?What Is Alzheimer’s Anyway
People talk about Alzheimer’s and dementia as if they are two different things. They’re not. Dementia is used to describe a group of conditions that affect your ability to think, remember, and go about your daily life. It ranges from mild impairment—you have trouble keeping track of the days or balancing a checkbook, say—to a total inability to take care of yourself.
There are, but the most common is Alzheimer’s disease—about 80% of people with dementia have Alzheimer’s, according to the . Mostly, it affects those over 65 (although there’s a rare early onset version that can strike people even in their 30s)—about one in 10 adults over the age of 65 have Alzheimer’s in the U.S., according to the . It’s also a progressive disease, meaning over the span of roughly four to 12 years, it can go from its mild form to its most severe. How fast it progresses tends to depend on the age you first show symptoms: People in their 60s decline faster than those who develop it in their 80s, though researchers don’t fully know why.
To understand Alzheimer’s, it’s good to know how a healthy brain works. Everything we think, do, and feel is the result of billions of nerve cells, called neurons, communicating with one another, sending messages via neurotransmitters to different parts of the brain. To keep the brain cells working, you need just the right amount of blood and nutrients to nourish them and enough glucose (a.k.a. blood sugar) to keep them powered up. When there’s too much debris and too many dead neurons in your brain, immune cells, including the microglia, clean up the mess.
In Alzheimer’s earliest stages—about 20 years before the first signs of the disease show up—the brain’s ability to keep everything running smoothly begins to break down. Here’s a step-by-step of what happens:
A protein known as beta-amyloid begins to build up in the brain. Everybody produces beta-amyloid, but for a variety of reasons—some genetic, some related to aging and inflammation—certain people lack the ability to clear out the excess, which then goes on to form clumps in the brain known as plaques.
Once there are enough plaques in the brain to do damage, another protein called tau, found inside the neurons, also starts to stick together. The tau proteins form long chains that tangle and then extend outside the cells, spreading through the brain, disrupting normal nerve function. And as if these tangles and plaques weren’t enough to deal with, there’s more.
Beta amyloid can also build up in the brain’s blood vessels, making them stiffer and less able to carry blood and nutrients to the cells. That means the brain doesn’t get glucose as efficiently as it once could and it doesn’t process it as well. The result? The brain doesn’t get the energy it needs.
Then, as immune cells try to clear up the plaques, inflammation fires up. Alzheimer’s disease is quite literally the bull inside your brain’s china shop.
This cascade of changes first affects the brain’s temporal lobes and the hippocampus, the parts of the brain involved in forming memory and learning. This is why one of the earliest signs of Alzheimer’s tends to be memory loss (but a particular kind—more on that later). Later more parts of the brain are impacted and more neurons die off, causing the brain to shrink in size. As that happens, people lose more critical thinking skills—like being able to remember events from their childhood or follow a TV show—and they struggle with day-to-day functions like the ability to dress themselves or even control their bladder.
? Is There a Cure for Alzheimer's Disease
There’s no cure for Alzheimer’s. At its most severe, you lose the skills you were born with, like swallowing, coughing, and breathing. People who die of Alzheimer’s usually die because they stop eating or have impaired swallowing and develop pneumonia or other infections. Or they may die because they can’t take the meds they need to manage another condition, like heart disease or diabetes. Right now, Alzheimer’s is the sixth leading cause of death in the U.S. (at least pre-2020).
It all sounds grim, but there are breakthroughs on the horizon, including a new blood test that can diagnose Alzheimer’s earlier and new medications in clinical trials that can slow the disease down. And because researchers have learned so much in the past decade, even if you’ve been diagnosed with the disease (or know someone who has) there are steps you can take today that can buy you more quality time.
Alcohol Use (and Abuse)
It’s better to have one drink a day than to binge drink or abstain completely, according to one study of roughly 3,000 people aged 72 years and older. Moderate drinking (defined as fewer than 14 drinks a week) may lower the risk of dementia.
The caveat: Moderate drinking may not be as good for you when you have trouble remembering appointments and paying bills, a condition known as mild cognitive impairment (MCI). People with MCI who continued to indulge in their once-a-day habit or, worse, drink more than 14 drinks a week, were at greater risk for developing dementia, including Alzheimer’s.
