Alzheimer’s disease (AD) is the most common form of dementia (loss of intellectual and social abilities severe enough to interfere with daily functioning). A person with AD experiences progressively increasing impairment of memory, thinking, reasoning, and language. Personality changes can also occur. AD can be inherited, but most cases are not related to inheritance.
What causes AD?
The exact cause or causes are not known. However, medical researchers have determined that about 15-20% of cases of AD appear to be inherited — and other areas of research may soon provide helpful clues. AD research is intensive and ongoing, so hopefully we will soon know more about why AD happens and what may be done to prevent it (see the next question) or to detect it earlier.
Can AD be prevented?
Some medical studies suggest that estrogen, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, and vitamin E may help protect against development of AD. Also, recent research has suggested that the actual changes in the brain that occur at the start of AD — before the person shows signs and symptoms of the disease — may become detectable, making earlier treatment possible. More research is needed, however. Your doctor can tell you whether you might benefit from any preventive measures.
How can the doctor tell if a person has AD?
Because there are many forms of dementia, with overlapping symptoms, the only sure way to diagnose AD has been at autopsy, when brain tissue can be examined under a microscope. Often AD is diagnosed through a process of elimination. Doctors use patients’ medical history, physical examination findings, tests of mental status, and diagnostic tests such as CT or MRI to check for other possible causes of dementia. These include stroke, brain tumors, infections, thyroid and other medical conditions, and psychological problems. If all these are ruled out, AD is then considered as a possible diagnosis.
Is dementia the same thing as senility?
No, because doctors now know there is no such condition as “senility” — mental degeneration that “occurs naturally” as a person ages. In fact, dementia is not a normal part of aging; it is always caused by some underlying condition.
Is there any treatment for AD?
No cure for AD has yet been found. However, drugs are now available that can temporarily improve mental abilities in some people with mild to moderate AD, and more drugs are being studied. Several genes have also been identified as relating to development of AD, and this research may lead to development of gene-based therapies. There is also some early research indicating that estrogen replacement therapy (ERT) may reduce the risk of developing AD in menopausal women; however, more research is needed before ERT can be recommended for AD treatment or prevention.
I’ve been getting more forgetful over the past few months. Could I have AD?
Everyone has occasional memory lapses, so no one should suspect he or she has AD on that basis alone. There are factors besides memory loss that may increase your chances of developing AD. These include being over age 65 (the average age of AD onset is about 80, though the disease can affect people as young as 40), being female (mainly because women tend to live longer than men do, so they “have time” to develop AD), and having family members with AD.