Alzheimer disease affects the brain, causing memory problems and eventually severe problems with mental function. It gets worse over time, and people with Alzheimer disease have gradual memory loss, as well as loss of judgment, trouble concentrating, loss of language skills, personality changes, and a decline in the ability to learn new tasks. In advanced stages, people with Alzheimer disease may lose all memory and mental abilities.
Alzheimer disease is the most common form of dementia. About 5 million Americans have Alzheimer disease, and this number is expected to grow as the population gets older. The disease progress is different for each person. If Alzheimer disease comes on quickly, it usually gets worse quickly. If it has been slow to get worse, it will often continue slowly.
Alzheimer disease symptoms happen because the disease kills brain cells. In a healthy brain, billions of neurons create chemical and electrical signals that are relayed from cell to cell. They help a person think, remember, and feel. Neurotransmitters, brain chemicals, help these signals move from cell to cell. In people with Alzheimer disease, neurons in some places start to die, and the brain makes lower levels of neurotransmitters. That causes the brain to have problems with its signals.
There is no cure for Alzheimer disease, but medicines can help slow the progression of the disease in some people. Herbs and supplements, and lifestyle adjustments, may also help reduce the risk or improve quality of life.
Signs and Symptoms
The early symptoms of Alzheimer disease can be missed because people may think they are due to "natural aging." The following are common signs and symptoms of Alzheimer disease:
Researchers are not sure what causes Alzheimer disease. Genetics and the environmental factors may both contribute. Recent research indicates that free radicals (molecules that damage cells and DNA) may play a role.
The brains of people with Alzheimer disease have a buildup of two types of proteins. Clumps of abnormal cells called plaques, are made of beta-amyloid protein. These plaques build up between neurons and may stop them from communicating with each other. Inside nerve cells are tangles, made of twisted tau protein. The brain needs tau protein to function, but in people with Alzheimer disease the protein gets twisted, which may damage brain cells.
People with the APOE-e4 gene are more likely to develop Alzheimer disease, it is known as a "risk gene" for the condition. But scientists think other genes may be involved. And even people without inherited genes for the disease can get Alzheimer disease.
The causes and risk factors linked to Alzheimer disease are not entirely clear but include:
There is no single test for Alzheimer disease. A true diagnosis can be made only after a person dies and an autopsy is done on the brain.
However, Alzheimer disease usually has a pattern of symptoms. A doctor will start by ruling out other possible causes. The doctor will ask questions about medical history and symptoms and do a physical exam, including a neurological exam.
The following tests may also be used:
In the early stages, brain scans may be normal. In later stages, an MRI may show certain brain areas have gotten smaller. While the scans do not confirm the diagnosis of Alzheimer disease, they rule out other causes of dementia, such as stroke and tumor.
No one knows exactly how to prevent Alzheimer disease, but eating a healthy diet and exercising regularly help.
The goals in treating Alzheimer disease are to:
There is no cure for Alzheimer disease. The most promising treatments include lifestyle changes and medications.
Studies show the following lifestyle changes may help improve behavior in people with Alzheimer disease:
Several drugs are available to help slow the progression of Alzheimer disease and possibly improve mental function.
Cholinesterase inhibitors: increase the amount of acetylcholine in the brain. Side effects can include nausea, fatigue, and diarrhea. This class of drugs includes:
Memantine (Namenda): This drug works by regulating a chemical messenger called glutamate, which is involved in information storage and retrieval in the brain. Side effects may include headache, constipation, confusion, and dizziness. It is the only drug approved for treatment of moderate-to-severe Alzheimer disease.
The following medications may also ease the symptoms related to Alzheimer disease:
Nutrition and Dietary Supplements
People with Alzheimer disease may need help with their diet. They often forget to eat and drink and can get dehydrated.
Follow these tips for a healthy diet:
Always tell you doctor about any herb or dietary supplement you are taking, because some could interact with other medicines. These supplements may help with some symptoms of Alzheimer disease, although more research is needed:
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting treatment. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.
Small studies have shown that transcutaneous electrical nerve stimulation (TENS), a technique used in physical therapy and certain types of acupuncture, may improve memory and daily living skills in people with Alzheimer disease. More studies are needed.
Massage and Physical Therapy
People with Alzheimer disease become frustrated and anxious because they cannot communicate well with language. Using touch, or massage, as nonverbal communication may help. In one study, people with Alzheimer disease who got hand massages and were spoken to in a calming manner had lower pulse rates and did not engage in as much inappropriate behavior. Health care professionals think that massage may help not only because it is relaxing, but because it provides a form of social interaction.
Music therapy, using music to calm and heal, cannot slow or reverse dementia. But it may improve quality of life for both a person with Alzheimer disease and their caregiver. Clinical reports suggest that music therapy may reduce wandering and restlessness and increase chemicals in the brain that promote sleep and ease anxiety. Studies also show that listening to music improves mood.
Preliminary studies suggest aromatherapy, including lavendar may help alleviate agitation among people who have dementia.
Support for the Caregiver
Studies suggest that caregivers who receive emotional support have better quality of life, which also benefits the people they care for.
Alzheimer disease can lead to many complications, including:
Alzheimer disease gets worse over time, however, people with the disease may live for many years. Those with a long-standing history of high blood pressure are more likely to get worse faster.
Aboukhatwa M, Dosanjh L, Luo Y. Antidepressants are a rational complementary therapy for the treatment of Alzheimer's disease. Mol Neurodegener. 2010;5:10.
Akhondzadeh S, Abbasi SH. Herbal medicine in the treatment of Alzheimer's disease. Am J Alzheimers Dis Other Demen. 2006;21(2):113-8.
Begum AN, Jones MR, Lim GP, Morihara T, Kim P, Heath DD, et al. Curcumin structure-function, bioavailability, and efficacy in models of neuroinflammation and Alzheimer's disease. J Pharmacol Exp Ther. 2008 Jul;326(1):196-208.
Bell DR, Gochenaur K. Direct vasoactive and vasoprotective properties of anthocyanin-rich extracts. J Appl Physiol. 2006;100(4):1164-70.
Christen Y. Oxidative stress and Alzheimer disease. Am J Clin Nutr. 2000;71(suppl):621S-629S.
Crawford TJ, Higham S, Mayes J, Dale M, Shaunak S, Lekwuwa G. The role of working memory and attentioonal disengagement on inhibitory control: effects of aging and Alzheimer's disease. Age (Dordr). 2013;35(5):1637-50.
DeKosky ST, et al; Ginkgo Evaluation of Memory (GEM) Study Investigators. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008 Nov 19;300(19):2253-62.
Diamond BJ, Shiflett SC, Feiwel N, et al. Ginkgo biloba extract: mechanisms and clinical indications. Arch Phys Med Rehabil. 2000;81:669-78.
Ferri: Ferri's Clinical Advisor 2015. Philadelphia, PA: Elsevier Mosby; 2014.
Fukui H, Arai A, Toyoshima K. Efficacy of music therapy in treatment for the patients with Alzheimer's disease. Int J Alzheimers Dis. 2012;2012:531646. doi: 10.1155/2012/531646.
Harris CS, Cuerrier A, Lamont E, et al. Investigating wild berries as a dietary approach to reducing the formation of advanced glycation endproducts; chemical correlates of in vitro antiglycation activity. Plant Foods Hum Nutr. 2014;69(1):71-7.
Heo JH, Lee ST, Chu K, Oh MJ, Park HJ, Shim JY, Kim M. An open-label trial of Korean red ginseng as an adjuvant treatment for cognitive impairment in patients with Alzheimer's disease. Eur J Neurol. 2008 Aug;15(8):865-8.
Howes MJ, Houghton PJ. Ethnobotanical treatment strategies against Alzheimer's disease. Curr Alzheimer Res. 2012 Jan;9(1):67-85. Review.
Ihl R, Tribanek M, Bachinskaya N; GOTADAY Study Group. Efficacy and tolerability of a once daily formulation of Ginkgo biloba extract EGb 761 in Alzheimer's disease and vascular dementia: results from a randomised controlled trial. Pharmacopsychiatry. 2012 Mar;45(2):41-6. doi: 10.1055/s-0031-1291217. Epub 2011 Nov 15.
Jiang H, Luo X, Bai D. Progress in clinical, pharmacological, chemical and structural biological studies of huperzine A: a drug of traditional Chinese medicine origin for the treatment of Alzheimer's disease. Curr Med Chem. 2003;10(21):2231-52.
Kelley BJ, Knopman DS. Alternative medicine and Alzheimer disease. Neurologist. 2008 Sep;14(5):299-306.
Kidd PM. Alzheimer's disease, amnestic mild cognitive impairment, and age-associated memory impairment: current understanding and progress toward integrative prevention. Altern Med Rev. 2008 Jun;13(2):85-115.
Koger SM, Brotons M. Music therapy for dementia symptoms (Cochrane Review). In: The Cochrane Library, Issue 4, 2000. Oxford: Update Software.
Le Bars PL, Kieser M, Itil KZ. A 26-week analysis of a double-blind, placebo-controlled trial of the Ginkgo biloba extract EGb761 in dementia. Dement Geriatr Cogn Disord. 2000;11:230-7.
Lee ST, Chu K, Sim JY, Heo JH, Kim M. Panax ginseng enhances cognitive performance in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008 Jul-Sep;22(3):222-6.
Lim YY, Maruff P, Pietrzak RH, et al. Effect of amyloid on memory and non-memory decline from preclinical to clinical Alzheimer's disease. Brain. 2014;137(Pt1):221-31.
Limpeanchob N, Jaipan S, Rattanakaruna S, Phrompittayarat W, Ingkaninan K.Neuroprotective effect of Bacopa monnieri on beta-amyloid-induced cell death in primary cortical culture.J Ethnopharmacol. 2008 Aug 5. (Epub ahead of print)
Lin PW, Chan WC, Ng BF, Lam LC. Efficacy of aromatherapy (Lavandula angustifolia) as an intervention for agitated behaviours in Chinese older persons with dementia: a cross-over randomized trial. Int J Geriatr Psychiatry. 2007;2(5):405-10.
Little JT, Walsh S, Aisen PS. An update on huperzine A as a treatment for Alzheimer's disease. Expert Opin Investig Drugs. 2008 Feb;17(2):209-15.
McDaniel MA, Maier SF, Einstein GO. "Brain-specific" nutrients: a memory cure? Nutrition. 2003;19(11-12):957-75.
Mantle D, Pickering AT, Perry AK. Medicinal plant extracts for the treatment of dementia: a review of their pharmacology, efficacy and tolerability. CNS Drugs. 2000;13:201-13.
Masaki KH, Losonczy KG, Izmirlian G. Association of vitamin E and C supplement use with cognitive function and dementia in elderly men. Neurology. 2000;54:1265-72.
Olazaran J, Reisberg B, Clare L, et al. Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dement Geratr Cogn Disord. 2010; 30(2):161-78.
Orr SK, Bazinet RP. The emerging role of docosahexaenoic acid in neuroinflammation. Curr Opin Investig Drugs. 2008 Jul;9(7):735-43.
Pettegrew JW, Levine J, McClure RJ. Acetyl-L-carnitine physical-chemical, metabolic, and therapeutic properties: relevance for its mode of action in Alzheimer's disease and geriatric depression. Mol Psychiatry. 2000;5:616-32.
Ringman JM, Frautschy SA, Teng E, Begum AN, et al. Oral curcumin for Alzheimer's disease: tolerability and efficacy in a 24-week randomized, double blind, placebo-controlled study. Alzheimers Res Ther. 2012 Oct 29;4(5):43.
Scherder EJ, Van Someren EJ, Bouma A, vd Berg M. Effects of transcutaneous electrical nerve stimulation (TENS) on cognition and behavior in aging. Behav Brain Res. 2000;111(1-2):223-5.
Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
Singh M, Arseneault M, Sanderson T, Murthy V, Ramassamy C. Challenges for research on polyphenols from foods in Alzheimer's disease: bioavailability, metabolism, and cellular and molecular mechanisms. J Agric Food Chem. 2008 Jul 9;56(13):4855-73. Review.
Snowdon DA, Tully CL, Smith CD, Riley KR, Markesbery WR. Serum folate and the severity of atrophy of the neocortex in Alzheimer disease: findings from the Nun Study. Am J Clin Nutr. 2000;71:993-8.
Szatmari SZ, Whitehouse PJ. Vinpocetine for cognitive impairment and dementia. Cochrane Database Syst Rev. 2003;(1):CD003119.
Tabet N, Birks J, Grimley Evans J. Vitamin E for Alzheimer's disease (Cochrane Review). In: The Cochrane Library, Issue 4, 2000. Oxford: Update Software.
van Marum RJ. Current and future therapy in Alzheimer's disease. Fundam Clin Pharmacol. 2008 Jun;22(3):265-74. Review.
Vellas B, Coley N, Ousset PJ, Berrut G, Dartigues JF, Dubois B, Grandjean H, Pasquier F, Piette F, Robert P, Touchon J, Garnier P, Mathiex-Fortunet H, Andrieu S; GuidAge Study Group. Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol. 2012 Oct;11(10):851-9. doi: 10.1016/S1474-4422(12)70206-5. Epub 2012 Sep 6. Review.
Wang J, Ho L, Zhao W, Ono K, Rosensweig C, Chen L, Humala N, et al. Grape-derived polyphenolics prevent Abeta oligomerization and attenuate cognitive deterioration in a mouse model of Alzheimer's disease. J Neurosci. 2008 Jun 18;28(25):6388-92.
Wettstein A. Cholinesterase inibitors and ginkgo extracts -- are they comparable in the treatment of dementia? Phytomed. 2000;6:393-401.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.
Yue J, Dong BR, Lin X, Yang M, Wu HM, Wu T. Huperzine A for mild cognitive impairment. Cochrane Database Syst Rev. 2012 Dec 12;12:CD008827. doi: 10.1002/14651858.CD008827.pub2.
Zhang HY, Zheng CY, Yan H, Wang ZF, Tang LL, Gao X, Tang XC. Potential therapeutic targets of huperzine A for Alzheimer's disease and vascular dementia. Chem Biol Interact. 2008 Sep 25;175(1-3):396-402. (Epub 2008 May 13)
Zhao Y, Zhao B. Natural antioxidants in prevention and management of Alzheimer's disease. Front Biosci (Elite Ed). 2012 Jan 1;4:794-808. Review.
Review Date: 4/23/2015
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.