Alzheimer’s 101: Things you need to know about your loved one with Alzheimer’s Disease

If you or a loved one live with Alzheimer’s disease, you are not alone. Alzheimer’s disease is the most common form of dementia in Australia. The Australian Institute of Health and Welfare estimates that between 386,200 and 472,000 Australians live with some form of dementia, equating to around 1.5% of the population. Dementia, including Alzheimer’s, is much more common with age. For Australians aged over 65 years, the prevalence of dementia increases to around 8.3% or 83 in every 1000 people.

When supporting a family member or friend living with Alzheimer’s, it’s helpful to better understand the condition so that we can support our loved one most effectively. Read on to learn more about Alzheimer’s, its early signs and symptoms, and the management and treatment options available.

What Is Alzheimer’s Disease?

Alzheimer’s is a degenerative brain disease that causes dementia symptoms that gradually progress over time. Alzheimer’s disease is a result of cell damage in the brain which leads to complex damage. Ageing is the greatest risk factor for Alzheimer’s, with far more people affected over the age of 65. However, Alzheimer’s or dementia are not normal parts of ageing and can affect younger adults as well. 

Alzheimer’s typically affects the part of the brain responsible for learning new information first. Early warning signs of the onset of Alzheimer’s disease are forgetting or struggling to remember new information. As the disease advances, more symptoms may arise such as confusion, behaviour changes, disorientation, and, eventually, difficulty speaking, walking, and swallowing. 

Who Is Affected by Alzheimer’s Disease?

Alzheimer’s can affect anyone, but it becomes more common with age. It is not known why some people develop Alzheimer’s, and others do not. Some people can inherit the genetic mutation that leads to Alzheimer’s from a relative, which is known as familial Alzheimer’s. Familial Alzheimer’s can cause symptoms to arise earlier than normal.

While the exact causes of Alzheimer’s are not fully understood, it appears to be a result of a combination of genetic, health, and lifestyle factors. Some potential contributors to the development of Alzheimer’s include:

• Physical inactivity
• Lack of mental ‘exercise’
• Smoking
• Obesity
• Diabetes
• High cholesterol
• High blood pressure.

Leading a healthy lifestyle may help to protect you or a loved one from Alzheimer’s, however, even healthy individuals can experience forms of dementia. 

Is Alzheimer’s Disease Genetic?

Anyone can get Alzheimer’s disease, even if they have no family history of the condition. However, a genetic component may increase the risk of developing Alzheimer’s. People with a first-degree relative (i.e., a parent or sibling) with Alzheimer’s are more likely to be diagnosed with it themselves. The risk is even higher for people with more than one sibling or relative with Alzheimer’s. These statistics indicate that Alzheimer’s can be caused by environmental and lifestyle factors, genetics, or a combination of both.

Genes and Alzheimer’s Disease

Genes that influence whether a person develops a certain disease are categorised as either risk genes or deterministic genes. Researchers have identified hereditary genes for Alzheimer’s disease in both of these categories.

Risk genes increase the risk of acquiring Alzheimer’s but do not guarantee it will happen. Risk genes for Alzheimer’s include APOE-e4 (present in 40-65% of Alzheimer’s diagnoses).

Deterministic genes directly cause disease to develop, meaning individuals with these genes are certain to acquire the disease in question. Deterministic genes for Alzheimer’s are rare, found in only a few families worldwide. Deterministic Alzheimer’s genes account for around 1% of Alzheimer’s cases, usually familial Alzheimer’s, which produces symptoms earlier in life.

Genetic tests are available for both APOE-e4 and the rare genes that directly cause Alzheimer’s. However, experts have warned against routine genetic testing for Alzheimer’s until the individual has received support and counselling to prepare them for the possible outcomes of their testing. If you are considering genetic testing to determine your Alzheimer’s risk, always talk to your doctor about the pros and cons of your unique situation first.

Alzheimer’s Disease vs Dementia: What’s The Difference?

Alzheimer’s disease and dementia are sometimes used interchangeably, but they are not the same condition. Dementia is a general term for any condition that produces specific symptoms like memory loss, reasoning, and other thinking and cognitive abilities. There are many different types of dementia that can be caused by different things. Alzheimer’s is a specific disease that causes dementia symptoms. Alzheimer’s is the most common type of dementia and also the most common cause.

Alzheimer’s affects the neurons in the brain, disrupting their ability to work normally and communicate with each other. People with Alzheimer’s have decreased amounts of important chemicals in the brain, including acetylcholine, norepinephrine, serotonin, and somatostatin. This makes it harder for the brain to function normally and exchange messages with other organs.

If you want to learn more about the different types of dementia, Dementia Australia has recently released a useful dementia guide available in three formats. You can listen to it as an audiobook, download it as a digital file or order a printed copy. The Dementia Guide provides useful information about the impact of dementia, treatment and support options, and effective management strategies you can use at home. Get your copy of the Dementia Guide via Dementia Australia’s website.

What Are the Signs and Symptoms of Alzheimer’s Disease?

Alzheimer’s can be difficult to detect, especially in its early stages, because its symptoms can initially be mild and subtle. Types of memory loss that disrupt daily life are often an early sign that someone may be experiencing some form of dementia, including Alzheimer’s. There are ten early warning signs of Alzheimer’s disease that you should never ignore. If you notice any of the following in yourself or a loved one, schedule an appointment with your doctor.

1. Memory loss disrupts daily life, such as forgetting recently learned information (like names and dates or asking the same question repeatedly).
2. Difficulty making plans or solving problems (such as confusion when reading familiar instructions).
3. Difficulty completing familiar tasks (such as driving to a familiar location or playing a once-favourite game).
4. Confusion around time and places (losing track of dates, seasons, and time passing).
5. Difficulty understanding visual information and poor spatial awareness (including difficulty balancing, trouble reading, or poor contrast or distance perception).
6. Problems with conversation (new problems with words, trouble following a conversation, struggles with vocabulary).
7. Losing things and inability to retrace their steps (may put things in unusual places, lose belongings, and be unable to remember where they are).
8. Poor judgement (may start to make bad decisions with money or stop taking care of their appearance or personal hygiene).
9. Disengaging from social or work activities (may withdraw from usual hobbies, social events, or other activities due to difficulty communicating).
10. Mood and personality changes (might become confused, irritable, anxious, depressed, suspicious, or fearful, especially outside their comfort zone).

Don’t delay seeking medical advice if you notice the above signs. Feeling uncertain or worried about talking to your loved one about changes you have noticed is normal. You might worry about how they will react or be nervous about hurting their feelings. However, it is important not to delay raising the issue with them.

Early detection can make a big difference to your loved one’s quality of life, so try to communicate that you want what is best for them and schedule an appointment as soon as possible to get them the help they need.

Alzheimer’s Disease Stages: Early, Middle, and Late-Stage

Like other types of dementia, Alzheimer’s disease is progressive, meaning its symptoms gradually worsen over time. The stages of Alzheimer’s disease are often categorised into early, middle, and late-stage. These stages are sometimes called mild, moderate, and severe in medical settings. Every person with Alzheimer’s is different and experiences these stages differently. These stages may overlap, and not every person will experience all of these symptoms.

Early (Mild) Stage Alzheimer’s Disease

In early-stage Alzheimer’s disease, the individual may still live independently, despite mild cognitive challenges. They may still be able to work, drive, socialise and do their usual activities. Signs and symptoms can be very difficult to spot in their early stages. The person may:

• Experience lapses in memory
• Struggle with vocabulary
• Forget names or places
• Lose belongings
• Forget information straight after reading it
• Have trouble making and following a plan.

If you notice any mild signs, there are diagnostic tools your doctor can use to determine in Alzheimer’s disease is the cause. Early intervention can greatly improve quality of life, so if in doubt, see your medical professional. 

Middle (Moderate) Stage Alzheimer’s Disease 

As the disease progresses into its middle stage, the individual will require greater care. Middle-stage Alzheimer’s typically lasts the longest and can extend for several years. The nerve cells in the brain are becoming more damaged at this stage, and the dementia symptoms will become more pronounced. Some common symptoms during middle-stage include:

• Forgetting events and/or personal history
• Moodiness or social withdrawal in challenging situations
• Forgetting important personal information like address, phone number, and the school(s) they attended
• Confusion about their location or the time and date
• Needing help to dress appropriately for weather or events
• Difficulty controlling their bladder and/or bowels
• Sleep changes, such as sleeping in the day and being awake or restless at night
• Wandering away and becoming lost
• Personality and behaviour changes, like becoming compulsive, delusional or suspicious
• Repetitive behaviours like hand wringing or tissue shredding.

During this stage, the person may be less independent and require more support. It is important to learn what works for the individual to continue to lead a fulfilling life with as much independence as is safe and reasonable. Professional respite care can be a huge help during this stage, as it helps ensure your loved one is safe while also allowing you to relax and focus on other things. Caregiving is a rewarding yet difficult task, so don’t feel you have to do it all alone. Homage has a team of dedicated home nurses and Care Pros highly trained in specialist dementia care. Reach out today to find out how we can help.

Late (Severe) Stage Alzheimer’s Disease

Dementia symptoms become severe in late-stage Alzheimer’s disease. The individual may struggle with communication, processing thoughts and emotions, and controlling their movement. Personality changes and a reduced ability to respond to the environment can mean the person needs high-level care and support. During late-stage Alzheimer’s disease, the individual may:

• Require assistance with personal care around the clock
• Become unaware of their surroundings and recent experiences
• Experience changes in their ability to walk, sit and swallow
• Struggle to communicate
• Be at higher risk for infections, particularly pneumonia.

Even though the person may struggle to communicate, they can still benefit from the company and gentle interactions with loved ones and trusted support staff. We can work with you to find the perfect Care Professional that you and your loved one feel comfortable with, so they can continue to have social engagement and support even as their condition becomes more severe.

How Is Alzheimer’s Disease Diagnosed?

No single diagnostic test can determine if a person has Alzheimer’s disease. Medical physicians use various tools and tests, often with the support of other medical professionals (like neurologists, neuropsychologists, and geriatricians), to determine the cause of dementia symptoms. Doctors can almost always confirm whether a person has dementia but cannot always specify if Alzheimer’s disease is the cause. During the diagnostic process, doctors will use the following tools to determine if the person has Alzheimer’s disease.

• Medical history
• Physical examination and diagnostic tests
• Ask about diet, nutrition, drug and alcohol use, and medications
• Take vital signs like blood pressure, temperature and pulse
• Listen to vital organs like the heart and lungs
• Perform blood or urine tests
• Perform neurological examinations, which may include testing reflexes, muscle strength, eye movement, speech and sensation
• Brain imaging
• Cognitive status tests
• Genetic testing
• Cerebrospinal Fluid (CSF) tests
• Blood tests.

Based on the results of these tests and screenings, your doctor will tell you the likely causes of dementia, and what management and treatment options are available to protect your loved one’s quality of life.

How Is Alzheimer’s Disease Treated?

Alzheimer’s disease is highly complex and different for each individual affected. There is no single treatment that cures Alzheimer’s disease, but there are treatment options that can control symptoms and improve quality of life. Treatment options can depend on the stage and severity of the disease, and the unique health and cognitive status of the individual.

Medications

Some medications can help alleviate symptoms of Alzheimer’s disease. In mild-to-moderate Alzheimer’s disease, a group of drugs called cholinergic drugs can temporarily improve cognitive function. The medicines boost acetylcholine levels in the brain, a chemical that restores communication between brain cells. 

Some other medications can improve symptoms like sleeplessness, agitation, anxiety, and depression. These medications don’t treat Alzheimer’s disease itself but can alleviate symptoms and improve overall well-being.

Recent medical developments have also led to a new type of therapeutic drug called aducanumab. It is the first type of drug to demonstrate that removing beta-amyloid from the brain can potentially reduce cognitive and functional decline in people living with early Alzheimer’s. While aducanumab does not ‘cure’ Alzheimer’s, it can slow its progression and give you more time to spend with your loved one while they can participate more fully in daily life activities and make meaningful memories.

Aducanumab works by targeting specific types of beta-amyloid that develop plaque build-up in the brain. Plaque can cause cell death and tissue loss, reducing brain function. Removing this substance to slow its accumulation can protect the brain and help it to function more efficiently. It may slow the rate of memory loss but will not restore memories that have already been lost.

Not all individuals are suited to this new type of drug, and it is important to understand the pros and cons before starting any new medication. Always speak to your doctor about the potential side effects and the likelihood of success before starting a new medical regime. 

Some drugs can be prescribed for moderate and severe Alzheimer’s to reduce symptoms and improve cognitive abilities. These drugs, including memantine, will not reverse the condition but may help your loved one stay a little more independent than they would without the medication. 

How Homage Can Help?

Do you need support to care for a loved one experiencing dementia? Our team of compassionate, highly trained Care Professionals is ready to help. Everyone’s care needs are unique. We would love to understand your and your loved ones’ needs to develop a personalised care plan. Leave your contact details, and we will be in touch.

For urgent care, speak with our Care Advisors at 0480 093 788 and get connected to care today. Our Care Hotline is operational from 9 am to 5 pm (weekdays) and 9am to 1 pm (weekends and PH).