Supplement to MAYO CLINIC HEALTH LETTER OCTOBER 2008
Alzheimer’s diseas. New research brings hope.
You’ve misplaced your car keys — again. Family members keep mentioning conversations you don’t remember having. You’ve been finding it difficult to concentrate, and you’re more irritable than you used to be. You wonder if these changes are a normal part of aging or something more serious — Alzheimer’s disease.
Healthy microtubules the loss of intellectual and social abilities severe enough to interfere with within a neuron daily functioning. (See “Dementia and Alzheimer’s,” page 2.) The Alzheimer’s Association estimates that 5.2 million older Americans have Alzheimer’s. This number is expected to increase dramatically over the next few Tau molecules decades — potentially reaching 11 million to 16 million by 2050. Although there’s no cure for Alzheimer’s disease, researchers have made progress. Treatments are available that improve the quality of life for some people with Alzheimer’s, and more drugs are being studied. If you do have Alzheimer’s or another form of dementia, the sooner you’re evaluated and diagnosed.
What’s Alzheimer’s disease?
Alzheimer’s disease is a progressive, degenerative disease in very different ways. This includes the rate which unravels at which the disease progresses and the type and severity of the symptoms. Nevertheless, certain patterns are common in almost everyone with
Formation of tangles
Alzheimer’s, and most people experience com-
Neurons have an internal support structure, which includes microtubules.
mon signs and symptoms such as:
A protein known as tau helps stabilize the microtubules. In Alzheimer’s, the makeup of tau changes, causing the tau to unravel and destabilize ■ Increasing and persistent forgetfulness — the microtubules. The pieces of tau clump together to form tangles. At its onset, Alzheimer’s disease is marked by
Dementia and Alzheimer’s
The term “dementia” isn’t just another word for Alzheimer’s disease. Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. It affects about 10 percent of people over age 70 and can be caused by many different disorders.
The most common specific cause of dementia is Alzheimer’s disease, which accounts for 60 to 80 percent of all cases.
Alzheimer’s is called a neurodegenerative disease because it leads to death of nerve cells in the brain.
Vascular conditions such as high blood pressure, cardiovascular disease and atherosclerosis also can lead to dementia by causing strokes that damage brain tissue. That condition is called vascular dementia. Other causes of dementia include infection, reaction to medication and certain nutritional deficiencies.
Some symptoms of dementia can be reversed, such as when cognitive impairment is induced by high fever, drugs, dehydration or poor nutrition. However, many causes of dementia are irreversible.
Diagnosing a specific cause of dementia isn’t easy. The various causes — both neurodegenerative and vascular — may share common signs and symptoms. Frequently, two types of dementia occur at the same time, making it difficult to distinguish between them.
periods of forgetfulness, especially of recent events or simple directions. But what begins as mild forgetfulness persists and worsens. People with Alzheimer’s may repeat things and forget conversations or appointments. They routinely misplace things, often putting them in illogical locations. They frequently forget names, and eventually, they may forget the names of family members and everyday objects.
■ Difficulty with abstract thinking — People with Alzheimer’s may initially have trouble balancing their checkbook, a problem that progresses to trouble recognizing and dealing with numbers.
■ Disorientation — People with Alzheimer’s often lose their sense of time and dates and may find themselves lost in familiar surroundings.
■ Difficulty finding the right word — It may be a challenge for those with Alzheimer’s to find the right words to express thoughts or even
■ Loss of judgment — Solving everyday problems, such as knowing what to do if food on the stove is burning, becomes increasingly difficult and eventually impossible. Alzheimer’s is characterized by greater difficulty with things that require planning, decision making and judgment.
■ Difficulty performing familiar tasks — Once-routine tasks that require sequential steps, such as cooking, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer’s may forget how to do even the most basic things.
■ Personality changes — People with Alzheimer’s may exhibit mood swings. Early on, this may be a response to the frustration they feel as they notice uncontrollable changes in their memory. As the disease progresses, people with Alzheimer’s may become anxious or aggressive and behave inappropriately.
Because symptoms in the early stages of the disease progress slowly, diagnosis is often delayed. People developing Alzheimer’s may be frighteningly aware of their problems — but careful to keep them hidden, refusing to see a doctor. As a result, even their families may fail to see what’s going on. When the signs and symptoms are too obvious to miss, those closest to the person often realize that similar — but less severe — difficulties have been present for years.
The disease’s course varies from person to person. Six to eight years is the average length of time from diagnosis of Alzheimer’s to death. Survival begins to decline three years after diagnosis, but some people live more than a decade with the disease.
Other conditions, such as depression, anxiety and sleep disorders, may accompany Alzheimer’s disease. The symptoms of these conditions can obscure or complicate a diagnosis of Alzheimer’s, and they may also hasten or increase the severity of mental decline. (See “Dementia and depression,” page 3.) Early diagnosis is important, since many of these conditions are treatable.
How the brain works
The effect of Alzheimer’s disease on brain tissue has been clearly demonstrated. Alzheimer’s damages and kills brain cells, causing progressive deterioration. Neurons receive messages from adjoining cells through the dendrites and send or relay messages via the axon.
To understand Alzheimer’s disease, it helps to know how the brain normally functions. A healthy brain has billions of nerve cells called neurons. Neurons generate electrical impulses that are relayed from neuron to neuron, allowing different parts of your brain to communicate with one another. They also receive and send information from and to all parts of the body. Chemicals called neurotransmitters modulate the transmission of these impulses through synapses, the gaps between neurons. This is what keeps your body functioning, allows you to laugh at a funny movie or feel pain from an injury. It’s also how memories are created.
As you age, the number of neurons in your brain naturally decreases and the number of connections between nerve cells is reduced. As a result, your brain atrophies, or “shrinks,” as brain mass decreases. Starting around age 50, many people begin to notice the effects of these changes, which include mental lapses such as forgetfulness, difficulty recalling names and facts, and absent-mindedness. This is normal to a certain degree in older adults and doesn’t necessarily indicate the presence of dementia.
In people with Alzheimer’s disease, neurons degenerate, lose their ability to communicate and die. Levels of important neurotransmitters are reduced. This deterioration usually starts in the central brain and eventually spreads throughout the organ. The structural and biochemical networking among neurons is vital for your brain to function properly. If your brain’s networking capabilities deteriorate, cognitive skills — such as your ability to think, reason and remember — are affected or lost. Eventually your physical capabilities also are affected. In the final stages of Alzheimer’s disease, most people are bedridden and completely dependent on others for care. The disease severely weakens the body’s systems, and as a result, the cause of death is rarely Alzheimer’s itself, but is more often secondary to an infection, such as pneumonia.
Physical characteristics: Plaques and tangles
They key question in Alzheimer’s disease is “What causes neurons to degenerate and die?” Although a definitive answer hasn’t been found, scientists agree that the disease is likely caused by a combination of factors. A characteristic feature of Alzheimer’s is the abundance of these two abnormal structures in the brain:
■ Amyloid plaques — These are large clumps of protein that develop between and around neurons. They’re made up of a normally harmless protein called beta-amyloid. The prevailing theory is that beta-amyloid is somehow responsible for much of the damage to neurons caused by Alzheimer’s. What causes beta-amyloid to accumulate in people with the more common, noninherited form of Alzheimer’s isn’t known.
For a long time, scientists believed that the plaques themselves were toxic to neurons, leading to cell death. But now some argue that betaamyloid is most toxic to neurons in the early stages of plaque formation. The fully formed plaques may have lost their toxicity and simply are byproducts of the disease. The unanswered question is whether betaamyloid is a direct cause of cognitive decline. Increasingly, researchers are leaning toward the belief that the best opportunity for reversing the disease may be during the early stages of plaque formation.
■ Neurofibrillary tangles — These are twisted masses that develop inside neurons from damage to the cell’s internal support structure. A protein called tau normally helps uphold the structure of a neuron, but
Dementia and depression
Depression is a serious illness that affects your thoughts, emotions, feelings, behaviors and physical health. Depression can mimic dementia and exhibit some of the same signs and symptoms, such as confusion and forgetfulness. Dementia of depression is a condition that causes cognitive impairment, but is due to depression. Furthermore, depression often accompanies dementia, affecting 20 to 30 percent of people with the disease.
Because the two conditions often coexist and may be mistaken for the other, it’s important to see your doctor to determine the underlying cause of any changes in cognitive abilities to ensure you receive proper treatment.
Neuron structure
Formation of plaques
Dense deposits of protein and cellular material outside and around neurons — called plaques — are one of the hallmarks of Alzheimer’s disease. Plaques are formed from a substance called amyloid precursor protein (APP). In Alzheimer’s, something causes the APP molecule to be snipped at a different location than normal, making the fragment longer, “stickier” and less able to dissolve. The fragments clump together and form into plaques.
As Alzheimer’s develops, the protein malfunctions and unravels, forming tangled masses inside the cell. These tangles have a devastating effect on the structure and function of neurons, leading to the collapse of inter-cellular communication. As with plaques, scientists continue to debate whether tangles are a cause of Alzheimer’s disease or a result of it. Accumulation of the tangles appears to be closely related to the severity of the disease’s symptoms. However, tangles don’t appear to necessarily cause neuron death.
Although the focus of much current research is determining how plaques and tangles are connected to the disease process, scientists are also studying other possible contributing factors. Researchers have observed inflammation in the brains of some people with Alzheimer’s disease. Inflammation is your body’s response to injury or infection and a natural part of the healing process. Even as beta-amyloid plaques develop in the spaces between neurons, immune cells are at work getting rid of dead cells and other waste products in the brain.
Although researchers believe the inflammation occurs before plaques have fully formed, they aren’t sure how this development relates to the disease process. There’s debate about whether inflammation damages neurons or if it’s beneficial in clearing away plaques — whether it’s a cause or effect of the disease.
Cardiovascular risk factors also are being examined, as Alzheimer’s symptoms may be more likely to develop if an individual has experienced strokes or damage to blood vessels in the brain.
Other risk factors
Research suggests that a number of other factors are connected to the Alzheimer’s disease process in some way. These include:
■ Age — Alzheimer’s usually affects people older than 65, but does, rarely, affect those younger than 40. About 10 percent of people over age 65 have Alzheimer’s. For people 85 and older, that number jumps to nearly 50 percent.
■ Sex — Women are more likely than men are to develop the disease because they live longer.
■ Education — Studies have found a correlation between a low level of education and higher risk of dementia and, conversely, a high level of education and lower dementia risk. Researchers theorize that the more you use your brain, the more synapses you create between neurons, which provide a greater reserve of brainpower as you age. It remains unclear, though, whether less education and less mental activity actually increase the risk of Alzheimer’s.
Recent research supports the idea that higher levels of education delay the onset of cognitive decline. However, more-educated individuals may be able to mask their symptoms and prevent detection of dementia in its early stages. Once these individuals are diagnosed with Alzheimer’s, the disease has already progressed, and cognitive decline actually occurs more quickly at this point than in those with less education who were diagnosed with the disease at an earlier stage. This may be related to the fact that drugs for treating Alzheimer’s tend to be most effective in the early stages of the disease, and that early detection may offer greater possibilities of slowing the disease’s progression.
Can you reduce your risk of developing Alzheimer’s?
Although there’s no proven way to delay or prevent the onset of Alzheimer’s disease, researchers are continuing to study several possibilities, including:
■ Physical activity and healthy living — Some of the most recent research indicates that taking steps to improve your cardiovascular health — such as losing weight, exercising, healthy eating, and controlling high blood pressure and cholesterol — may also help prevent Alzheimer’s disease and other forms of dementia. A new Mayo Clinic study has found that regular physical exercise may help protect against mild cognitive impairment, a condition that may be a precursor of Alzheimer’s. In general, being physically active, getting enough sleep, limiting alcohol and managing stress all contribute to keeping your brain at its optimum function — and are good for your overall health.
■ Diet — Like physical activity, your diet influences conditions such as high blood pressure, high cholesterol and diabetes, which may be risk factors for Alzheimer’s. A recent study found that consumption of fruit and vegetable juices may delay Alzheimer’s. Other research suggests this protection may be related to consuming certain antioxidants (polyphenols) found in fruits and vegetables. However, taking the antioxidant vitamin E doesn’t appear to have a protective effect. Another study indicates that the Mediterranean diet is related to a lower risk of Alzheimer’s disease. This diet is characterized by generous amounts of fruits and vegetables, healthy fats such as olive oil, small portions of nuts, red wine in moderation, eating fish on a regular basis, and very little red meat. As a result of observations that eating fish seems to be associated with a reduced risk of Alzheimer’s, researchers are also examining the role omega-3 fatty acids may play in the disease. Mayo Clinic is participating in a large clinical trial to determine whether a type of omega-3 fatty acid may slow progression of the disease.
■ Alzheimer’s vaccine — Several years ago, investigators began preliminary studies of a potential Alzheimer’s vaccine. These trials were halted because some of the participants in the original study developed brain inflammation as a side effect. Scientists haven’t lost hope and continue to work on second-generation vaccines. Participants who didn’t develop inflammation showed positive results. If side effects can be minimized, immunization may yet prove to be an effective therapy.
■ Enzyme inhibitors — Certain enzymes are involved in the formation of plaques. Scientists believe that if they can create a drug that inhibits the action of these enzymes, it will decrease the number of plaques and thus the degeneration of neurons. Such a drug is being tested on mice. Although the drug requires much further study, there’s hope it could eventually work for humans.
■ Cardiovascular therapies — Some studies of cholesterol-lowering drugs in the statin class have indicated that regular use of these medications in midlife decreases a person’s risk of dementia. However, two recent clinical tests failed to find any benefits of statins in treating Alzheimer’s. There’s evidence that controlling high blood pressure may have a therapeutic effect on Alzheimer’s.
■ Nonsteroidal anti-inflammatory drugs (NSAIDs) — Because inflammation has been observed in the brains of some people who have Alzheimer’s, one focus of research has been on the role anti-inflammatory agents may have in the disease process. Several studies indicate that the NSAIDs ibuprofen (Advil, Motrin, others), naproxen (Aleve, Naprosyn, others) and indomethacin (Indocin) may reduce risk of Alzheimer’s. However, recent trials that included naproxen, celecoxib (Celebrex) and aspirin failed to confirm the association between the NSAIDs and Alzheimer’s prevention. Until more conclusive trials are done, researchers don’t recommend NSAIDs solely to prevent Alzheimer’s.
■ Estrogen — Early studies suggested that estrogen may have a protective effect against Alzheimer’s, but more recent studies have failed to demonstrate that role. Raloxifene (Evista), a drug that mimics some of estrogen’s effects, is used to treat osteoporosis and also appears to lower the risk of developing mild cognitive impairment, a memory disorder that often precedes Alzheimer’s. Right now, raloxifene shouldn’t be used as a treatment to prevent Alzheimer’s.
■ Mental fitness — Some studies have suggested that remaining mentally active throughout your life, especially in your later years, reduces the risk of Alzheimer’s disease.
Dementia risk: Apples vs. pears
Being obese puts you at risk of a number of health conditions, including Alzheimer’s disease. But where your body stores fat also determines your level of risk. A recent study indicates that carrying more fat around your belly in your middle ages increases dementia risk — even for people who are at a healthy weight overall.
This finding adds to a growing awareness that apple-shaped people, who store fat around their abdomen, have higher risks of disease than do pear shapes, who store fat around their hips and thighs.
What’s normal aging?
As you age, you may begin to second-guess minor memory lapses and wonder if they’re the first signs of Alzheimer’s disease. It’s true that changes naturally occur to your thinking skills as you age. Minor memory lapses happen to everyone.
Forgetting where you left your car keys or reading glasses, or even forgetting an acquaintance’s name can be a normal part of aging. But while it’s possible for any older adult to develop Alzheimer’s disease, having the disease is not a normal part of aging. In fact, 87 percent of people age 65 and older don’t have Alzheimer’s.
Talking with your doctor about what to expect as you age may help allay your fears and prepare you if something more serious develops.
■ Lifestyle — High blood pressure, high cholesterol and diabetes in midlife may increase the likelihood that you’ll develop vascular cognitive impairment. As vascular dementia and Alzheimer’s increasingly appear connected, these may also be risk factors for Alzheimer’s. Drinking large amounts of alcohol on a regular basis increases the risk of dementia. But moderate amounts of alcohol, especially in the form of red wine, might actually be protective. Smoking is almost certainly another risk factor. In addition, new research indicates that obesity and the distribution of body fat in midlife are linked to dementia risk.
■ Heredity — Certain genetic mutations are known to cause a small percentage — around 1 percent — of inherited forms of Alzheimer’s disease. People who inherit one of these rare mutations usually begin to experience symptoms before the age of 65. This is known as early-onset Alzheimer’s. Children whose parents have any one of these mutations have a 50 percent chance of inheriting the abnormal gene and developing the disease. In addition, a new gene variation has recently been associated with late-onset Alzheimer’s. Symptoms of and treatment for inherited forms of the disease are generally no different than for noninherited forms of Alzheimer’s.
■ Head injury — The observation that some ex-boxers eventually develop dementia suggests that serious traumatic injury to the head — for example, a concussion with a prolonged loss of consciousness — may be a risk factor for Alzheimer’s. Several studies indicate a significant link between the two, but others do not. One theory is that head injury may interact with a gene linked to Alzheimer’s disease.
The emerging picture of Alzheimer’s disease involves an intricate process that likely includes a number of different factors. Its occurrence in specific individuals may be precipitated by different combinations of genetic and environmental triggers. The difficulty of predicting who will or will not develop Alzheimer’s may remain a characteristic of the disease itself.
Diagnosis and evaluation
It’s estimated that more than 50 percent of people who have dementia never receive a diagnosis. They may think that they’re just “getting old,” or they may be afraid of the possibility it might be something more serious and hesitate to see their doctor. However, an early diagnosis is important for a variety of reasons. It can give you the opportunity to be involved in making important legal, financial, social and medical decisions that affect both you and your family members. Additionally, it can give you time to prepare mentally and emotionally for the changes ahead and allow your family to plan living arrangements and care.
There’s no one test that can diagnose Alzheimer’s disease. An experimental imaging study using positron emission tomography has shown promise in research, but it’s not available for regular clinical use. And, it appears as if its use will be limited to unusual or atypical cases. For now, doctors use a process of elimination to rule out other conditions and rely on screening tools to identify key characteristics of Alzheimer’s. However, the clinical diagnosis of Alzheimer’s is really quite accurate and shouldn’t be mistrusted simply because there’s no definitive laboratory test for it.
Mild cognitive impairment
Mild cognitive impairment (MCI) is an early transition stage between normal cognition and Alzheimer’s. Individuals with MCI experience cognitive problems beyond what’s considered normal, age-related decline, but not so much that their quality of life or ability to perform daily activities is significantly impaired. People with memory-related MCI develop dementia at a rate of about 10 to 15 percent a year. About half the people who have MCI don’t go on to develop any type of dementia. Researchers have taken a keen interest in this concept of a pre-dementia stage because, if the ability to diagnose a disease such as Alzheimer’s in its earliest phase is developed, it opens up the possibility of new therapies that can slow the disease. Although individuals with MCI are more likely to develop Alzheimer’s than those without the condition, not everyone with mild cognitive impairment develops dementia.
The concept of this transition stage is still evolving, and a great deal of research is progressing designed to characterize who will progress to Alzheimer’s more rapidly. As research begins to reveal patterns, an understanding of this transition stage will contribute clues to the way dementia develops, particularly in the case of Alzheimer’s. This may extend the options for diagnosis and treatment of many cognitive disabilities.
The first step usually involves compiling a medical history and conducting a physical exam. Then, a series of interviews and written tests are used to evaluate mental status and determine which cognitive functions are affected, such as memory, attention span, problem-solving abilities, counting skills and language. Your doctor may also test physiological aspects of the brain such as balance and sensation. This brief screening may be followed by more thorough testing to help determine the nature and severity of impairment. A doctor may recommend an evaluation of vitamin B-12 levels, thyroid function and neuropsychological testing to rule out other problems. A brain scan may also be done to help pinpoint visible abnormalities such as shrinkage of certain parts of the brain or evidence of small strokes.
Using these different methods, doctors are able to make an accurate diagnosis of Alzheimer’s about 90 percent of the time. The disease can be diagnosed with complete accuracy only after death, using a microscopic examination of brain tissue to check for plaques and tangles. Screening tests are available that can tell if a person carries susceptibility genes associated with Alzheimer’s, but the tests can’t predict who will or will not get the disease.
Although being diagnosed with Alzheimer’s is a frightening experience, it also gives you the chance to seek out appropriate treatment options that can help alleviate your signs and symptoms.
Treatment
Currently, there’s no known cure that can halt or prevent Alzheimer’s. Treatment strategies focus on managing the symptoms of the disease through a combination of drug therapies and behavioral strategies.
■ Medications — Cholinesterase inhibitors are a group of drugs that improve the levels of neurotransmitters in the brain and help stabilize cognitive functions. They include donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne). In 2007, a patch became available that delivers rivastigmine through the skin, maintaining steady levels of the drug in the bloodstream. The patch, which is replaced every 24 hours, has shown similar effectiveness as the highest dose of the oral form of the drug. In addition, its side effects may be less severe.
Cholinesterase inhibitors are generally used only in the mild to moderate stages of Alzheimer’s, as they seem to lose much of their effectiveness after this point. However, in 2006, donepezil was approved for use at the severe stages of the disease after its effectiveness in improving cognitive functions was established. Donepezil is modestly and temporarily effective in people with mild cognitive impairment. In addition, Mayo Clinic researchers have found that donepezil may slow the rate of brain shrinkage in people with mild cognitive impairment and a genetic predisposition for Alzheimer’s.
About half of the people taking cholinesterase inhibitors show some improvement in their signs and symptoms. Gastrointestinal problems — such as diarrhea and stomach pain — are common side effects of these medications, but they usually lessen with time.
Another drug, memantine (Namenda), is a newer class of medication intended for use at the moderate and severe stages of Alzheimer’s. Memantine seems to slow the loss of daily living skills.
Strategies for caring for those with Alzheimer’s
While medications can help, caregiving is at the ■ Avoid large, noisy settings — These can be heart of Alzheimer’s treatment. The key to caregiv-overwhelming and disorienting. ing is focusing on the things your loved one can ■ Control visitor encounters — Consider limit-still do and enjoy at each stage. ing the number of visitors at one time.
As behavior changes occur, be patient and Caring for a person with Alzheimer’s disease is reassuring. Keep in mind that the person is express-physically and emotionally demanding. Feelings of ing real emotions. Help engage your loved one by anger, guilt, frustration, discouragement, worry, listening, making eye contact, and using familiar grief and social isolation are common. If you’re a words and clear statements. Try these strategies: caregiver for someone with Alzheimer’s disease,
■ Stick to a daily routine — A familiar schedule you can help yourself by asking friends and family can make things easier for both of you. members for help and by joining a support group.
■ Break tasks down into small, orderly steps — Learn as much as you can about the disease, and Don’t rush through things — it will just add to your talk with the doctor and other health care profesloved one’s confusion and slow things down. sionals involved in the care of your loved one.
■ Limit choices and participate together — It’s also critical to make self-care a priority. Involve your loved one in tasks as much as possi-Thinking about yourself may seem at odds with ble. Getting dressed may seem overwhelming your role as a caregiver. But, staying healthy and when faced with a closet full of clothes. Instead, making sure to focus on your own needs is the best offer two outfits and let the individual decide. way to maintain the levels of emotional and physi
■ Be respectful and reassuring — Preserve your cal energy that you’ll need to remain a caregiver loved one’s dignity while assisting with personal for the long term. Staying motivated increases tasks, and respond to his or her emotions with feelings of well-being and reassurance, for both understanding and empathy, not reason. you and your loved one.
Helpful resources
Here are additional resources:
■ Alzheimer’s Disease Education and Referral (ADEAR) Center — ADEAR offers information on research findings and participation in clinical trials. Call 800-4384380, or visit the Web site www.nia.nih.gov/Alzheimers.
■ Mayo Clinic Guide to Alzheimer’s Disease — Available at the online bookstore at www.Bookstore.MayoClinic.com or by calling toll-free 877-6476397.
ing, eating and going to the bathroom. It sometimes is used in combination with a cholinesterase inhibitor. Memantine’s most common side effect is dizziness.
■ Behavioral strategies — Extreme changes in mood and behavior become common as Alzheimer’s disease progresses and can include aggression, agitation, delusions, paranoia and sleep disturbances. These behaviors may be the only way individuals can express themselves as their communication skills decline. Managing these challenging behaviors requires patience and understanding on the part of caregivers.
Drugs such as antidepressants, antipsychotics and mood stabilizers may help treat the behavioral symptoms of Alzheimer’s. However, these drugs can intensify cognitive losses, and their side effects can be severe in older adults. In general, they’re used when the patient, family and doctor feel the benefits of their use outweigh risks.
Hope on the horizon
Just because there’s no cure for Alzheimer’s right now doesn’t mean that you shouldn’t seek treatment for the disease. There are still many things you can do to ease symptoms and improve the quality of life for everyone involved. Most researchers expect to see major progress in the treatment and prevention of Alzheimer’s in the next few decades, providing hope for millions of Americans and their loved ones.