Understanding Alzheimer’s Disease

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In recognition of Alzheimer’s Disease Awareness Month, Look insideKP NCAL has a conversation with neurologist Craig Hou, MD.

Most everyone has a family member or friend who has been affected by Alzheimer’s disease. It is the most common cause of dementia among older adults, and the number of people diagnosed with the disease is growing. Today there are more than 5 million people living with the diagnosis, and by the year 2050 the number is expected to reach nearly 14 million.

Craig Hou, MD

Craig Hou, MD, chief of Neurology at Kaiser Permanente South San Francisco, specializes in degenerative conditions of the brain such as Alzheimer’s disease. Look insideKP NCAL recently spoke with Dr. Hou about what is being learned about the disease and how we might reduce our risk.  

What’s the difference between dementia and Alzheimer’s disease?

Dementia is a decline in thinking, remembering, and reasoning that is severe enough to interfere with someone’s daily life. People with dementia may forget to pay their bills, forget to turn off the stove, or may repeat questions over and over. We all forget things periodically, but we’re still able to function in our lives. That is not dementia.

There can be a number of causes of dementia, but Alzheimer’s disease accounts for 60 to 80 percent of cases. With Alzheimer’s, at a microscopic level, abnormal proteins build up inside the brain, and the accumulation causes the brain’s nerve cells to slowly die. The damage affects the brain’s ability to function, and this causes symptoms of dementia.

Alzheimer’s is a progressive disease that causes dementia symptoms to worsen over the course of years as the abnormal proteins spread and brain tissue shrinks significantly.

What are the risk factors for the disease?

The largest risk factor is advancing age. A small percentage of people are diagnosed with Alzheimer’s disease before the age of 65, but it is largely a disease of older people. There is some risk associated with genetics and some with vascular health.

Studies show women are more likely to develop Alzheimer’s than men. That may be due in part to the fact that women live longer than men on average.

We also know that older Hispanics are about one and a half times as likely as older whites to have Alzheimer’s and other dementias, while older African-Americans are about twice as likely to have the disease as older whites. This is probably not related to race or ethnicity. It is more likely related to vascular health, because these groups have higher rates of hypertension, high cholesterol, and diabetes.

What treatments are available?

Unfortunately, there are no medications currently available to prevent, stop, or slow the progression of Alzheimer’s disease. There are medications available to treat the symptoms of people in the earlier stages of the disease. The medications are helpful for some people, but the effect tends to be temporary.

I see hope in the fact that researchers are beginning to understand the pathology of the disease better, and that will help us develop specific targets for treatment in the future.

What is your advice for reducing risk?

What’s good for the heart is good for the brain, so it’s important to get your general health in order. Eating a healthy balanced diet and regularly exercising have been shown to be helpful in reducing risk.

There’s also evidence that getting a good 7 to 8 hours of sleep regularly can help the brain function day to day and perhaps into the future. The thinking is that the brain resets itself or clears out toxins during sleep.

Finally, make it a goal to be a lifelong learner. Learn a new language, pick up a hobby, or consider writing your own autobiography. Exercising your brain may also help reduce your risk.

Learn more about Alzheimer’s disease and dementia.

Discussion6 Comments

  1. Hi Dr Hou,
    Is there a way to test early on if a person has Alzheimer’s? My mother was formally diagnosed at age 76, she is now 83 years old. I am 55 and I have noticed lately that I sometimes place things in the wrong drawer or cupboard in my house (I live alone). My father has always said that this is how my mother first started showing signs. I did some genetic testing with 23andme and I carry the ‘late’ onset gene for Alzheimer’s which I know doesn’t necessarily mean that I will definitely get it. Your answer above seems to address people who are already showing more advanced signs and symptoms.

    • There is ongoing debate and study about how early can Alzheimer’s disease be detected. Currently, there is no widely accepted or clinically useful way to detect Alzheimer’s disease before someone shows any symptoms. Genetic testing for someone with a family member with late onset Alzheimer’s disease is generally not recommended because there are no specific ways to prevent or treat Alzheimer’s disease for someone at risk.

      Thanks
      Craig Hou, MD

  2. Hi Dr. Hou,
    Would you recommend Dr. Dale Bredesen’s book on “The End of Alzheimer’s”, the latest science into a practical plan that can reverse Alzheimer’s and dramatically improve brain health and function?

    • Dolores Radding

      From Craig Hou, MD:

      There is not enough data or rigorous study of Dr. Bredesen’s theory and hypothesis to recommend it for everyone. His approach includes general principles that are applicable to everyone, such as proper diet, regular exercise, stress management, and adequate sleep.

  3. My mom was diagnosed with vascular dementia but she only answered a series of questions. What diagnostic tools are used to determine if someone has dementia or Alzheimer’s?

    • Dolores Radding

      From Craig Hou, MD:

      Dementia is the symptoms and troubles that the person is having and that are visible to other people. Alzheimer’s disease is what is occurring at the microscopic level, what is affecting the brain, and causing the dementia symptoms. Vascular dementia refers to dementia from injury to the brain from decreased blood flow and oxygen to parts of the brain, most often from hardening of the small and tiny blood vessels in the brain.

      Alzheimer’s disease is diagnosed based upon an interview with and information from a person’s loved one or caregiver. A physical and neurological examination is also often performed. Questions assessing a person’s memory and thinking ability are also asked. Blood tests and brain scans are often ordered to evaluate for other possible causes of dementia. If those tests are negative or normal, then the most likely cause of dementia is Alzheimer’s disease.

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