Alzheimer’s Disease


Nearly 4.5 million people in the United States suffer from Alzheimer’s disease. Alzheimer’s disease is the leading cause of dementia and is the fourth leading cause of death in developed nations (after heart disease, cancer and stroke). Up to 70% of dementias are due to Alzheimer’s disease, with blood vessel disease (stroke and atherosclerosis) being the second most common cause.

The frequency of Alzheimer’s among 60-year olds is about 1/0. This incidence doubles approximately every 5 years, with some estimates that by age 85 as many as 50% suffer from some form of dementia.

Alzheimer’s disease leads to death within an average of 8 years after diagnosis. Besides memory loss, Alzheimer’s disease patients show dramatic personality changes, disorientation, declining physical coordination, and an inability to care for themselves. Death is usually due to pneumonia or urinary tract infection.


  • Amyloid seems to contribute to the formation of neurofibrillary tangles
  • Plaques cause inflammation which causes degeneration and loss of neurotransmifters
  • Impaired metabolism of glucose in the brain leads to loss of ability to get glucose into the brain, though the brain can still use it.
  • The parts of the brain that use insulin are the areas affected (not all areas of the brain use insulin)
  • Develops decades before symptoms develop

Risk Factors

  • Strong
    • Age (although after the age of 90 years the incidence of AD drops off significantly)
    • Family history of Alzheimer’s or Parkinson’s disease
    • Apolipopr otein E (ApoE) e4 allele
      • E2/E4 or E31E4 — 47% increased risk
      • E41E4 — 91% increased risk
      • E4 women not on ERT have the most rapid decline
      • Risk is associated with earlier age of onset and is more progressive
    • Head injury
    • Low estrogen
    • Diabetes
    • Reduced blood flow
    • Stroke
    • Poor word fluency
    • Cardiac risk factors
    • Systolic hypertension
    • High cholesterol
    • Elevated homocysteine level
    • Elevated Hs-CRP level
    • Mild Cognitive Impairment
  • Probable
    • Toxic damage
    • Alcohol abuse
    • Nutrient deficiencies to the brain
    • Neurotransmitter deficits
    • Metabolic defects
    • Underactivity
    • Lower educational level
  • Possible
    • Depression
    • Latent viruses
    • Sugar consumption
    • Aluminum exposur


Warning Signs:
The Alzheimer’s Association’s warning signs include:

  • Memory loss
  • Difficulty performing familiar tasks
  • Problems with language
  • Disorientation to time and place
  • Poor or decreased judgment
  • Problems with abstract thinking
  • Misplacing things
  • Changes in mood or behavior
  • Changes in personality
  • Loss of initiative

The National Institutes of Health’s warning signs include:

  • Asking the same question over and over again
  • Repeating the same story, word for word, again and again
  • Forgetting how to cook, how to make repairs, how to play cards, or other activities that were previously done with ease.
  • Losing the ability to pay bills or balance a checkbook
  • Getting lost in familiar surroundings or misplacing household objects
  • Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean
  • Relying on a spouse or others to make decisions or answer questions they previously would have handled themselves


  • Prior to diagnosis, social withdrawal and depression are common symptoms
  • Mild AD
    • Forgetfulness, unable to learn new information
    • Difficulty managing finances, planning meals, taking medication on schedule
    • Depression symptoms
    • Still able to do most activities, drive car
    • Gets lost going to familiar places
  • Moderate AD
    • Forgetfulness extends to forgetting old facts (e.g., past career, names of friends)
      • Continually repeats stories
      • Makes up stories to fill gaps
    • Difficulty performing tasks
      • Following written notes
      • Using the shower or toilet
    • Agitation, behavioral symptoms common
      • 80% develop agitation
      • Restlessness, repetitive movements
      • Wandering
      • Paranoia, delusions, hallucinations
    • Deficits in intellect and reasoning (e.g., poor judgment, forgets manners)
    • Concern for appearance, hygiene, and sleep become more noticeable
  • Severe AD
    • May groan, scream, mumble, or speak gibberish
    • Behavioral symptoms common
      • Refuses to eat
      • Inappropriately cries out
    • Failure to recognize family or faces
    • Difficulty with all essential activities of daily living (e.g., eating, toileting