What Is Alzheimer's Disease?

Alzheimer's Disease, named after German neurologist Dr. Alois Alzheimer, is the most common form of dementia. Simply put, a patient's healthy brain tissue dies, causing a steady decline in memory and mental abilities. Eventually this loss of intellectual and social skills becomes severe enough to interfere with a person's activities of daily living.

Symptoms of AD may include:

Increasing and persistent forgetfulness. At its onset, Alzheimer's disease is marked by periods of forgetfulness, especially of recent events or simple directions. But what begins as mild forgetfulness persists and increases. People with Alzheimer's may repeat things and forget conversations or appointments. They routinely misplace things, often putting them in illogical locations. They frequently forget names, and, eventually, they may forget the names of family members and everyday objects such as a comb or a watch.

Difficulty finding the right word. It may be a challenge for those with Alzheimer's to find the right words to express thoughts or even follow conversations. Eventually, reading and writing are also affected.

Disorientation. People with Alzheimer's may lose a sense of time and dates. They may find themselves lost in familiar surroundings. Eventually, they may even wander from home.

Loss of judgment. Solving everyday problems, such as knowing what to do if food on the stove is burning, becomes increasingly impossible. Alzheimer's is characterized by greater difficulty in doing things that require planning, decision making and judgment.

Difficulty performing familiar tasks. Once-routine tasks that require sequential steps, such as cooking, become a struggle as the disease progresses. Eventually, people with Alzheimer's may forget how to do the most basic things, like brushing their teeth.

Personality changes. People with Alzheimer's may exhibit mood swings. They may express distrust in others, show increased stubbornness and withdraw socially. Early on, this may be a response to the frustration they feel as they notice uncontrollable changes in their memory. Depression often coexists with Alzheimer's disease. Restlessness is also a common sign. As the disease progresses, people with Alzheimer's may become anxious or aggressive and behave inappropriately.

Difficulties with abstract thinking. People with Alzheimer's may initially have trouble balancing their checkbook, a problem that progresses to trouble understanding and recognizing numbers.

Alzheimer's generally progresses from mild to moderate to severe. A person with mild dementia can usually live independently with only minimal impairment in work or social activities. With moderate dementia, he or she may seem capable, but independent living becomes increasingly hazardous. Dress may appear careless, work and family responsibilities may go neglected. The person may do things such as leave the stove or iron turned on or become disoriented while away from home. As the disease becomes more severe, the need for supervision becomes constant. Short-term memory falters, and the ability to perform routine tasks is lost. He or she may have difficulty recalling words. Later, the person may string together unrelated words into meaningless sentences.

To help diagnose Alzheimer's Disease from other causes of memory loss - which are often treatable - doctors may rely on:

Medical history. Doctors ask about a person's general health and past medical problems. They will want to know about any problems a person may have with daily activities. It's likely doctors will also want to speak with a person's family or friends to get more information.

Mental status tests. These tests are used to evaluate memory, problem solving abilities, attention spans, counting skills and language. They help pinpoint specific problems a person may have with cognition. For instance, doctors might test recent and long-term memory by asking: What day is it today? Or, when were you married? Physicians may list familiar objects and then ask a person to repeat them immediately, and again 5 minutes later.

Basic medical tests. Blood and urine tests may be done. In some cases testing a small sample of spinal fluid also may help.

Brain scans. Several types of brain scans are available - including a computerized tomography (CT) scan, a magnetic resonance imaging (MRI) scan and a positron emission tomography (PET) scan. By looking at a picture of the brain, doctors may be able to pinpoint any visible abnormalities. Using the methods above, doctors can accurately diagnose 90 percent of Alzheimer's cases.

Caregiving. According to the National Alzheimer's Association, 1 in 10 families have a relative with Alzheimer's Disease. Of the 4 million people with Alzheimer's disease in the United States, 70 percent live at home - often receiving part- or full-time care from family members.

A loved one with Alzheimer's disease may seem like a different person. As he or she slowly loses the ability to express needs, concerns and memories. you may find yourself gauging the needs of your loved one based on words and behaviors that often don't make sense.

People with Alzheimer's disease often experience a mixture of emotions - confusion, frustration, anger, fear, uncertainty, grief and depression. You can help a person cope with the disease by being there to listen, reassuring the person that life can still be enjoyed, providing unconditional love and doing your best to help the person retain dignity and self-respect.

The key to caregiving is focusing on things that the person with Alzheimer's can still do and enjoy. In fact, learning ways to reduce the impact of impaired abilities and behavior problems can help avoid some of the most difficult aspects the disease.

The key words are patience, compassion and creativity.

The tools to care for each person will vary depending upon symptomoly. Caregiving creativity is critical for caregiver survival. See which ones work best for you and adapt them to your specific situation.

Use memory aids. Memory aids may help a friend or family member remain independent. Write out a list of the day's activities, the phone numbers that can be used to call for help and instructions on how to do simple tasks, like make a cup of tea or use the telephone.

Provide structure. A home environment that provides serenity and stability reduces behavior problems. New situations, noise, large groups of people, being rushed or pressed to remember or being asked to do a task that's too difficult can cause anxiety. As a person with Alzheimer's becomes upset, the ability to think clearly declines even more.

Monitor wandering. Wandering is a common problem. In some cases, a pocket card with simple instructions, such as "Call home" (with a phone number below) may help. Make sure your loved one wears a bracelet with his or her name, phone number and a notation such as "memory impaired." The Alzheimer's Association offers this resource through its national Safe Return Program. Also try to determine the cause of wandering. It may simply be a signal that the person with Alzheimer's is looking for something, such as a bathroom, or is seeking a meaningful activity or reassurance. Some experts believe taking your loved one for a vigorous daily walk helps reduce wandering.

Establish a night-time ritual. Behavior is often worse at night. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup and active family members. Leave night lights on to prevent disorientation. Limiting caffeine during the day, discouraging daytime napping and offering opportunities for exercise during the day may help prevent nighttime restlessness.

Enhance communication. When talking with your loved one, stand where you can be seen and touch his or her arm or shoulder to focus attention. Speak slowly, in simply sentences and don't rush the response. Present only one idea or instruction at a time. Use gestures and cues, such as pointing to objects. Avoid asking questions or offering difficult choices because trying to come up with answers may prove frustrating.

Create a safe environment. Make your home familiar and safe. Keep furniture in the same place to avoid clutter and help prevent falls. Install locks on cabinets containing medicines, alcohol, guns, toxic substances and dangerous utensils and tools. Remove electrical appliances from your bathroom to prevent shocks, set your water heater no higher than 120 F to prevent scalding, and install grab rails to prevent falls.

Encourage exercise. Exercise carries many benefits for someone with Alzheimer's disease. The fact that these benefits often are the same for people without Alzheimer's disease does not lessen their importance. In fact, it just makes exercise a more important activity for caregivers and people with Alzheimer's to engage in together. The main benefits of exercise include improved strength, endurance and cardiovascular health. Exercise also can improve energy, sleep, circulation, stamina and mood. For people with Alzheimer's disease, exercise can also help retain motor skills, impart a sense of meaning or purpose, create a calming effect and sustain strength, flexibility and balance - lessening the risk of serious injury from a fall.

Very IMPORTANT

Caring for a person with Alzheimer's Disease can be an all-absorbing experience. The physical and emotional demands of caregiving can be exhausting. Feelings of anger and guilt, frustration and discouragement, worry and grief and social isolation are common.

Take care of your physical and spiritual health.

Ask friends or other family members for help.

Join a support network with other caregivers.