What is Alzheimer’s disease?
Yesterday I discussed dementia in general. Today, let’s look at Alzheimer’s in more detail.
According to the Alzheimer’s Association, Alzheimer’s disease is the most common form of dementia. While it is a form of dementia, it may represent 60-80% of all the cases. And, remember that “dementia” is a condition in which memory loss and a decline in other cognitive abilities is serious enough to interfere with daily life.
What characterizes Alzheimer’s specifically?
Essentially in my layman’s terms, your brain works through the activity of neurons, the connections between which create memory and hold all the details you use to think and reason. I explain it as the neuron connections that you need to think are getting interrupted. But, that isn’t all that happens. The damage spreads … and it is permanent. Eventually, the symptoms start to show up as forgetfulness and confusion.
Can you make it easy to understand?
I can try … in your brain are many complex processes. One of those goes haywire and accidentally starts to destroy neurons. Then, the brain’s response just makes it worse. Eventually, the disease actually shrinks your brain as tissue is affected. As that happens your memories, and your capability to think and reason, are lost.
There is a lot going on at a very deep level inside the brain of a person with Alzheimer’s.
When do symptoms start?
As you might tell from the description, Alzheimer’s begins without showing symptoms, and it might take years, but it is relentless and ultimately fatal.
This initial part is called the pre-clinical stage, which isn’t even part of the official stages of Alzheimer’s. Some estimates are that people are “asymptomatic” for 10-20 years! That means that their brains are changing, and no one can tell early enough for treatments to start. In fact, this makes medical research studies difficult because we really do not know if a person without symptoms has the disease or not.
Planning is important
Does this worry you? It probably shouldn’t!
Sure, you, or I, could be living with a disease that stays hidden for years, but that can be true with other diseases as well. My advice is not to worry … each day has worries enough. Knowledge and planning will make a difference for you and your loved ones, no matter what the eventual troubles really become.
If you already have a diagnosis of Alzheimer’s or any other dementia, you have had to process that knowledge personally and for many people it is discouraging, disappointing, and even terrifying. But, there is a ton of research going on, and we still work toward a cure.
Meanwhile, learning how the disease affects people and their families and caregivers is important. Talking with your loved ones, diagnosed or not, is important for a healthy response to any medical condition.
That is the point of my emails … to help you understand the issues and to develop new ways of thinking or relating to people with and without the disease. Working together, we make a difference in lives around us.
Tomorrow, I’ll look deeper into the symptoms and later into the stages of the disease.
See you then!
P.S. Here is another slightly more accurate description of the process
For some reason, Alzheimer’s patients had unusual buildups of proteins called amyloids in their brains. These proteins are a normal part of everyday function in healthy people, but instead of breaking down as they should, they form plaques that eventually destroy neurons.
Simultaneously—although it’s unclear if this is because of the amyloid buildups or in addition to them—proteins called tau, which form connections within and between neurons, become dense with extra phosphorus atoms. Eventually, the tau proteins become knotted, and end up destroying affected neurons, which also impairs the connection between other neurons. Worse, the tau then starts spreading. The destruction starts in the hippocampus, the tiny, seahorse-shaped memory hub at the base of the center of the brain, and extends outward, eventually overwhelming the entire organ.
For a while, the brain maintains normal function with these malformed proteins and dying neurons, but eventually, it hits a tipping point. The hippocampus starts to shrink and people who could once remember to-do lists, names, and directions start to become more forgetful and confused, which understandably leads to intense anxiety and confusion. The cognitive symptoms only get worse from there, followed by physical decline that is eventually fatal.
The damage caused by the disease is permanent.
P.P.S. – Here is the really technical explanation… continue at your own risk!
According to Dr. Sara Adaes, writing for “Brain Blogger” in 2015, the technical details are this:
There are some pathological features in AD brain tissue that are considered hallmarks of the disease. Specifically, amyloid plaques – extracellular deposits of the amyloid-beta (A-beta) peptide – and neurofibrillary tangles, intracellular accumulations of the hyperphosphorylated tau (p-tau), a microtubule assembly protein. Other characteristic changes include increased microglial reactivity and widespread loss of neurons, white matter and synapses.
Ok, that is a mouthful.