The most common cause of dementia, Alzheimer’s disease, is a degenerative brain condition. When neurons (nerve cells) in the areas of the brain used for cognitive functions become damaged or destroyed, individuals experience symptoms, including difficulty with memory, language, problem-solving and other cognitive skills, which impact the ability to engage in the activities of daily living. Although the cause for Alzheimer’s disease is unknown and there is currently no cure, many research studies are currently searching for pharmaceutical and behavioral treatments.

Risk factors for Alzheimer’s disease include age, having a family history of Alzheimer’s, and carrying the APOE-e4 gene. As 82 percent of individuals with Alzheimer’s disease are age 75 or older, Alzheimer’s disease primarily affects the elderly. However, approximately 200,000 individuals were living with younger-onset Alzheimer’s disease in 2017.² Individuals with a first-degree relative who has Alzheimer’s are more likely to develop Alzheimer’s.³  The APOE gene is related to the proteins that transport cholesterol in the bloodstream. Having the APOE-e4 form of this gene increases the risk of developing Alzheimer’s.⁴

The health of the heart and blood vessels has a substantial impact upon the brain. Factors that increase the risk of cardiovascular disease which are also associated with an increase in the risk of dementia include obesity, diabetes, hypertension, high cholesterol, and smoking. Additionally, individuals who have more education⁵ and who are socially, physically, and mentally active throughout their life have a lower risk of developing Alzheimer’s disease.⁶ A healthy diet and ongoing learning/cognitive training may also lessen the risk of developing Alzheimer’s.⁷

There are currently six drugs approved by the U.S. Food and Drug Administration for the treatment of Alzheimer’s disease. These drugs temporarily improve the symptoms but do not slow or stop Alzheimer’s. Many non-pharmacologic therapies have been used to help maintain or improve cognitive function in individuals with Alzheimer’s disease. Some studies have found that exercise has a positive impact upon cognitive function.^{8, 9}

One way to increase the quality of life for individuals with Alzheimer’s disease is by actively managing the disease through controlling other co-diseases, coordinating care among health professionals and caregivers, participating in socially meaningful activities, and appropriately using any therapy options. Additionally, there are many community resources to help individuals with Alzheimer’s disease and their caregivers. The Alzheimer’s Association (https://www.alz.org/) is the foremost voluntary health organization for individuals living with Alzheimer’s disease and their families/caregivers. Each state designates Area Agencies on Aging (find your local AAA by visiting www.eldercare.gov), a non-profit agency, to address the needs and concerns of older individuals living in the state. Another state-based resource, Aging and Disabilities Resource Connections, provides a coordinated system of partnering organizations that aim to support individuals and family members who are aging or living with a disability. Additional caregiver resources can be found through the Rosalynn Carter Institute for Caregiving (http://www.rosalynncarter.org/).

References

1. National Center for Health Statistics. Health, United States, 2016: With Chartbook on Long-Term Trends in Health. Hyattsville, MD; 2017. https://www.cdc.gov/nchs/data/hus/hus16.pdf#019. Accessed August 27, 2018.
2. Alzheimer’s Association. 2017 Alzheimer’s disease facts and figures. Alzheimers Dement. 2017;13(4):325-373. doi:10.1016/j.jalz.2017.02.001
3. Loy CT, Schofield PR, Turner AM, Kwok JB. Genetics of dementia. Lancet Lond Engl. 2014;383(9919):828-840. doi:10.1016/S0140-6736(13)60630-3
4. Farrer L, Cupples L, Haines J, et al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA. 1997;278(16):1349-1356.
5. Fitzpatrick AL, Kuller LH, Ives DG, et al. Incidence and prevalence of dementia in the Cardiovascular Health Study. J Am Geriatr Soc. 2004;52(2):195-204.
6. Wang H-X, Xu W, Pei J-J. Leisure activities, cognition and dementia. Biochim Biophys Acta. 2012;1822(3):482-491. doi:10.1016/j.bbadis.2011.09.002
7. Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimers Dement J Alzheimers Assoc. 2015;11(6):718-726. doi:10.1016/j.jalz.2015.05.016
8. Groot C, Hooghiemstra A, Raijmakers PGHM, et al. The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials. Ageing Res Rev. 2016;25:13-23. doi:10.1016/j.arr.2015.11.005
9. Farina N, Rusted J, Tabet N. The effect of exercise interventions on cognitive outcome in Alzheimer’s disease: a systematic review. Int Psychogeriatr. 2014;26(1):9-18. doi:10.1017/S1041610213001385

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