They can take care of financial and legal matters , address potential safety issues , learn about living arrangements, and develop support networks. Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions.
Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Precision medicine — getting the right treatment to the right person at the right time — will likely play a major role. Several medications are approved by the U. All of these drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons.
They may help reduce symptoms and help with certain behavioral problems. They are effective for some but not all people and may help only for a limited time. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.
This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug.
Results of the phase 4 clinical trial for aducanumab are expected to be available by early Scientists are learning why these symptoms occur and are studying new treatments — drug and nondrug — to manage them. The demands of day-to-day care, changes in family roles, and decisions about placement in a care facility can be difficult. NIA supports efforts to evaluate programs, strategies, approaches, and other research to improve the quality of care and life for those living with dementia and their caregivers.
Becoming well-informed about the disease is one important long-term strategy. For example, staying physically active provides physical and emotional benefits. Some caregivers have found that joining a support group is a critical lifeline. These support groups enable caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. Read about this topic in Spanish.
Receive weekly tips and resources on Alzheimer's disease and related dementias from NIA's Alzheimers. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources. Scientists do not fully understand what causes the disease, although age, personal health, family history, genetics and abnormal protein deposits in the brain are believed to contribute. Familiar tasks, like cooking or paying bills, may become challenging.
According to the Alzheimer's Association, the following are the most common symptoms of Alzheimer's disease. However, each individual may experience symptoms differently. Symptoms may include:. Loss of ability to recognize who people are, even people well known to the individual, such as his or her child or spouse, when the disease progresses to a severe stage.
The only way to confirm the disease is through autopsy. Examination and evaluation are essential in determining whether the dementia is the result of a treatable illness. In addition to a complete medical history and extensive neurological motor and sensory exam, diagnostic procedures for Alzheimer's disease may include the following:.
Mental status test. This is a brief and simple test of memory and some other common cognitive or thinking skills; it is usually part of a complete neurological exam. Lumbar puncture spinal tap. A procedure performed by inserting a hollow needle into the lower back lumbar spine. This testing helps doctors distinguish dementia from other conditions that can cause similar symptoms, such as age-associated memory impairment Dementia Dementia is a slow, progressive decline in mental function including memory, thinking, judgment, and the ability to learn.
Information from the above sources can usually help doctors rule out delirium as the cause of symptoms see table Comparing Delirium and Dementia Comparing Delirium and Dementia Delirium and dementia are the most common causes of mental cognitive dysfunction—the inability to acquire, retain, and use knowledge normally. Doing so is essential because delirium, unlike dementia, can often be reversed if promptly treated. Differences between the two include the following:.
Dementia typically begins gradually and has no definite beginning point. Delirium begins suddenly and often has a definite beginning point. Usually, the most noticeable symptom, particularly in the beginning, is forgetting recent events or not being able to form new memories. Memory and other mental functions have gradually deteriorated and are continuing to deteriorate.
Doctors have ruled out other brain disorders such as a brain tumor or stroke that could be causing the problems. Some symptoms can help doctors distinguish Alzheimer disease from other dementias. For example, visual hallucinations seeing things or people that are not there are more common and occur earlier in dementia with Lewy bodies Dementia With Lewy Bodies and Parkinson Disease Dementia Dementia with Lewy bodies is progressive loss of mental function characterized by the development of Lewy bodies in nerve cells.
Parkinson disease dementia is loss of mental function characterized Also, people with Alzheimer disease are often better-groomed and neater than people with other dementias. Information from additional tests helps doctors make the diagnosis of Alzheimer disease and exclude other types and causes of dementia. Analysis of cerebrospinal fluid CSF , obtained during a spinal tap Spinal Tap Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination.
Electroencephalography EEG is a simple, painless procedure in which A radionuclide is a radioactive form of an element, which means it is an unstable atom that becomes more stable by releasing If CSF analysis detects a low level of beta-amyloid and if PET scans show amyloid deposits or tau deposits in the brain, the diagnosis is more likely to be Alzheimer disease.
However, these tests are not routinely available. The diagnosis of Alzheimer disease can be confirmed only when a sample of brain tissue is removed after death, during an autopsy and examined under a microscope. Then, the characteristic loss of nerve cells, neurofibrillary tangles, and senile plaques containing beta-amyloid can be seen throughout the brain, particularly in the area of the temporal lobe that is involved in forming new memories.
Controlling cholesterol levels: Some evidence suggests that having high cholesterol levels may be related to developing Alzheimer disease. Thus, people may benefit from a diet low in saturated fats and, if needed, drugs such as statins to lower cholesterol and other fats lipids.
Exercising: Exercising helps the heart function better and, for unclear reasons, may help the brain function better. Keeping mentally active: People are encouraged to continue doing activities that challenge the mind, such as learning new skills, doing crossword puzzles, and reading the newspaper.
These activities may promote the growth of new connections synapses between nerve cells and thus help delay dementia. Drinking alcohol in modest amounts: In modest amounts not more than 3 drinks a day , alcohol may help lower cholesterol and maintain blood flow.
Alcohol may even help with thinking and memory by stimulating the release of acetylcholine and causing other changes in nerve cells in the brain. However, there is no convincing evidence that people who do not drink alcohol should start drinking to prevent Alzheimer disease. Once dementia develops, abstaining from alcohol is usually best because it can make symptoms of dementia worse.
Treatment of Alzheimer disease involves general measures to provide safety and support, as for all dementias. Also, certain drugs can help for a while. The person with Alzheimer disease, family members, other caregivers, and the health care practitioners involved should discuss and decide on the best strategy for that person. Pain and any other disorders or health problems such as a urinary tract infection or constipation are treated.
Such treatment may help maintain function in people with dementia. Generally, the environment should be bright, cheerful, safe, stable, and designed to help with orientation.
Some stimulation, such as a radio or television, is helpful, but excessive stimulation should be avoided. Structure and routine help people with Alzheimer disease stay oriented and give them a sense of security and stability. Any change in surroundings, routines, or caregivers should be explained to people clearly and simply. Following a daily routine for tasks such as bathing, eating, and sleeping helps people with Alzheimer disease remember. Following a regular routine at bedtime may help them sleep better.
Activities scheduled on a regular basis can help people feel independent and needed by focusing their attention on pleasurable or useful tasks. Such activities should include physical and mental activities. Activities should be broken down in small parts or simplified as the dementia worsens. Safe: Extra safety measures are usually needed.
Hiding car keys may help prevent accidents and placing detectors on doors may help prevent wandering. If wandering is a problem, an identification bracelet or necklace is helpful.
Familiar: People with dementia usually function best in familiar surroundings. Moving to a new home or city, rearranging furniture, or even repainting can be disruptive. Stable: Establishing a regular routine for bathing, eating, sleeping, and other activities can give people with dementia a sense of stability.
Regular contact with the same people can also help. Planned to help with orientation: A large daily calendar, a clock with large numbers, a radio, well-lit rooms, and a night-light can help with orientation. Also, family members or caregivers can make frequent comments that remind people with dementia of where they are and what is going on.
The cholinesterase inhibitors donepezil , galantamine , and rivastigmine increase the level of acetylcholine in the brain. Acetylcholine is a neurotransmitter that helps with memory, learning, and concentration. This level may be low in people with Alzheimer disease.
These drugs may temporarily improve mental function, including memory, but they do not slow the progression of the disease. Only some of the people who have Alzheimer disease benefit from these drugs. For these people, the drugs may effectively turn the clock back 6 to 9 months. These drugs are most effective in people with mild to moderate disease.
The most common side effects include nausea, vomiting, weight loss, and abdominal pain or cramps. Memantine appears to help relieve symptoms of moderate to severe Alzheimer disease. Memantine can be used with a cholinesterase inhibitor. Aducanumab is a new drug recently approved to treat Alzheimer disease. It is injected under the skin once a month.
Aducanumab is a monoclonal antibody designed to target beta-amyloid an abnormal protein , which accumulates in the brain of people with Alzheimer disease. Studies showed that aducanumab can reduce the number of beta-amyloid plaques in the brain. Thus, some experts predict that aducanumab may eventually be shown to slow the progression of Alzheimer disease. However, according to others, more evidence is needed to show that aducanumab reduces the symptoms and slows the progression of Alzheimer disease.
In addition, aducanumab has side effects. It can cause swelling and bleeding in the brain, detected by magnetic resonance imaging MRI. In most people, these abnormalities are small and do not cause symptoms, but a few people have severe symptoms, including confusion, disorientation, difficulty walking, loss of balance, blurred vision, headaches, nausea, and falls.
Researchers continue to study other drugs that may prevent or slow the progression of Alzheimer disease. Estrogen therapy for women, nonsteroidal anti-inflammatory drugs NSAIDs, such as ibuprofen or naproxen , and ginkgo biloba have been studied.
But none has consistently proved to be effective. Moreover, estrogen appears to do more harm than good. Vitamin E is an antioxidant that theoretically might help protect nerve cells from damage or help them function better. Whether vitamin E is useful is unclear. Before people take any dietary supplement, they should discuss the risks and benefits with their doctor. Caring for people with Alzheimer disease is stressful and demanding, and caregivers may become depressed and exhausted, often neglecting their own mental and physical health.
The following measures can help caregivers:. Learning about how to effectively meet the needs of people with Alzheimer disease and what to expect from them: Caregivers can get this information from nurses, social workers, organizations, and published and online materials. Seeking help when it is needed: Caregivers can talk to social workers including those in the local community hospital about appropriate sources of help, such as day-care programs, visits by home nurses, part-time or full-time housekeeping assistance, and live-in assistance.
Counseling and support groups can also help. Caring for self: Caregivers need to remember to take care of themselves. They should not give up their friends, hobbies, and activities. Caring for people with dementia is stressful and demanding, and caregivers may become depressed and exhausted, often neglecting their own mental and physical health.
Learning about how to effectively meet the needs of people with dementia and what to expect from them: For example, caregivers need to know that scolding about making mistakes or not remembering may only make behaviors worse.
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