Alzheimer’s Disease

Alzheimer's disease affects approximately 24 million people worldwide.

Unlike normal ageing, Alzheimer’s accelerates cognitive decline, leading to pronounced memory loss, confusion, difficulty recognising familiar faces, and impaired daily functioning.

What is Alzheimer’s disease?

Alzheimer’s disease is a chronic neurodegenerative disorder caused by the accumulation of abnormal protein, amyloid and tau proteins, deposits in and around brain cells.

These deposits disrupt communication between neurons and lead to their death.

Stages of Alzheimer’s Disease

1. Early Stage (Mild): Early symptoms are often subtle and mistaken for ageing. Most can still function independently with little support.
2. Middle Stage (Moderate): Individuals may require caregiver assistance as confusion, agitation, and behavioural changes become more frequent.
3. Late Stage (Severe): The disease severely impacts physical and cognitive abilities, leaving individuals unable to communicate or care for themselves.

Alzheimer’s Disease vs. Dementia

Causes and Risk Factors

While the exact cause is not fully understood, genetic, environmental, and lifestyle factors contribute to its development.

1. Genetic Factors: APOE-e4 is the most significant genetic risk factor, but not all carriers develop the disease. Early-onset Alzheimer's diseases are often linked to specific gene mutations.
2. Age: Risk increases dramatically after age 65.
3. Gender: Women are more affected, possibly due to hormonal differences and longer life expectancy.
4. Cardiovascular Health: Conditions like high blood pressure, diabetes, and high cholesterol raise risk by damaging brain blood vessels.
5. Head Injury: Past brain injuries may elevate Alzheimer’s risk.
6. Lifestyle Factors: Poor diet, inactivity, smoking, and excessive alcohol intake raise risk; healthy habits lower it.
7. Chronic Inflammation and Immune Dysfunction: Inflammation caused by stress or chronic illness may accelerate brain damage.

Symptom Progression Through the Stages

Early Stage (Mild)

• Memory lapses (e.g., forgetting recent events).
• Difficulty completing familiar tasks.
• Trouble with language.
• Mood changes and poor judgment.

Middle Stage (Moderate)

• Increased memory loss and confusion.
• Communication difficulties.
• Impaired judgment and personality changes.
• Greater dependency on others.
• Sleep disturbances.

Late Stage (Severe)

• Severe memory and communication loss.
• Complete dependence on caregivers.
• Physical decline (mobility loss, infections).
• Unresponsiveness to environment.

Diagnosis and Testing

1. Medical History and Symptom Assessment: Covers memory changes, daily activities, family history, and coexisting health issues.
2. Cognitive and Neuropsychological Testing: Includes MMSE, MoCA, and detailed neuropsychological evaluations.
3. Physical and Neurological Exams: Assess motor skills, speech, and vision to rule out other causes.
4. Laboratory Tests: Check for conditions like thyroid problems or vitamin deficiencies.
5. Brain Imaging: MRI, CT, PET scans, and fMRI reveal brain atrophy and plaque deposits.
6. Genetic Testing: Recommended primarily for early-onset suspicions or family history; genetic counselling is advised.

Treatment and Management

Currently, there is no cure, only symptom management and support.

Medications for Symptom Management

• Cholinesterase Inhibitors: Donepezil, Rivastigmine, and Galantamine slow cognitive symptoms.
• NMDA Receptor Antagonists: Memantine helps in moderate-to-severe Alzheimer's disease.
• Behavioural Medications: Antidepressants, antipsychotics, and anxiolytics address mood and behaviour issues.

Non-Pharmacological Treatments

• Cognitive stimulation and reality orientation therapies.
• Reminiscence and music therapies to boost memory and mood.
• Physical exercise programs to enhance mental and physical health.

Lifestyle Changes and Support

• Diet: Mediterranean diet is recommended.
• Exercise: Regular aerobic and strength training.
• Social engagement: Vital for emotional and cognitive health.
• Sleep hygiene: Establishing healthy routines.
• Caregiver support: Critical for the well-being of patients and families.

Is Alzheimer's disease inherited?

The genes you inherit from your parents can influence your risk of developing Alzheimer’s disease, though the overall increase in risk is typically small.

However, in rare cases, a single inherited gene can directly cause Alzheimer’s, significantly raising the likelihood of the condition being passed down within family members.

How to prevent Alzheimer's disease?

1. Stay Mentally Active: Puzzles, reading, learning new skills, and social interaction build cognitive reserve.
2. Physical Exercise: 150 minutes of aerobic activity weekly is recommended.
3. Eat a Brain-Healthy Diet: Mediterranean diet rich in omega-3s and antioxidants.
4. Manage Heart Health: Control blood pressure, cholesterol, and diabetes.
5. Get Quality Sleep: Establish routines and treat sleep disorders.
6. Avoid Smoking and Excessive Alcohol: Both habits damage brain health.
7. Manage Stress: Mindfulness, meditation, and physical activity help reduce harmful stress effects.
8. Regular Health Check-Ups: Early identification of risks through regular assessments.

Compassionate Care and Early Detection

Early detection allows for better planning and symptom management. Compassionate caregiving is vital as the disease progresses, ensuring dignity and quality of life.

As Alzheimer's disease progresses, support for caregivers is equally important.

At Prince Court, the leading hospital in Kuala Lumpur, Malaysia, our expert neurologists and mental health professionals provide world-class care and the latest treatments for Alzheimer’s disease.

With continued research and personalised support, we are here to help individuals and families navigate this journey with confidence.

Trust Prince Court for exceptional neurological care.

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