About 5.8 million Americans are living with Alzheimer's disease. By 2050, that will jump to 14 million, according to the Alzheimer's Association. One in three seniors dies from the disease or dementia, but how do we know if the memory lapses everybody experiences are due to aging or are signs of disease?
Dr. Gene E. Alexander is a professor in the University of Arizona's departments of psychology and psychiatry. He's a director at the Arizona Alzheimer’s Disease Center and studies brain aging and Alzheimer’s disease.
"I think the key point is that every day we all have common experiences of forgetfulness," he said. "We forget where we parked the car or we might forget where we left our keys, but often times after a few minutes we remember or we can think of ways or strategies to help us remember where we left things. With Alzheimer’s Disease, it’s more significant."
What are the red flags?
According to the Alzheimer's Association:
- Memory loss that disrupts daily life
- Challenges in planning or solving problems
- Difficulty completing familiar tasks
- Confusion with time or place
- Trouble understanding visual images and spatial relationships
- New problems with words in speaking or writing
- Misplacing things and losing the ability to retrace steps
- Decreased or poor judgment
- Withdrawal from work or social activities
- Changes in mood and personality
What are signs of typical aging?
According to the Alzheimer's Association:
- Sometimes forgetting names or appointments, but remembering them later.
- Making occasional errors when managing finances or household bills.
- Occasionally needing help to use microwave settings or to record a TV show.
- Getting confused about the day of the week but figuring it out later.
- Sometimes having trouble finding the right word.
- Misplacing things from time to time and retracing steps to find them.
- Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.
- Sometimes feeling uninterested in family or social obligations.
- Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
Do patients realize they might have an issue?
"Some individuals early on might be very sensitive to the loss of function and realize there’s something going on and want to be evaluated quickly to identify if there’s a problem, and with other people it sneaks up," Alexander said. "It’s what we call insidious. It develops gradually and may be harder to recognize because it’s so gradual."
How can the disease be caught early?
"It’s often times important for the caregivers, the friends and family to be able to provide input about how a person’s doing... It can be very valuable to say their loved one has shown real changes and can’t do the things they used to do," Alexander said.
"Those kinds of observations are really valuable in assessing how things have changed. Sometimes the person may not see all of the difficulties or it just may be painful to recognize that there’s significant changes going on."
Could a poor memory be indicative of anything else?
Problems with memory could also mean an elderly patient might have a mild cognitive impairment. A person with MCI has more memory issues than a normal aging adult, but is still able to perform normal daily activities, he said.
About 15 to 20 percent of the elderly have MCI, according to the Alzheimer's Association.
"We think people who have mild cognitive impairment are at increased risk for developing Alzheimer’s disease in the next three to five years," Alexander said. "That’s an early transition point that we’re very interested in understanding why that occurs in people and how we can sort of slow that."
Are there drugs to help MCI patients?
While there are drugs available to address the symptoms of Alzheimer's, they don't seem to help people with MCI. Nor do they prevent the progression to dementia, according to the Alzheimer's Association. There are also no drugs available to modify the course of Alzheimer's.
What are researchers working on now?
Researchers are really focused right now on identifying people who are at increased risk for Alzheimer's and dementia so treatments can be created to prevent the development of the disease, Alexander said.
"I think we’ve made tremendous progress in terms of understanding the disease and understanding the changes that occur in the brain that lead to the cognitive problems that we experience," Alexander said. "We’ve made tremendous advances in trying to develop what we call bio-markers, which detect the earliest signs of it early."
Biomarkers are measurable biological factor, such as levels of a protein, that indicates the presence or absence of a disease.
What's taking so long?
"It’s a very heterogenous disease. We don’t understand fully the causes," Alexander said. "We know there are abnormalities in the brain, but we don’t know which ones are the most important in terms of leading to the disease, so we’re working through some of those characteristics and how to target those for disease treatment."
Is there hope?
"I’m hopeful in the next few years we’ll really make some breakthroughs in that direction, but there's still quite a bit of work to do. We need as much support as we can have put toward this so we can address it," Alexander said. "Once we have enough research that shows which biomarkers are the most useful, then have a way to help people in the clinical settings, but not there yet."