Dementia
Introduction
Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906.
Scientists have learned a great deal about Alzheimer’s disease in the century since Dr. Alzheimer first drew
attention to it. Today we know that Alzheimer’s:
Is a progressive and fatal brain disease. As many as 5 million Americans are living with Alzheimer’s disease.
Alzheimer's destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect
work, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. Today it is the seventh-leading
cause of death in the United States. For more information, see Warning Signs and Stages of Alzheimer’s Disease.
Is the most common form of dementia, a general term for the loss of memory and other intellectual abilities serious
enough to interfere with daily life. Vascular dementia, another common type of dementia, is caused by reduced
blood flow to parts of the brain. In mixed dementia, Alzheimer’s and vascular dementia occur together.
Has no current cure. But treatments for symptoms, combined with the right services and support, can make life
better for the millions of Americans living with Alzheimer’s. We’ve learned most of what we know about Alzheimer’s
in the last 15 years. There is an accelerating worldwide effort under way to find better ways to treat the disease,
delay its onset, or prevent it from developing. Learn more about recent progress in Alzheimer science and research
funded by the Alzheimer’s Association in the Research section.
Alzheimer's and the brain
Just like the rest of our bodies, our brains change as we age. Most of us notice some slowed thinking and
occasional problems remembering certain things. However, serious memory loss, confusion and other major
changes in the way our minds work are not a normal part of aging. They may be a sign that brain cells are failing.
The brain has 100 billion nerve cells (neurons). Each nerve cell communicates with many others to form networks.
Nerve cell networks have special jobs. Some are involved in thinking, learning and remembering. Others help us see,
hear and smell. Still others tell our muscles when to move.
To do their work, brain cells operate like tiny factories. They take in supplies, generate energy, construct equipment
and get rid of waste. Cells also process and store information. Keeping everything running requires coordination as
well as large amounts of fuel and oxygen.
In Alzheimer’s disease, parts of the cell’s factory stop running well. Scientists are not sure exactly where the trouble
starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As
damage spreads, cells lose their ability to do their jobs well. Eventually, they die.
The role of plaques and tangles
Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells.
Plaques and tangles were among the abnormalities that Dr. Alois Alzheimer saw in the brain of Auguste D., although
he called them different names.
Plaques build up between nerve cells. They contain deposits of a protein fragment called beta-amyloid (BAY-tuh AM-
uh-loyd). Tangles are twisted fibers of another protein called tau (rhymes with “wow”).
Tangles form inside dying cells. Though most people develop some plaques and tangles as they age, those with
Alzheimer’s tend to develop far more. The plaques and tangles tend to form in a predictable pattern, beginning in
areas important in learning and memory and then spreading to other regions.
Scientists are not absolutely sure what role plaques and tangles play in Alzheimer’s disease. Most experts believe
they somehow block communication among nerve cells and disrupt activities that cells need to survive.
Early stage and young onset
Early-stage is the early part of Alzheimer’s disease when problems with memory, thinking and concentration may
begin to appear in a doctor’s interview or medical tests. Individuals in the early-stage typically need minimal
assistance with simple daily routines. At the time of a diagnosis, an individual is not necessarily in the early stage of
the disease; he or she may have progressed beyond the early stage.
The term young-onset refers to Alzheimer's that occurs in a person under age 65. Young-onset individuals may be
employed or have children still living at home. Issues facing families include ensuring financial security, obtaining
benefits and helping children cope with the disease. People who have young-onset dementia may be in any stage of
dementia – early, middle or late. Experts estimate that some 500,000 people in their 30s, 40s and 50s have
Alzheimer's disease or a related dementia.
History
At a scientific meeting in November 1906, German physician Alois Alzheimer presented the case of “Frau Auguste
D.,” a 51-year-old woman brought to see him in 1901 by her family. Auguste had developed problems with memory,
unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to
her. Her symptoms rapidly grew worse, and within a few years she was bedridden. She died in Spring 1906, of
overwhelming infections from bedsores and pneumonia.
Dr. Alzheimer had never before seen anyone like Auguste D., and he gained the family’s permission to perform an
autopsy. In Auguste’s brain, he saw dramatic shrinkage, especially of the cortex, the outer layer involved in memory,
thinking, judgment and speech. Under the microscope, he also saw widespread fatty deposits in small blood
vessels, dead and dying brain cells, and abnormal deposits in and around cells.
The condition entered the medical literature in 1907, when Alzheimer published his observations about Auguste D. In
1910, Emil Kraepelin, a psychiatrist noted for his work in naming and classifying brain disorders, proposed that the
disease be named after Alzheimer.
Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906.
Scientists have learned a great deal about Alzheimer’s disease in the century since Dr. Alzheimer first drew
attention to it. Today we know that Alzheimer’s:
Is a progressive and fatal brain disease. As many as 5 million Americans are living with Alzheimer’s disease.
Alzheimer's destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect
work, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. Today it is the seventh-leading
cause of death in the United States. For more information, see Warning Signs and Stages of Alzheimer’s Disease.
Is the most common form of dementia, a general term for the loss of memory and other intellectual abilities serious
enough to interfere with daily life. Vascular dementia, another common type of dementia, is caused by reduced
blood flow to parts of the brain. In mixed dementia, Alzheimer’s and vascular dementia occur together.
Has no current cure. But treatments for symptoms, combined with the right services and support, can make life
better for the millions of Americans living with Alzheimer’s. We’ve learned most of what we know about Alzheimer’s
in the last 15 years. There is an accelerating worldwide effort under way to find better ways to treat the disease,
delay its onset, or prevent it from developing. Learn more about recent progress in Alzheimer science and research
funded by the Alzheimer’s Association in the Research section.
Alzheimer's and the brain
Just like the rest of our bodies, our brains change as we age. Most of us notice some slowed thinking and
occasional problems remembering certain things. However, serious memory loss, confusion and other major
changes in the way our minds work are not a normal part of aging. They may be a sign that brain cells are failing.
The brain has 100 billion nerve cells (neurons). Each nerve cell communicates with many others to form networks.
Nerve cell networks have special jobs. Some are involved in thinking, learning and remembering. Others help us see,
hear and smell. Still others tell our muscles when to move.
To do their work, brain cells operate like tiny factories. They take in supplies, generate energy, construct equipment
and get rid of waste. Cells also process and store information. Keeping everything running requires coordination as
well as large amounts of fuel and oxygen.
In Alzheimer’s disease, parts of the cell’s factory stop running well. Scientists are not sure exactly where the trouble
starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As
damage spreads, cells lose their ability to do their jobs well. Eventually, they die.
The role of plaques and tangles
Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells.
Plaques and tangles were among the abnormalities that Dr. Alois Alzheimer saw in the brain of Auguste D., although
he called them different names.
Plaques build up between nerve cells. They contain deposits of a protein fragment called beta-amyloid (BAY-tuh AM-
uh-loyd). Tangles are twisted fibers of another protein called tau (rhymes with “wow”).
Tangles form inside dying cells. Though most people develop some plaques and tangles as they age, those with
Alzheimer’s tend to develop far more. The plaques and tangles tend to form in a predictable pattern, beginning in
areas important in learning and memory and then spreading to other regions.
Scientists are not absolutely sure what role plaques and tangles play in Alzheimer’s disease. Most experts believe
they somehow block communication among nerve cells and disrupt activities that cells need to survive.
Early stage and young onset
Early-stage is the early part of Alzheimer’s disease when problems with memory, thinking and concentration may
begin to appear in a doctor’s interview or medical tests. Individuals in the early-stage typically need minimal
assistance with simple daily routines. At the time of a diagnosis, an individual is not necessarily in the early stage of
the disease; he or she may have progressed beyond the early stage.
The term young-onset refers to Alzheimer's that occurs in a person under age 65. Young-onset individuals may be
employed or have children still living at home. Issues facing families include ensuring financial security, obtaining
benefits and helping children cope with the disease. People who have young-onset dementia may be in any stage of
dementia – early, middle or late. Experts estimate that some 500,000 people in their 30s, 40s and 50s have
Alzheimer's disease or a related dementia.
History
At a scientific meeting in November 1906, German physician Alois Alzheimer presented the case of “Frau Auguste
D.,” a 51-year-old woman brought to see him in 1901 by her family. Auguste had developed problems with memory,
unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to
her. Her symptoms rapidly grew worse, and within a few years she was bedridden. She died in Spring 1906, of
overwhelming infections from bedsores and pneumonia.
Dr. Alzheimer had never before seen anyone like Auguste D., and he gained the family’s permission to perform an
autopsy. In Auguste’s brain, he saw dramatic shrinkage, especially of the cortex, the outer layer involved in memory,
thinking, judgment and speech. Under the microscope, he also saw widespread fatty deposits in small blood
vessels, dead and dying brain cells, and abnormal deposits in and around cells.
The condition entered the medical literature in 1907, when Alzheimer published his observations about Auguste D. In
1910, Emil Kraepelin, a psychiatrist noted for his work in naming and classifying brain disorders, proposed that the
disease be named after Alzheimer.
Warning Signs of Alzheimer's
Some change in memory is normal as we grow older, but the warning signs of
Alzheimer’s disease are more than simple lapses in memory.
People with Alzheimer’s experience difficulties communicating, learning, thinking and
reasoning — problems severe enough to have an impact on an individual's work,
social activities and family life.
The Alzheimer's Association has developed a checklist to help you recognize the
difference between normal age-related memory changes and possible warning signs
of Alzheimer’s disease.
There’s no clear-cut line between normal changes and warning signs. It’s always a
good idea to check with a doctor if a person’s level of function seems to be changing.
The Alzheimer’s Association believes that it is critical for people diagnosed with
dementia and their families to receive information, care and support as early as
possible.
10 warning signs of Alzheimer's:
1. Memory loss. Forgetting recently learned information is one of the most common
early signs of dementia. A person begins to forget more often and is unable to recall
the information later.
What's normal? Forgetting names or appointments occasionally.
2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or
complete everyday tasks. Individuals may lose track of the steps involved in preparing
a meal, placing a telephone call or playing a game.
What's normal? Occasionally forgetting why you came into a room or what you planned
to say.
3. Problems with language. People with Alzheimer’s disease often forget simple words
or substitute unusual words, making their speech or writing hard to understand. They
may be unable to find the toothbrush, for example, and instead ask for "that thing for
my mouth.”
What's normal? Sometimes having trouble finding the right word.
4. Disorientation to time and place. People with Alzheimer’s disease can become lost in
their own neighborhood, forget where they are and how they got there, and not know
how to get back home.
What's normal? Forgetting the day of the week or where you were going.
5. Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately,
wearing several layers on a warm day or little clothing in the cold. They may show poor
judgment, like giving away large sums of money to telemarketers.
What's normal? Making a questionable or debatable decision from time to time.
6. Problems with abstract thinking. Someone with Alzheimer’s disease may have
unusual difficulty performing complex mental tasks, like forgetting what numbers are
for and how they should be used.
What's normal? Finding it challenging to balance a checkbook.
7. Misplacing things. A person with Alzheimer’s disease may put things in unusual
places: an iron in the freezer or a wristwatch in the sugar bowl.
What's normal? Misplacing keys or a wallet temporarily.
8. Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid
mood swings – from calm to tears to anger – for no apparent reason.
What's normal? Occasionally feeling sad or moody.
9. Changes in personality. The personalities of people with dementia can change
dramatically. They may become extremely confused, suspicious, fearful or dependent
on a family member.
What's normal? People’s personalities do change somewhat with age.
10. Loss of initiative. A person with Alzheimer’s disease may become very passive,
sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual
activities.
What's normal? Sometimes feeling weary of work or social obligations.
--------------------------------------------------------------------------------
The difference between Alzheimer's and normal age-related memory changes
Someone with Alzheimer's disease symptoms Someone with normal age-related
memory changes
Forgets entire experiences
Forgets part of an experience
Rarely remembers later
Often remembers later
Is gradually unable to follow written/spoken directions
Is usually able to follow written/spoken directions
Is gradually unable to use notes as reminders
Is usually able to use notes as reminders
Is gradually unable to care for self
Is usually able to care for self
Some change in memory is normal as we grow older, but the warning signs of
Alzheimer’s disease are more than simple lapses in memory.
People with Alzheimer’s experience difficulties communicating, learning, thinking and
reasoning — problems severe enough to have an impact on an individual's work,
social activities and family life.
The Alzheimer's Association has developed a checklist to help you recognize the
difference between normal age-related memory changes and possible warning signs
of Alzheimer’s disease.
There’s no clear-cut line between normal changes and warning signs. It’s always a
good idea to check with a doctor if a person’s level of function seems to be changing.
The Alzheimer’s Association believes that it is critical for people diagnosed with
dementia and their families to receive information, care and support as early as
possible.
10 warning signs of Alzheimer's:
1. Memory loss. Forgetting recently learned information is one of the most common
early signs of dementia. A person begins to forget more often and is unable to recall
the information later.
What's normal? Forgetting names or appointments occasionally.
2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or
complete everyday tasks. Individuals may lose track of the steps involved in preparing
a meal, placing a telephone call or playing a game.
What's normal? Occasionally forgetting why you came into a room or what you planned
to say.
3. Problems with language. People with Alzheimer’s disease often forget simple words
or substitute unusual words, making their speech or writing hard to understand. They
may be unable to find the toothbrush, for example, and instead ask for "that thing for
my mouth.”
What's normal? Sometimes having trouble finding the right word.
4. Disorientation to time and place. People with Alzheimer’s disease can become lost in
their own neighborhood, forget where they are and how they got there, and not know
how to get back home.
What's normal? Forgetting the day of the week or where you were going.
5. Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately,
wearing several layers on a warm day or little clothing in the cold. They may show poor
judgment, like giving away large sums of money to telemarketers.
What's normal? Making a questionable or debatable decision from time to time.
6. Problems with abstract thinking. Someone with Alzheimer’s disease may have
unusual difficulty performing complex mental tasks, like forgetting what numbers are
for and how they should be used.
What's normal? Finding it challenging to balance a checkbook.
7. Misplacing things. A person with Alzheimer’s disease may put things in unusual
places: an iron in the freezer or a wristwatch in the sugar bowl.
What's normal? Misplacing keys or a wallet temporarily.
8. Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid
mood swings – from calm to tears to anger – for no apparent reason.
What's normal? Occasionally feeling sad or moody.
9. Changes in personality. The personalities of people with dementia can change
dramatically. They may become extremely confused, suspicious, fearful or dependent
on a family member.
What's normal? People’s personalities do change somewhat with age.
10. Loss of initiative. A person with Alzheimer’s disease may become very passive,
sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual
activities.
What's normal? Sometimes feeling weary of work or social obligations.
--------------------------------------------------------------------------------
The difference between Alzheimer's and normal age-related memory changes
Someone with Alzheimer's disease symptoms Someone with normal age-related
memory changes
Forgets entire experiences
Forgets part of an experience
Rarely remembers later
Often remembers later
Is gradually unable to follow written/spoken directions
Is usually able to follow written/spoken directions
Is gradually unable to use notes as reminders
Is usually able to use notes as reminders
Is gradually unable to care for self
Is usually able to care for self
