Alzheimer’s Disease 101

Alzheimer's disease is not a normal part of aging. It’s a brain disorder that gets worse over time. The disease causes cognitive decline by slowly destroying brain cells responsible for learning, thinking, paying attention and remembering. Eventually, Alzheimer’s disease leads to the inability to do simple, everyday tasks like eating or bathing.

Although research is ongoing as to the direct cause of Alzheimer’s disease, studies show the build up of abnormal proteins in the brain, called amyloid plaques and tau tangles, are associated with the disease and can be detected up to 20 years before symptoms start.

There are different stages of Alzheimer’s disease and symptoms of Alzheimer’s disease advance slowly over many years.

The most common symptom of Alzheimer’s disease in its earlier stages is mild memory loss that disrupts everyday life, such as misplacing items, forgetting names and asking the same questions repetitively. Changes in behavior, like not wanting to see friends or family or withdrawing from social events, are also symptoms of Alzheimer’s disease in its earlier stages.

The earlier stages of Alzheimer’s disease include:

Cognitively unimpaired Alzheimer’s disease: No noticeable cognitive symptoms, but biological changes in the brain may be present.

Early-stage Alzheimer’s with mild cognitive impairment (MCI): Memory loss can be noticeable, but independent living (the ability to do household chores, driving, keeping up with personal care) is still possible. Help may be needed for complicated tasks like managing medications and finances.

Early-stage Alzheimer’s with mild dementia: Changes in cognitive function and behavior start to affect everyday life. Help may be needed for activities of daily functioning. Common symptoms of early-stage Alzheimer’s with mild dementia include difficulty finding the right words, frequent memory lapses, and misplacing or losing items more frequently.

As Alzheimer’s progresses into its moderate stages, damage to nerve cells in the brain makes it difficult to communicate thoughts and feelings and perform everyday activities without help.

Other symptoms of Alzheimer’s in its moderate stages can include:

• Forgetting events or personal details like address or phone number
• Personality changes such as becoming suspicious or delusional
• Compulsive, repetitive behaviors such as tissue shredding or hand-wringing
• Needing assistance with proper clothing for an event or season
• Problems with bladder and bowel control
• Changes in sleep patterns, such as sleeping during the day and being restless at night
• Wandering or getting lost

In the later stages of Alzheimer’s disease, mental and physical symptoms advance and become severe. During this time, functions like communicating, walking, eating and swallowing may become difficult or impossible. Eventually, people with later-stage Alzheimer’s disease can no longer care for themselves and need 24-hour care.

Although research is ongoing as to the direct cause of Alzheimer’s disease, there are multiple factors that can increase the risk for the disease.

Risk factors for Alzheimer’s disease include:

• Older age (the risk doubles every five years after age 65)
• Having a head injury or history of head injuries
• Having high blood pressure, Type 2 diabetes and/or cardiovascular disease
• Testing positive for the apolipoprotein E (APOE) e4 gene
• Having a family history of Alzheimer’s disease

The risk for Alzheimer’s disease goes up if you have a parent or sibling with the disease compared to people who don’t have an immediate family member with the disease. This is especially important to note for women considering 1 in 3 women reported a family history of Alzheimer’s disease or dementia, according to a recent survey conducted by HealthyWomen.

Read: New Survey Finds 90% of Midlife Women Are Open to Early Alzheimer’s Testing, But Only 9% Say Their Providers Are Bringing Up Cognitive Health >>

Clinicians use a combination of different tests and medical information to help diagnose Alzheimer’s disease. The diagnosis process can include:

• Going over your medical history
• Physical exams
• Neurological exams
• Mental status and cognitive testing
• Brain imaging
• Lumbar puncture (also called a spinal tap)
• Blood, urine or other standard medical tests that can help identify other possible causes of your symptoms

Blood tests for Alzheimer’s disease are among the most recent advancements in detection and diagnosis for the disease.

Today, there are four blood tests cleared by the FDA to help detect recognized markers of Alzheimer’s disease, such as beta-amyloid proteins and phosphorylated tau (p-tau) proteins. These blood tests can’t diagnose Alzheimer’s disease on their own but can be part of the process to help rule out or diagnose the disease in people who are showing symptoms of cognitive decline.

Curious? You’re not alone. Our survey found 9 out of 10 women were open to a blood test to help diagnose Alzheimer’s disease early.

Read: New Blood Tests for Alzheimer’s Can Help Diagnose the Disease >>

Although there currently is no cure for Alzheimer’s disease, there are two categories of FDA-approved medications for Alzheimer’s disease: drugs that are actively monitored for safety and/or side effects. They are used in the earlier stages of the disease to help slow progression and medications that help temporarily ease symptoms.

For earlier stages: Anti-amyloid drugs remove beta-amyloids — proteins that form plaques in the brain that cause cells to die.

• Donanemab (Brand name: Kisunla)
• Lecanemab (Brand name: Leqembi)

For management of cognitive symptoms: These medications help with memory, thinking and performing everyday tasks.

• Cholinesterase inhibitors
• Glutamate regulators
• Combination cholinesterase inhibitor and glutamate regulator

Because symptoms vary from person to person, other medications may be prescribed for insomnia, mood, behavioral changes and other health problems.

The best offense is a good defense when it comes to your brain health. Research shows about 45% of all dementia cases may be delayed or prevented, so small changes can make a big difference.

Talk to your clinician about any risk factors you have and whether a blood test or screening for Alzheimer’s disease is something you should consider. And be proactive: In our survey, only about 1 in 10 women reported having a conversation with their clinician about Alzheimer’s disease screening even though more than 9 out of 10 acknowledged that an early diagnosis would give them more time to explore treatment options.

In addition to talking to your clinician, lifestyle choices can have a big impact on your brain.

Some ways you can help lower the risk for Alzheimer’s disease:

• Get regular exercise (150 minutes a week)
• Manage or prevent high blood sugar levels
• Manage stress and blood pressure levels
• Prevent or correct any hearing loss
• Limit alcohol use
• Don’t smoke or quit smoking
• Limit sugar, ultraprocessed foods and unhealthy fats
• Engage in activities that stimulate your brain, like doing puzzles or taking up a new hobby
• Maintain social relationships

Read: Why Brain Health Matters >>

Diagnosis and treatment of Alzheimer’s disease have come a long way. There’s no time like the present to be proactive about your brain health.

Alzheimer’s Association

American Academy of Neurology

HealthyWomen Brain Health Hub

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