condition, particularly in the early stages. Recognizing abnormalities early and undergoing appropriate medical evaluation can therefore help treatment and care planning begin sooner, supporting the patient’s safety and quality of life.
What Are the Symptoms of Alzheimer’s Disease Near the End of Life?
In the late stages of the disease, patients may become increasingly unable to care for themselves, with limited communication and mobility. They may also experience difficulties eating or swallowing. Close care is therefore necessary to maintain the patient’s safety, comfort, and quality of life during the final stage of life.
Medically Reviewed by
DR. VONGKANOK KOWATANAMONGKON
Neurology
Medical Neurology - Stroke and Vascular
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