A Guide to Alzheimer's Disease

By Harvard Health Publications
Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Dear Reader,

Are you having memory problems that seem to go beyond the ordinary, or do you see this happening to someone you love? Are there other difficulties, like struggling to follow a conversation or find the right word, getting confused in new places, or botching tasks that once came easily? Everyone has these experiences sometimes, but if they happen regularly, they may be early signs of Alzheimer's disease.

The condition strikes fear in people's hearts, and with good reason. It is the leading cause of dementia, a brain disorder that robs people of their cognitive function and eventually of their very selves. About 5.2 million Americans have Alzheimer's disease. It is the sixth leading cause of death in the United States. There is no cure, and current treatments alleviate symptoms temporarily at best. However, many new drugs are under investigation, and the first disease-altering treatments may become available in the next several years. Meanwhile, caring for someone with Alzheimer's is one of the toughest jobs in the world. It is stressful, physically and emotionally draining, and very expensive.

The information in this guide includes help for family members and caregivers, as well as for individuals with Alzheimer's. Because the disease is progressive, coping with it requires foresight and careful advance planning. This includes getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare. People in the early stages of Alzheimer's often can be partners in that planning.

In this report, you'll learn about these and other facets of Alzheimer's disease:

  • the destructive brain process that causes symptoms

  • brain imaging technology that can diagnose Alzheimer's early, improving the opportunities for symptom management

  • discoveries that may someday stop Alzheimer's from attacking the brain

  • factors that increase or may lower your risk for the disease

  • techniques for managing the care of people with Alzheimer's

  • legal and financial planning and long-term care options.

This information is designed to help ease the stress of Alzheimer's disease. With planning, patience, knowledge, and support, you can better meet the challenges posed by this disease and improve the quality of your life and that of your loved ones.

Sincerely,

John H. Growdon, M.D.
Medical Editor

What is Alzheimer's disease?

Alzheimer's disease is a degenerative brain disorder that results in memory loss, impaired thinking, difficulty finding the right word when speaking, and personality changes (see "Warning signs of Alzheimer's disease"). Its course is marked by a continual loss of neurons (nerve cells) and their connections with other neurons (synapses) that are crucial to memory and other mental functions. In advanced Alzheimer's disease, the dramatic loss of neurons causes the brain to shrink (see Figure 1). Levels of brain chemicals known as neurotransmitters, which carry complex messages back and forth among billions of nerve cells, are also diminished. After the symptoms first appear, people live anywhere from two to 20 years in an increasingly dependent state that exacts a staggering emotional, physical, and economic toll on families.

There is no cure or proven means of prevention. But early diagnosis is important because drugs are available that may temporarily stabilize or delay worsening of cognitive symptoms, and they work best in the early stages of the disease.

Figure 1: Brain changes in Alzheimer's disease

Brain changes in Alzheimer's disease

The massive loss of brain cells that occurs in advanced Alzheimer's disease causes the brain to wither and shrink, as shown in these crosswise slices through the middle of the brain between the ears. In the Alzheimer's brain, the outer layer (cortex) shrivels up, damaging areas involved in thinking, planning, and remembering. The hippocampus, a structure that plays a vital role in memory formation, is one of the hardest-hit areas (see Figure 6).

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More than 5.3 million people in the United States are living with Alzheimer's disease, with a new person developing the disease every 70 seconds. Americans ages 65 and older with Alzheimer's and dementia pay three times as much in health care costs.