8 Frequently Asked Questions About Alzheimer’s Disease

1. What is the difference between Alzheimer’s disease and dementia?

Alzheimer’s disease is a type of dementia. Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a person’s daily life and activities. Alzheimer’s disease is the most common cause of dementia among older people. Other types of dementia include frontotemporal disorders, Lewy body dementia, and vascular dementia.

2. What are the early signs of Alzheimer’s disease?

Memory problems are typically one of the first signs of Alzheimer’s disease, though different people may have different initial symptoms. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease.

Mild cognitive impairment, or MCI, is a condition that can also be an early sign of Alzheimer’s disease — but not everyone with MCI will develop Alzheimer’s. In addition to memory problems, movement difficulties and problems with the sense of smell have been linked to MCI. If you have MCI, it’s important to see a doctor or specialist regularly to monitor any changes in memory or thinking .

3. What are the stages of Alzheimer’s disease?

Alzheimer’s disease progresses in several stages: preclinical, early (also called mild), middle (moderate), and late (severe). During the preclinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain. A person in the early stage of Alzheimer’s may exhibit the signs listed above.

As Alzheimer’s disease progresses to the middle stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. As Alzheimer’s disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Eventually, they need total care.

4. What are the causes of Alzheimer’s disease?

Scientists do not yet fully understand what causes Alzheimer’s disease in most people. In early-onset Alzheimer’s, which occurs between a person’s 30s and mid-60s, there may be a genetic component. Late-onset Alzheimer’s, which usually develops in a person’s mid-60s, arises from a complex series of age-related brain changes that occur over decades. The causes probably include a mix of these changes, along with genetic, environmental, and lifestyle factors. These factors affect each person differently.

Down syndrome, a genetic condition, increases a person’s risk of developing Alzheimer’s disease. Estimates suggest that 50% or more of people with Down syndrome will develop Alzheimer’s disease and may begin to show symptoms in their 40s.

5. Is Alzheimer’s disease hereditary?

If a family member has alzheimer's disease, will I have it too? infographic icon. Click through for full text.
Read and share this infographic to learn more about how Alzheimer’s disease runs in families.

Just because a family member has Alzheimer’s disease does not mean that you will get it, too. Most cases of Alzheimer’s are late-onset. This form of the disease occurs in a person’s mid-60s and is not linked to a specific genetic mutation. However, genetic factors appear to increase a person’s risk of developing late-onset Alzheimer’s.

Early-onset Alzheimer’s disease, which is rare, can be caused by mutations, or changes, in certain genes. If one of the gene mutations is passed down, the child will usually — but not always — have the disease. For other cases of early-onset Alzheimer’s, research shows other genetic components are involved.

Learn more about assessing risk for Alzheimer’s disease.

6. Is there a cure for Alzheimer’s disease?

Currently, there is no cure for Alzheimer’s disease. Some sources claim that products such as coconut oil or dietary supplements can cure or delay Alzheimer’s. However, there is no scientific evidence to support these claims.

The U.S. Food and Drug Administration (FDA) has approved several drugs to treat people with Alzheimer’s disease, and certain medicines and interventions may help control behavioral symptoms.

Learn more about how Alzheimer’s disease is treated.

Scientists are developing and testing possible new treatments for Alzheimer’s. Learn more about taking part in clinical trials that help scientists learn about the brain in healthy aging and what happens in Alzheimer’s and other dementias. Results of these trials are used to improve diagnosis, treatment, and prevention methods.

7. Is there a way to prevent Alzheimer’s disease?

Currently, there is no definitive evidence about what can prevent Alzheimer’s disease or age-related cognitive decline. What we do know is that a healthy lifestyle — one that includes a healthy diet, physical activity, appropriate weight, and control of high blood pressure — can lower the risk of certain chronic diseases and boost overall health and well-being. Scientists are very interested in the possibility that a healthy lifestyle might delay, slow down, or even prevent Alzheimer’s. They are also studying the role of social activity and intellectual stimulation in Alzheimer’s disease risk.

Learn more about cognitive health and older adults and reducing your risk for Alzheimer’s disease.

8. Where can I find financial help for people with Alzheimer’s disease or their caregivers?

There are several possible sources of financial help, depending on your situation. Looking into programs offered by the government is a great place to start. Several federal and state programs provide help with health care-related costs. Read Paying for Care for information on government programs and other payment sources.

What Is Dementia? Symptoms, Types, and Diagnosis

Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — to such an extent that it interferes with a person’s daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change. 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 living.

Dementia is more common as people grow older (about one-third of all people age 85 or older may have some form of dementia) but it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia.

There are several different forms of dementia, including Alzheimer’s disease. A person’s symptoms can vary depending on the type.

What are the signs and symptoms of dementia?

Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.

The symptoms of dementia can vary and may include:

  • Experiencing memory loss, poor judgment, and confusion
  • Difficulty speaking, understanding and expressing thoughts, or reading and writing
  • Wandering and getting lost in a familiar neighborhood
  • Trouble handling money responsibly and paying bills
  • Repeating questions
  • Using unusual words to refer to familiar objects
  • Taking longer to complete normal daily tasks
  • Losing interest in normal daily activities or events
  • Hallucinating or experiencing delusions or paranoia
  • Acting impulsively
  • Not caring about other people’s feelings
  • Losing balance and problems with movement

People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. It’s important to consider a person’s current abilities and to monitor for changes over time that could signal dementia.

What causes dementia?

The causes of Alzheimer’s and related dementias can vary, depending on the types of brain changes that may be taking place. While research has found that some changes in the brain are linked to certain forms of dementia, in most cases, the underlying causes are unknown. Rare genetic mutations may cause dementia in a relatively small number of people.

Although there is no proven prevention, in general, leading a healthy lifestyle may help reduce risk factors that have been associated with these diseases.

What are the different types of dementia?

Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.

The five most common forms of dementia are:

  • Alzheimer’s disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
  • Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
  • Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
  • Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
  • Mixed dementia, a combination of two or more types of dementia.

What is mixed dementia?

It is common for people with dementia to have more than one form of dementia. For example, many people with dementia have both Alzheimer’s disease and vascular dementia.

Researchers who have conducted autopsy studies have looked at the brains of people who had dementia, and have suggested that most people age 80 and older probably have mixed dementia caused by a combination of brain changes related to Alzheimer’s disease, vascular disease-related processes, or another condition that involves the loss of nerve cell function or structure and nerve cell death (called neurodegeneration).

Scientists are investigating how the underlying disease processes in mixed dementia start and influence each other. Further knowledge gains in this area will help researchers better understand these conditions and develop more personalized prevention and treatment strategies.

Other conditions that cause dementia-like symptoms can be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.

In addition, medical conditions such as stress, anxiety, depression, and delirium can cause serious memory problems that resemble dementia, as can side effects of certain medicines.

Researchers have also identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:

  • Argyrophilic grain disease, a common, late-onset degenerative disease
  • Creutzfeldt-Jakob disease, a rare brain disorder
  • Huntington’s disease, an inherited, progressive brain disease
  • Chronic traumatic encephalopathy, caused by repeated traumatic brain injury
  • HIV-associated dementia, a rare disease that occurs when the HIV virus spreads to the brain

The overlap in symptoms of various dementias can make it difficult to get an accurate diagnosis. But a proper diagnosis is important to get the best treatment.

How is dementia diagnosed?

Doctor studying brain scans

To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.

A review of a person’s medical and family history can provide important clues about risk for dementia. Typical questions might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.

The following procedures also may be used to diagnose dementia:

  • Cognitive and neurological tests. These tests are used to assess thinking and physical functioning. These include assessments of memory, problem solving, language skills, and math skills, as well as balance, sensory response, and reflexes.
  • Brain scans. These tests can identify strokes, tumors, and other problems that can cause dementia. Scans also identify changes in the brain’s structure and function. The most common scans are:
    • Computed tomography (CT), which uses X-rays to produce images of the brain and other organs
    • Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to produce detailed images of body structures, including tissues, organs, bones, and nerves
    • Positron emission tomography (PET), which uses radiation to provide pictures of brain activity
  • Psychiatric evaluation. This evaluation will help determine if depression or another mental health condition is causing or contributing to a person’s symptoms.
  • Genetic tests. Some dementias are caused by a person’s genes. In these cases, a genetic test can help people know if they are at risk for dementia. It is important to talk with a genetic counselor before and after getting tested, along with family members and the doctor.
  • Blood tests. It is now possible for doctors to order a blood test to measure levels of beta-amyloid, a protein that accumulates abnormally in people with Alzheimer’s. Several other blood tests are in development. However, the availability of these diagnostic tests for Alzheimer’s and related dementias is still limited.

Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.

Sometimes, a person with dementia will agree to donate their brain. Brain donation helps researchers study brain disorders, such as Alzheimer’s disease and related dementias, which affect millions of people. By studying the brains of people who have died, researchers learn more about how types of dementia affect the brain and how we might better treat and prevent them. When donating as part of a research study or to the NIH NeuroBioBank, there is no cost to the family for the donation and an autopsy report.

Who can diagnose dementia?

Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists — doctors who specialize in disorders of the brain and nervous system — are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.

If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimer’s Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.

Source: Reference articles from National Institute of Health (NIH), http://www.nia.nih.gov

What Do We Know About Diet and Prevention of Alzheimer’s Disease?

Can eating a specific food or following a particular diet help prevent or delay dementia caused by Alzheimer’s disease? Many studies suggest that what we eat affects the aging brain’s ability to think and remember. These findings have led to research on general eating patterns and whether they might make a difference.

The Mediterranean diet, the related MIND diet (which includes elements designed to lower blood pressure), and other healthy eating patterns have been associated with cognitive benefits in studies, though the evidence is not as strong as it is for other interventions like physical activity, blood pressure and cognitive training. Currently, researchers are more rigorously testing these diets to see if they can prevent or delay Alzheimer’s disease or age-related cognitive decline.

older woman and man cooking

Diet and Dementia Risk

Changes in the brain can occur years before the first symptoms of Alzheimer’s appear. These early brain changes suggest a possible window of opportunity to prevent or delay dementia symptoms. Scientists are looking at many possible ways to do this, including drugs, lifestyle changes and combinations of these interventions. Unlike other risk factors for Alzheimer’s that we can’t change, such as age and genetics, people can control lifestyle choices such as diet, exercise and cognitive training.

How could what we eat affect our brains? It’s possible that eating a certain diet affects biological mechanisms, such as oxidative stress and inflammation, that underlie Alzheimer’s. Or perhaps diet works indirectly by affecting other Alzheimer’s risk factors, such as diabetes, obesity and heart disease. A new avenue of research focuses on the relationship between gut microbes — tiny organisms in the digestive system — and aging-related processes that lead to Alzheimer’s.

The Mediterranean and MIND Diets and Alzheimer’s

One diet that shows some promising evidence is the Mediterranean diet, which emphasizes fruits, vegetables, whole grains, legumes, fish, and other seafood; unsaturated fats such as olive oils; and low amounts of red meat, eggs, and sweets. A variation of this, called MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay) incorporates the DASH (Dietary Approaches to Stop Hypertension) diet, which has been shown to lower high blood pressure, a risk factor for Alzheimer’s disease.

Ingredients of the MIND Diet

The MIND diet focuses on plant-based foods linked to dementia prevention. It encourages eating from 10 healthy food groups:

  • Leafy green vegetables, at least 6 servings/week
  • Other vegetables, at least 1 serving/day
  • Berries, at least 2 servings/week
  • Whole grains, at least 3 servings/day
  • Fish, 1 serving/week
  • Poultry, 2 servings/week
  • Beans, 3 servings/week
  • Nuts, 5 servings/week
  • Wine, 1 glass/day*
  • Olive oil

The MIND diet limits servings of red meat, sweets, cheese, butter/margarine and fast/fried food.

*Be careful about how much alcohol you drink. How the body handles alcohol can change with age. Learn more about alcohol and older adults.

Some, but not all, observational studies — those in which individuals are observed or certain outcomes are measured, without treatment — have shown that the Mediterranean diet is associated with a lower risk for dementia. These studies compared cognitively normal people who ate a Mediterranean diet with those who ate a Western-style diet, which contains more red meat, saturated fats and sugar.

Evidence supporting the MIND diet comes from observational studies of more than 900 dementia-free older adults, which found that closely following the MIND diet was associated with a reduced risk of Alzheimer’s disease and a slower rate of cognitive decline.

Not all studies have shown a link between eating well and a boost in cognition. Overall, the evidence suggests, but does not prove, that following a Mediterranean or similar diet might help reduce the risk for Alzheimer’s dementia or slow cognitive decline. To find out more, scientists supported by NIA and other organizations are conducting clinical trials—considered the gold standard of medical proof—to shed more light on any cause and effect. (See a list of trials currently recruiting participants at the end of this article.)

salmon with vegetables

While scientists aren’t sure yet why the Mediterranean diet might help the brain, its effect on improving cardiovascular health might in turn reduce dementia risk. Two recent studies suggest that, as part of this diet, eating fish may be the strongest factor influencing higher cognitive function and slower cognitive decline. In contrast, the typical Western diet increases cardiovascular disease risk, possibly contributing to faster brain aging.

In addition, the Mediterranean diet might increase specific nutrients that may protect the brain through anti-inflammatory and antioxidant properties. It may also inhibit beta-amyloid deposits, which are found in the brains of people with Alzheimer’s or improve cellular metabolism in ways that protect against the disease.

A Look at the Evidence

Studies that observed changes in thinking of people who ate the Mediterranean or MIND diet suggest it might help the brain. For example:

  • In one observational study of 116 cognitively normal adults, those who followed a Mediterranean diet had thicker cortical brain regions than those who did not. These brain regions shrink in people with Alzheimer’s, so having thicker regions could mean cognitive benefit.
  • A follow-up observational study showed lower glucose metabolism and higher levels of beta-amyloid protein — both seen in Alzheimer’s — in people who did not follow the Mediterranean diet closely, compared to those who did.
  • An analysis of diet and other factors found that, after an average of 4.5 years, people who adhered most closely to the MIND diet had a 53% reduced rate of Alzheimer’s disease compared to those who did not follow the diet closely.
  • In a similar study, following the MIND diet was associated with a substantial slowing of cognitive decline during an average of almost 5 years.
    The Age-Related Eye Disease Studies originally looked at diet and eye disease. Further analysis by the researchers showed that people who followed the Mediterranean-style diet had a lower risk of developing cognitive problems while maintaining a higher level of cognitive function.

What Do We Know About Individual Foods?

Many foods — blueberries, leafy greens, and curcumin (found in the spice turmeric), to name a few — have been studied for their potential cognitive benefit. These foods were thought to have anti-inflammatory, antioxidant or other properties that might help protect the brain. So far, there is no evidence that eating or avoiding a specific food can prevent Alzheimer’s disease or age-related cognitive decline.

But scientists continue to look for clues. One study, based on older adults’ reports of their eating habits, found that eating a daily serving of leafy green vegetables such as spinach and kale was associated with slower age-related cognitive decline, perhaps due to the neuroprotective effects of certain nutrients. Research has also shown that eating a diet that includes regular fish consumption is associated with higher cognitive function and slower cognitive decline with age. Another recent study, in mice, found that consuming a lot of salt increased levels of the protein tau, found in the brains of people with Alzheimer’s, and caused cognitive impairment.

What About Vitamins and Supplements?

Observational studies and clinical trials have looked at many over-the-counter vitamins and dietary supplements, including vitamins B and E and gingko biloba, to prevent Alzheimer’s disease or cognitive decline. The idea is that these dietary add-ons might attack oxidative damage or inflammation, protect nerve cells, or influence other biological processes involved in Alzheimer’s.

Despite early findings of possible benefits for brain health, no vitamin or supplement has been proven to work in people. Overall, evidence is weak as many studies were too small or too short to be conclusive.

Take DHA (docosahexaenoic acid) for example. Studies in mice showed that this omega-3 fatty acid, found in salmon and certain other fish, reduced beta-amyloid plaques, a hallmark of Alzheimer’s. However, clinical trials in humans have had mixed results. In a study of 485 older adults with age-related cognitive decline, those who took a DHA supplement daily for 24 weeks showed improved learning and memory, compared to those who took a placebo. Another study of 4,000 older adults — conducted primarily to study eye disease — concluded that taking omega-3 supplements, alone or with other supplements, did not slow cognitive decline.

At this time, no vitamin or supplement is recommended for preventing Alzheimer’s or cognitive decline. Although widely available from drugstores and on the internet, many of these have not been tested for their effects on thinking. Their safety and effectiveness are largely unknown, and they may interact with other medications. (Note: A deficiency in vitamin B12 or folate may cause memory problems that are reversible with proper treatment.)

For more information, visit the National Center for Complementary and Integrative Health and the U.S. Food and Drug Administration.

The Connection Between the Digestive System and the Brain

Researchers are learning how the biochemical processes of food intake and digestion interact with changes in the brain. They are finding that the gut microbiome — the community of viruses, bacteria and other microbes in the digestive system — may influence the onset and progression of Alzheimer’s disease.
Studies in mice and humans show that the composition of the gut microbiome in Alzheimer’s and mild cognitive impairment is different from that in cognitively normal beings.
Changes in the gut microbiome as people age have been linked to disruptions in the immune system, persistent inflammation and chronic diseases, including neurological disorders such as Alzheimer’s. Researchers are exploring how these changes are related to each other and to brain changes related to Alzheimer’s, including neurodegeneration and the accumulation of toxic proteins beta-amyloid and tau.
Identifying the good and bad gut microbes associated with Alzheimer’s could help scientists learn more about the biology of the disease and develop a new way to predict and potentially treat it.

Researchers Continue to Seek Answers

The idea of Alzheimer’s as a metabolic disease that affects the brain, and Alzheimer’s markers such as glucose metabolism, have led scientists in various directions. Besides the Mediterranean diet and its variations, they are looking at other diets as well as individual foods and nutrients.

For example, the ketogenic diet is a high-fat, low-carbohydrate diet that prompts the production of ketones, chemicals that help brain cells work. Studies show that this diet may affect gut bacteria in distinctive ways in people with and without cognitive impairment, and may help brain cells better use energy, improving their overall function.

Researchers are seeking answers to these questions:

  • Which foods are critical to brain health and should be included in diet-based interventions?
  • Which groups of people are most likely to benefit from dietary interventions targeting prevention of dementia and cognitive decline?
  • Can dietary interventions introduced in midlife lead to better outcomes?

What Are the Early Signs of Dementia?

Confusion, memory loss, and personality changes are just a few of the early signs that a person has dementia, an umbrella term describing the symptoms of several different brain disorders that can interfere with one’s ability to live independently.

Depending on the cause, sometimes dementia symptoms are treatable, but, in other cases, they are permanent or progressive. This is why early detection of cognitive decline is important. The right medical treatment might reverse or relieve symptoms.

What to Know About Dementia

Here’s what you should know about about dementia signs, symptoms, causes, and coping:

  • Dementia is a catchall term to describe the symptoms of the group of brain disorders associated with cognitive decline.
  • Types of dementia include Alzheimer’s, vascular dementia, Lewy body dementia, and frontotemporal dementia.
  • Early signs of dementia include trouble remembering newly-learned information, misplacing items, trouble reasoning, and poor judgment.
  • Conditions linked to dementia include traumatic brain injury, Parkinson’s disease, Creutzfeldt-Jakob disease, and Huntington’s disease. 
  • Development of dementia symptoms increases with age, but people of all ages can experience them, depending on the cause. 
  • Some conditions associated with dementia-like symptoms are treatable or reversible, such as brain tumors, nutritional deficiencies, thyroid problems, and immune disorders.
  • Diet and exercise, managing cardiovascular health, and refraining from drinking and smoking, are some steps people can take to maintain their cognitive health.

Women May Have Faster Cognitive Decline in Old Age

Dementia Signs and Symptoms

A long list of symptoms is associated with dementia, but many overlap with other health conditions, meaning that having some of them does not confirm that an individual is cognitively impaired.

That said, don’t hesitate to consult a healthcare provider if you or a loved one is showing signs of dementia, which can be cognitive or psychological in nature:

  • Trouble remembering new information
  • Confusion, particularly related to time or place
  • Disorientation
  • Changes in mood or personality 
  • Getting easily irritated
  • Growing depressed and withdrawn
  • Trouble problem-solving
  • Trouble completing tasks
  • Trouble organizing
  • Increased anxiety
  • Trouble communicating (in verbal or written form)
  • Trouble with physical coordination 
  • Getting lost, especially on one’s way to familiar places
  • Routinely misplacing commonly-used items
  • Exhibiting signs of paranoia
  • Exercising poor judgment

Not everyone will notice these symptoms right away, and a checklist alone can’t determine if a person has a dementia-related disorder. In fact, not even a test can do so.

Diagnosis

To make a diagnosis, a physician such as a neurologist, geriatrician, or mental health professional will complete a comprehensive evaluation that includes a physical exam, a review of one’s medical history, blood tests, and assessments related to behavior and overall functionality.

Identifying dementia early might not only alleviate symptoms but also give patients the opportunity to participate in clinical drug trials and plan for life in the future.

Common Causes of Dementia

Medical intervention for dementia or dementia-like symptoms depends on the source of the problem. Although it’s widely believed that such conditions solely affect the elderly, that’s inaccurate.

People of any age can experience these symptoms because the causes are related to a variety of health conditions—from traumatic brain injury to Alzheimer’s disease.  

Alzheimer’s Disease

Alzheimer’s disease is arguably the most widely-known form of dementia and it is also the most common cause, representing 60% to 80% of dementia-related diagnoses, according to the Alzheimer’s Association.1

Although increased age heightens one’s risk of developing Alzheimer’s disease, 200,000 people living with the disease are younger than age 65.2 These individuals have what’s known as early-onset Alzheimer’s or younger-onset Alzheimer’s. One of the first signs people with Alzheimer’s disease (early-onset or otherwise) report having is trouble recalling information they’ve recently learned.3 This occurs because Alzheimer’s compromises part of the brain involved in learning processes.

Unfortunately, Alzheimer’s is a progressive condition, meaning that symptoms will worsen over time, but medical treatment can help manage them.  

Other Types of Dementia

Other progressive forms of dementia include frontotemporal dementia, Lewy body dementia, and vascular dementia—and it’s also possible to have a combination of dementia types.4

Frontotemporal Dementia

With frontotemporal dementia, nerve cells in the parts of the brain involved in behavior, communication, and personality begin to degenerate. Thus, people with this condition typically have symptoms that impact how they behave, reason, or communicate. Movement is also affected. 

Lewy Body Dementia

In Lewy body dementia, wads of protein accumulate in the brain. These proteins can also be found in patients with Parkinson’s and Alzheimer’s diseases. People with this form of dementia might hallucinate, have trouble concentrating, or experience difficulty with physical coordination and movement.

Vascular Dementia

Vascular dementia is second only to Alzheimer’s in its prevalence in people with dementia. It occurs as a result of problems with the blood vessels that involve the brain. While people with this form of dementia may have difficulty with recall, their most obvious symptoms are likely to be trouble with organization, reasoning, concentration, and thinking quickly.  

Conditions Linked to Dementia

Several other medical conditions have been implicated in dementia diagnoses.5 They include (the previously mentioned) traumatic brain injury and Parkinson’s disease as well as Creutzfeldt-Jakob disease and Huntington’s disease. People with these disorders have dementia-like symptoms or go on to develop a form of dementia. 

Traumatic Brain Injury

Traumatic brain injury, which develops after repeat head trauma, is common in athletes who have played aggressive contact sports such as football, rugby, or boxing, but these injuries can also occur in sports such as volleyball, cheerleading, or water polo. If certain parts of the brain are injured, dementia may subsequently develop.

Symptoms of traumatic brain injury include memory loss, difficulty communicating, depression, and rage.

Parkinson’s Disease

It is also possible for symptoms related to Parkinson’s disease, which is caused by nerve cell damage in the brain, to form. People with Parkinson’s often suffer from tremors, move slowly, and have trouble with balance and coordination. It is common for people with Parkinson’s to go on to experience dementia symptoms.

Creutzfeldt-Jakob Disease

Creutzfeldt-Jakob disease is a heritable disease characterized by the accumulation of proteins known as prions. It is a fatal condition that occurs very rarely. In addition to genetic predisposition, this illness can develop after exposure to infected nervous system tissue during a transplant.

In cattle, it is widely known as mad cow disease, which humans can contract from eating contaminated meat. Signs include confusion, disorientation, depression, coordination problems, and difficulty speaking and concentrating. 

Huntington’s Disease

Huntington’s disease is an inherited disorder in which nerve cells in the brain deteriorate. Symptoms include forgetfulness, depression, difficulty communicating and difficulty with physical movement. This condition typically appears in one’s 30s or 40s.

While traumatic brain injury, Parkinson’s, Creutzfeldt-Jakob, and Huntington’s diseases are not reversible, a number of other conditions associated with dementia are. Having a brain tumor, nutritional deficiency, thyroid problem, or immune disorder are just a few examples of conditions that can cause dementia-like symptoms to develop that can be medically treated and reversed.

Preventing Cognitive Decline

Many causes of dementia are genetic and the likelihood of exhibiting signs increases with age, but experts still recommend that people do what they can to reduce the odds of experiencing symptoms.

Abstaining from excessive drinking and smoking (in any quantity), managing conditions such as hypertension and diabetes, and eating well and exercising are among many steps the public can take to stay on top of their cognitive health. 

Author: Nadra Nittle, Updated on April 24, 2021, Medically reviewed by Huma Sheikh, MD

Can Alzheimer’s Disease Be Prevented?

Original author: alz.org,

Researchers around the globe are exploring how to prevent Alzheimer’s. While Alzheimer’s prevention has no definitive answers at this time, research has shown that we can take action to reduce our risk of developing it.

What causes Alzheimer’s?

Experts agree that in the vast majority of cases, Alzheimer’s, like other common chronic conditions, probably develops as a result of complex interactions among multiple factors, including age, genetics, environment, lifestyle and coexisting medical conditions. Although some risk factors — such as age or genes — cannot be changed, other risk factors — such as high blood pressure and lack of exercise — usually can be changed to help reduce risk. Research in these areas may lead to new ways to detect those at highest risk.

Prevention studies

A small percentage of people with Alzheimer’s disease (less than 1%) have an early-onset type associated with genetic mutations. Individuals who have these genetic mutations are guaranteed to develop the disease. An ongoing clinical trial conducted by the Dominantly Inherited Alzheimer Network (DIAN), is testing whether antibodies to beta-amyloid can reduce the accumulation of beta-amyloid plaque in the brains of people with such genetic mutations and thereby reduce, delay or prevent Alzheimer’s symptoms. Participants in the trial are receiving antibodies (or placebo) before they develop symptoms, and the development of beta-amyloid plaques is being monitored by brain scans and other tests.

Another clinical trial, known as the A4 trial (Anti-Amyloid Treatment in Asymptomatic Alzheimer’s), is testing whether antibodies to beta-amyloid can reduce the risk of Alzheimer’s disease in older people (ages 65 to 85) at high risk for the disease. The A4 trial is being conducted by the Alzheimer’s Disease Cooperative Study.

Though research is still evolving, evidence is strong that people can reduce their risk by making key lifestyle changes, including participating in regular activity and maintaining good heart health. Based on this research, the Alzheimer’s Association offers 10 Ways to Love Your Brain — a collection of tips that can reduce the risk of cognitive decline.

Heart–head connection

Several conditions known to increase the risk of cardiovascular disease — such as high blood pressure, diabetes and high cholesterol — also increase the risk of developing Alzheimer’s. Some autopsy studies show that as many as 80% of individuals with Alzheimer’s disease also have cardiovascular disease.

A longstanding question is why some people develop hallmark Alzheimer’s plaques and tangles but do not develop the symptoms of Alzheimer’s. Vascular disease may help researchers eventually find an answer. Some autopsy studies suggest that plaques and tangles may be present in the brain without causing symptoms of cognitive decline unless the brain also shows evidence of vascular disease. More research is needed to better understand the link between vascular health and Alzheimer’s.

Physical exercise and diet

Regular physical exercise may be a beneficial strategy to lower the risk of Alzheimer’s and vascular dementia. Exercise may directly benefit brain cells by increasing blood and oxygen flow in the brain. Because of its known cardiovascular benefits, a medically approved exercise program is a valuable part of any overall wellness plan.

Current evidence suggests that heart-healthy eating may also help protect the brain. Heart-healthy eating includes limiting the intake of sugar and saturated fats and making sure to eat plenty of fruits, vegetables, and whole grains. No one diet is best. Two diets that have been studied and may be beneficial to lowering the risk of Alzheimer’s are the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet.

  • The DASH diet emphasizes vegetables, fruits, fat-free or low-fat dairy products, whole grains, fish, poultry, beans, seeds, nuts and vegetable oils. The DASH diet limits sodium, sweets, sugary beverages and red meats.
  • A Mediterranean diet includes relatively little red meat. It emphasizes whole grains, fruits and vegetables, fish and shellfish, and healthy fats like nuts and olive oil.

Social connections and intellectual activity

A number of studies indicate that maintaining strong social connections and keeping mentally active as we age might lower the risk of cognitive decline and Alzheimer’s. Experts are not certain about the reason for this association. It may be due to direct mechanisms through which social and mental stimulation strengthen connections between nerve cells in the brain.

Head trauma

There appears to be a strong link between future risk of cognitive decline and serious head trauma, especially when injury involves loss of consciousness. You can help reduce your risk of Alzheimer’s and protect your head by:

  • Wearing a seat belt.
  • Using a helmet when participating in sports.
  • “Fall-proofing” your home by minimizing clutter, loose rugs and poor lighting.

What you can do now

While research is not yet conclusive — partially due to the need for more large-scale studies in diverse populations — certain lifestyle choices, such as physical activity and diet, may help support brain health and prevent Alzheimer’s. Many of these lifestyle changes have been shown to lower the risk of other diseases, like heart disease and diabetes, which have been linked to Alzheimer’s. With few drawbacks and plenty of known benefits, healthy lifestyle choices can improve your health and possibly protect your brain.

In addition, taking care of your health now may help improve your outcomes in the long term, such as reducing your risk for Alzheimer’s and dementia. Research released at the Alzheimer’s Association International Conference 2020 suggests flu and pneumonia vaccination—especially multiple vaccinations over time—is associated with a lower risk of Alzheimer’s in later life. While it is too early to tell if getting a flu vaccination on its own can reduce risk of Alzheimer’s, this paves the way for future studies to explore why vaccinations may be protective.

Understanding prevention research

Here are some things to keep in mind about the research underlying much of our current knowledge about possible prevention:

  • Insights about potentially modifiable risk factors apply to large population groups, not to individuals. Studies can show that factor X is associated with outcome Y, but cannot guarantee that any specific person will have that outcome. As a result, you can “do everything right” and still have a serious health problem or “do everything wrong” and live to be 100.
  • Much of our current evidence comes from large epidemiological studies such as the Honolulu-Asia Aging Study, the Nurses’ Health Study, the Adult Changes in Thought Study and the Kungsholmen Project. These studies explore pre-existing behaviors and use statistical methods to relate those behaviors to health outcomes. This type of study can show an “association” between a factor and an outcome but cannot “prove” cause and effect. This is why we describe evidence based on these studies with such language as “suggests,” “may show,” “might protect,” and “is associated with.”
  • The gold standard for showing cause and effect is a clinical trial in which participants are randomly assigned to a prevention or risk management strategy or a control group. Researchers follow the two groups over time to see if their outcomes differ significantly.
  • It is unlikely that some prevention or risk management strategies will ever be tested in randomized trials for ethical or practical reasons. One example is exercise. Definitively testing the impact of exercise on Alzheimer’s risk would require a huge trial enrolling thousands of people and following them for many years. The expense and logistics of such a trial would be prohibitive, and it would require some people to go without exercise, a known health benefit.

Coping With Early-Onset Alzheimer’s Disease

Alzheimer’s disease is a brain condition that causes memory loss and confusion. It also affects your behavior. 

While it commonly affects older adults above the age of 60, roughly 10% of all people with Alzheimer’s start to experience symptoms in their 30s or 40s, which is referred to as early-onset or young-onset Alzheimer’s disease.1

Alzheimer’s is a progressive, irreversible condition, which means it gets worse over time and cannot be cured. As it progresses, it can make daily living activities and interacting with others difficult. However, medication can help with the symptoms and slow down the disease’s progression.

“It can be difficult to cope with Alzheimer’s at any age, but particularly with early-onset because people understandably don’t expect it to happen so early,” says Richard Marottoli, MD, MPH, a physician at Yale Medicine who specializes in treating Alzheimer’s disease.

How to Cope With Your Emotions

Being diagnosed with early-onset Alzheimer’s disease can be distressing for you and your loved ones.

The key is to get help, first with the practical aspects, but also with the emotional aspects. Counseling can help you cope emotionally.— RICHARD MAROTTOLI, MD, MPH

Counseling can help with:

  • Accepting the diagnosis: Being diagnosed with a terminal illness at an early age can cause you to experience a range of emotions, such as shock, numbness, anger, disbelief, grief, and fear. Counseling can help you cope with these emotions and accept the diagnosis.
  • Planning for the future: It’s critical to plan for the later stages of the disease and beyond, and make arrangements. Counseling can provide the support you need while you get your affairs in order.
  • Adjusting your expectations: Alzheimer’s disease can make it harder to do things that you were once able to do with ease. This can cause shame and embarrassment and you may find yourself hiding these incidents from loved ones. Counseling can help you adjust your expectations and focus on your abilities rather than your disabilities.
  • Offering different perspectives: Alzheimer’s disease can alter your perception of yourself and your relationships with your loved ones. Counseling can provide different perspectives and help you maintain a positive outlook.
  • Managing symptoms: Counseling can help manage some of the cognitive and behavioral symptoms of Alzheimer’s disease. You may also find complementary practices such as Tai chi and brain exercises such as puzzles helpful.

Counseling can also be helpful to your loved ones. “Early-onset Alzheimer’s can be hard on the patient, but particularly hard on the family–the partner may or may not be working and depending on how early the onset, there may be relatively young children, who may have a very difficult time adjusting,” says Marottoli.

How to Cope With Your Physical Health

Alzheimer’s disease causes your health to deteriorate. These are some strategies that can help you cope physically:

  • Get regular health check-ups: Seeing your healthcare provider regularly to evaluate the progression of your condition, discuss your symptoms, adjust your medication, and check for other health conditions can help ensure that you’re getting the appropriate treatment.
  • Get your flu shots: Alzheimer’s disease can make you more susceptible to pneumonia and the flu. Taking your flu shots regularly can help prevent you from falling ill.
  • Take medication as prescribed: Taking your medication consistently and reporting any side effects to your healthcare provider can help you manage symptoms. 
  • Stay active: Marottoli recommends staying as socially engaged and physically and mentally active as possible.
  • Follow a healthy lifestyle: Maintain a healthy lifestyle, exercise regularly, and follow a balanced, healthy diet such as the Mediterranean diet, says Marottoli.
  • Take steps to prevent falls: Alzheimer’s disease can make you more prone to falling and injuring yourself. Clearing any clutter from the floor, avoiding loose clothing that can trip you up, wearing sturdy shoes, and leaving a light on at night can help prevent falls.

Can You Spot the Early Signs of Dementia?

How to Maintain Social Relationships

It’s important to involve close family and friends in your journey, for emotional and practical support, but also to minimize social isolation and allow you to remain active and engaged, even if the nature of your participation in activities has to change over time, says Marottoli.

For instance, Marottoli says an avid tennis player may no longer be able to keep score, but may still enjoy playing without the element of scoring, or switching to a different activity like walking, if eye-hand coordination deteriorates over time.

Resources & Organizations

Marottoli lists organizations that can offer resources and support for people with early-onset Alzheimer’s:

  • Alzheimer’s Association: The Alzheimer’s Association is an excellent resource to identify what’s available in your community. They also often have early-onset support groups, both for patients and families so that you can talk to other people undergoing similar things at a comparable stage in life. The other thing that’s important at any age, but particularly for early-onset, is to get financial and legal help with estate issues and determining how to access things like disability insurance or social security disability. The Alzheimer’s Association may be able to help with this too.
  • School counseling services: If your children are still in school, their school may have counseling services and resources to help them deal with related issues.
  • Local Alzheimer’s disease research centers: Because early-onset individuals often have fewer comorbid illnesses than late-onset individuals, it’s worth contacting a local Alzheimer’s disease research center or academic medical center to find out about clinical trials, as there are new treatment agents coming along.

How to Find a Support Group Meeting Near You

Caring for Someone Who Has Alzheimer’s

If you are caring for a person with Alzheimer’s disease, here are some strategies that can be helpful:

  • Set reminders: Alzheimer’s disease can make the person forgetful, so it can be helpful to set reminders on their phone for important tasks, like taking medication.
  • Maintain a fixed routine: Sticking to a fixed daily routine can help the person know what to expect at each time of day and prevent confusion or anxiety.
  • Budget plenty of time: As the condition progresses, daily tasks like showering, getting dressed, and eating can take longer, so it’s important to plan and keep plenty of time on hand.
  • Offer reassurance: Make it a point to offer comfort and reassurance and let the person know you’re available to help.
  • Speak simply: Speak to the person in words that are easy to understand and say or ask one thing at a time.
  • Avoid arguing: Try not to argue or reason with the person and avoid showing them your anger or frustration. If you’re upset, leave the room for a few minutes to calm down, provided it’s safe to leave the person.
  • Use distraction tactics: Use humor, singing, dancing, and music to distract the person.
  • Ask for their help: Ask the person for help with simple tasks, like setting the table or folding clothes, to keep them involved and engaged. 
  • Focus on safety: The home environment and daily activities can be hazardous for people with Alzheimer’s. Ensure that all the windows are locked and sharp objects or dangerous items are kept out of reach.
  • Look for other explanations for behavior: If the person is upset or aggravated, they may be upset about something else and unable to communicate it. Looking for other causes can help explain their behavior.
  • Report symptoms to their healthcare provider: As Alzheimer’s progresses, the person may experience paranoia, mood swings, anger, and aggression. They may also bite or hit caregivers. Their healthcare provider may be able to prescribe medication that can help with these symptoms.
  • Make the most of your time with them: If you’re caring for a loved one, enjoy your time with them and maintain a positive outlook.

In order to care for someone with Alzheimer’s, it’s important to take care of your own physical and emotional health, says Marottoli. He recommends being realistic about your own abilities and limitations and asking for help when you need it.

Author: Sanjana Gupta, Updated on October 18, 2021, Medically reviewed by Huma Sheikh, MD