We’re just going to go ahead and state the obvious: Alzheimer’s disease is terrible, and no one should ever have to deal with it. Whether you fear a loved one is showing signs of Alzheimer’s or they’ve received a diagnosis, you may be confused, scared, and not sure what to expect. Here, we’ve rounded up 10 essential facts about Alzheimer’s disease to offer some understanding of what the condition entails.
1. Alzheimer’s disease is an irreversible, progressive condition that destroys a person’s memory and other important mental (and eventually physical) functions.
If someone has Alzheimer’s, they typically experience mild confusion and difficulty remembering things to start, but eventually they may forget important people in their lives, undergo dramatic personality changes, have trouble planning, communicating, and making safe decisions, and need full-time care.
2. Alzheimer’s progresses through five stages, and the first one doesn’t cause any symptoms at all.
This first stage is called preclinical Alzheimer’s disease, according to the Mayo Clinic. People in this stage don’t exhibit any outward symptoms of the condition, but they are undergoing brain changes that will induce signs of Alzheimer’s down the line. Although symptoms aren’t apparent at this point, experts are working on developing innovative brain imaging technology that might be able to pick up on signs of the condition at this stage.
After preclinical Alzheimer’s, which can last for years, a person develops what’s called mild cognitive impairment due to Alzheimer’s disease. This involves confusion, trouble making decisions, and issues remembering things such as recent conversations or upcoming appointments, but not at a severe enough level for it to really affect a person’s job or relationships, the Mayo Clinic explains. (Of course, these symptoms aren’t always a sign of Alzheimer’s—we’ll discuss that a bit more down below.)
The following phase is mild dementia due to Alzheimer’s disease. This is when symptoms become apparent enough that they often lead to an Alzheimer’s diagnosis, the Mayo Clinic notes. At this point, Alzheimer’s is affecting a person’s day-to-day life with symptoms such as noticeable short-term memory loss, trouble with problem-solving, poor decision-making, mood changes, losing items, getting lost themselves (even in familiar locations), and having a hard time expressing themselves. This can translate into the person asking the same question repeatedly because they forget the answer, a difficult time handling what used to be manageable responsibilities (like tracking their budget), and irritability or anger as their world begins to shift in confounding ways.
This eventually progresses into moderate dementia due to Alzheimer’s disease, which is essentially an intensifying of symptoms. A person with this stage of Alzheimer’s tends to need more care making it through the day and avoiding dangerous situations, such as becoming lost (wandering around to find a familiar setting is common in this stage). This is also when long-term memory becomes more compromised, so a person with this level of Alzheimer’s may begin to forget who their loved ones are or get them confused with each other.
Lastly, during severe dementia due to Alzheimer’s disease, a person may be unable to communicate coherently, even if they are physically able to speak. As they lose control over physical functions such as walking, holding their head up, and bladder and bowel activity, they may depend on others to care for them. People with this final stage of Alzheimer’s may also have difficulty swallowing. Sadly, this is often how death from Alzheimer’s can come about. Food or drinks can wind up in the lungs due to impaired swallowing, leading to pneumonia, or a person may become dehydrated or malnourished.
There’s no set amount of time it takes for every person with Alzheimer’s to advance through each of these stages, but the Mayo Clinic notes that people with the condition live eight to 10 years after diagnosis on average.
3. Normal forgetfulness is a thing, and it’s very different from Alzheimer’s-related memory loss.
It’s completely fine to occasionally forget where you put things, the names of people you don’t see that often, why you entered a room, and other minor details. Memory lapses can happen for all sorts of reasons, from a lack of sleep to normal cognitive changes as you grow older.
“Mild forgetfulness is a common complaint in people as they age,” Verna R. Porter, M.D., a neurologist and director of the Alzheimer’s Disease Program at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. “The main difference between age-related memory loss and dementia (such as Alzheimer’s disease) is that in normal aging, the forgetfulness does not interfere with your ability to carry on with daily activities,” Dr. Porter says. “The memory lapses have little impact on your daily life.”
If you or a loved one is dealing with persistent memory loss and accompanying symptoms such as difficulty staying organized, confusion, and mood changes, that’s more of a cause for concern.
4. Alzheimer’s affects millions of people in the United States, causing over 110,000 deaths each year.
Estimates range, but the National Institute on Aging (NIA) says that more than 5.5 million people in the United States have the disease. According to the Centers for Disease Control and Prevention, it was the sixth leading cause of death in the United States in 2017, killing 116,103 people.
5. Doctors aren’t totally sure what causes Alzheimer’s disease, but brain changes are definitely involved.
Alzheimer’s disease damages and kills brain cells. This destruction is what affects a person’s cognitive, social, and physical abilities.
Researchers have also discovered two specific abnormalities in the brains of people with Alzheimer’s disease, the Mayo Clinic says. One is that they have plaques, or buildup of a protein called beta-amyloid that may harm brain cells, including by impeding cell-to-cell communication. Another is tangles in the transportation system that brain cells rely on to move nutrients and other substances that are necessary for your brain to function properly.
6. There’s also a genetic component for some people, especially those with early-onset Alzheimer’s disease.
Early-onset Alzheimer’s disease happens when a person develops the condition anywhere from their 30s to mid-60s, according to the NIA. People with this early-onset form comprise less than 10 percent of the Alzheimer’s population. These cases are sometimes due to three specific gene mutations or other genetic factors. However, this kind of genetic influence is only involved in less than 5 percent of Alzheimer’s disease cases overall, according to the Mayo Clinic.
Late-onset Alzheimer’s (which is much more common and typically shows up in someone’s mid-60s) mainly arises due to age and brain changes. Genetics are sometimes involved, but much more rarely than in a person who starts exhibiting symptoms when they’re younger.
7. Experts have pinpointed certain risk factors that increase your odds of developing Alzheimer’s disease.
Getting older is the biggest one, the Mayo Clinic says. To be clear, Alzheimer’s isn’t just a regular part of aging that everyone should expect, but it’s much more common in people over 65. This is part of why women seem to be at a greater risk of developing Alzheimer’s disease—they simply tend to live longer.
Having a first-degree relative (like a dad or sister) with the disease also seems to raise your risk. This is due to that genetic component, which doctors are still investigating.
Another potential factor: past head trauma, like a concussion. “In general, head injuries can result in less brain [matter] because an accompanying brain injury can occur,” Amit Sachdev, M.D., an assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University, tells SELF. “Less brain means less ability for the brain to age gracefully.”
There’s also a surprising potential link between heart disease risk factors and those that contribute to your chances of getting Alzheimer’s. For example, high blood pressure, high blood cholesterol, obesity, and poorly controlled type 2 diabetes can increase your risk of developing both conditions, according to the Mayo Clinic. This may be because of a health issue called vascular dementia, which is when impaired blood vessels in the brain cause memory and cognitive difficulties.
In addition, Down syndrome is one of the strongest risk factors for one day developing Alzheimer’s, and symptoms tend to present 10 to 20 years earlier than they do in the general population, according to the Mayo Clinic. The Down/Alzheimer’s link may center around having an extra copy of chromosome 21, which is what brings about characteristics of Down syndrome. This extra chromosome material contains the gene that produces those beta-amyloid plaques that can harm brain cells, the NIA explains.
8. Doctors can’t definitively diagnose Alzheimer’s without looking at a person’s brain, but they know enough about the symptoms to tell when someone has it.
The only current test to absolutely confirm Alzheimer’s involves a microscopic exam of a deceased person’s brain to look for those plaques and tangles, according to the Mayo Clinic. Although tests to confirm whether or not a living person has Alzheimer’s seem to be forthcoming, they’re not yet ready for widespread use.
Instead, doctors basically make an extremely educated guess. They do this with strategies like ordering blood tests to rule out other causes of memory loss, administering mental status tests to evaluate a person’s thinking and memory, ordering brain imaging such as an MRI or CT scan, and testing a person’s cerebrospinal fluid for biological markers that can point toward the possibility of Alzheimer’s.
9. There’s no proven way to prevent Alzheimer’s disease, but certain lifestyle factors could reduce your risk.
Research has found a link between engaging in socially and mentally stimulating activities and a reduced risk of Alzheimer’s disease, the Mayo Clinic points out. It seems as though these types of activities strengthen your “cognitive reserve,” making it easier for your brain to compensate for age-related changes, according to the NIA.
Reducing your risk of heart disease may also help lower your risk of Alzheimer’s the Mayo Clinic says. “Things that promote a healthy body will promote a healthy brain,” Dr. Sachdev says. “In this case, healthier blood vessels are less likely to become damaged and more likely to support the brain.”
Lowering your risk of heart disease and Alzheimer’s means staying active and eating well, among other things. “Exercise may slow existing cognitive deterioration by stabilizing older brain connections and [helping to] make new connections,” Dr. Porter says. Experts are also investigating if exercise can bolster the size of brain structures that are key for memory and learning. In any case, the American Heart Association recommends getting 150 minutes of moderate exercise every week or 75 minutes of vigorous movement (or a mix of moderate and vigorous workouts) each week.
The Mediterranean Diet, which focuses on eating produce, healthy oils, and foods low in saturated fat, has also been linked with a lowered risk of developing heart disease and Alzheimer’s, the Mayo Clinic says.
Does this mean you have to overhaul the way you currently eat in order to avoid Alzheimer’s? No. It only means that scientists have studied one specific way of eating enough to land on this result. Healthy eating looks different for different people, and a lot of this can depend on your culture, too. The point is really to eat in a way that helps to reinforce your body and mind, not that you need to follow any one type of way for optimal health.
10. There is no cure for Alzheimer’s disease, but there are treatment options to help with symptoms.
The U.S. Food and Drug Administration (FDA) has approved two types of medications to help manage the memory loss, confusion, and problems with thinking and reasoning of Alzheimer's disease, according to the NIA.
Cholinesterase inhibitors are reserved for mild to moderate Alzheimer’s. It seems as though they impede the breakdown of acetylcholine, a brain chemical implicated in memory and thinking, but these drugs may start to work less effectively as Alzheimer’s progresses and a person produces less acetylcholine.
When it comes to moderate to severe Alzheimer’s, doctors may use a drug called memantine, which appears to regulate glutamate, a neurotransmitter that can cause brain cell death in large amounts. Sometimes doctors prescribe both cholinesterase inhibitors and memantine drugs, since they work in different ways.
Unfortunately, these drugs won’t fully stop the progression of the disease. But they may help slow the symptoms so that a person with Alzheimer’s can have a better quality of life for a longer period of time.