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Factors that put you at risk for alzheimers

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Factors that put you at risk for alzheimers

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Age

Genetics

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USA - 6MIL
World- 50 mil

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An estimated 6.9 million Americans age 65 and older are living with Alzheimer's in 2024. Seventy-three percent are age 75 or older.

About 1 in 9 people age 65 and older (10.9%) has Alzheimer's.

Almost two-thirds of Americans with Alzheimer's are women.

Older Black Americans are about twice as likely to have Alzheimer's or other dementias as older Whites.

Older Hispanics are about one and one-half times as likely to have Alzheimer's or other dementias as older Whites.

As the size of the U.S. population age 65 and older continues to grow, so too will the number and proportion of Americans with Alzheimer's or other dementias. By 2050, the number of people age 65 and older with Alzheimer's may grow to a projected 12.7 million, barring the development of medical breakthroughs to prevent or cure Alzheimer's disease.

Alzheimer's is not just memory loss. Alzheimer's kills.

One in 3 older Americans dies with Alzheimer's or another dementia. It kills more than breast cancer and prostate cancer combined.

Deaths from Alzheimer's have more than doubled between 2000 and 2021, while those from heart disease - the leading cause of death - have decreased.

At age 70, older Americans living with Alzheimer's are twice as likely to die before age 80 than those who do not have the disease.

People age 65 and older survive an average of four to eight years after a diagnosis of Alzheimer's, yet some live as long as 20 years with Alzheimer's. This reflects the slow, uncertain progression of the disease.
Eighty-three percent of the help provided to older adults in the United States comes from family members, friends or other unpaid caregivers. Nearly half of all caregivers who provide help to older adults do so for someone living with Alzheimer's or another dementia.
Who are the caregivers?

About 30% of caregivers are age 65 or older.

Approximately two-thirds of caregivers are women; more specifically, over one-third of dementia caregivers are daughters.

Most caregivers (66%) live with the person with dementia in the community.

Approximately one-quarter of dementia caregivers are "sandwich generation" caregivers - meaning that they care not only for an aging parent but also for at least one child.

Alzheimer's takes a devastating toll on caregivers. Compared with caregivers of people without dementia, twice as many caregivers of those with dementia indicate substantial emotional, financial and physical difficulties.
As the prevalence of Alzheimer's disease increases, so does the need for more members of the paid workforce to be knowledgeable and skillful about working with a diverse population of people living with dementia, as well as with their families.
Of the total lifetime cost of caring for someone with dementia, 70% is borne by families - either through out-of-pocket health and long-term care expenses or from the value of unpaid care.
The costs of health care and long-term care for individuals living with Alzheimer's or other dementias are substantial, and dementia is one of the costliest conditions to society.

Fifty-five percent of primary care physicians (PCPs) caring for people living with Alzheimer's report there are not enough dementia care specialists in their communities.

Between 2021 and 2031, more than 1 million additional direct care workers will be needed to care for the growing population of people living with dementia - the largest worker gap of any single occupation in the U.S.

Half of PCPs reported that they do not feel adequately prepared to care for individuals with Alzheimer's and other dementias.

The U.S. will have to nearly triple the number of geriatricians to effectively care for the number of people projected to have Alzheimer's in 2050.

Turnover rates for direct care workers are high - estimated at 77% annually for those providing home care and 99% for nursing assistants in nursing homes.

In 2024, health and long-term care costs for people living with Alzheimer's and other dementias are projected to reach $360 billion - not including the value of unpaid caregiving. Medicare and Medicaid are expected to cover $231 billion (64%), while out-of-pocket spending is expected to be $91 billion. Total payments for health care, long-term care and hospice care for people living with dementia are projected to increase to nearly $1 trillion in 2050.

The total lifetime cost of care for a person living with dementia is estimated at almost $400,000. Seventy percent of these costs are borne by family caregivers in the forms of unpaid caregiving and out-of-pocket expenses.

People living with Alzheimer's or other dementias have twice as many hospital stays per year as other older people.

Medicare beneficiaries with Alzheimer's or other dementias are more likely than those without dementia to have other chronic conditions, such as heart disease, diabetes and kidney disease.

Older people living with Alzheimer's or other dementias have more skilled nursing facility stays and home health care visits per year than other older people.

People living with Alzheimer's or other dementias make up a large proportion of all elderly people who receive adult day services and nursing home care.

Dementia care is a complex maze with interactions between primary care providers, specialists, social services, medication management and caregiver support. Navigating this maze is difficult and often frustrating for people living with Alzheimer's or other dementia and their caregivers. Without a clear path forward, any roadblock or detour along the way can have considerable consequences - whether they be missed opportunities for treatment, missed connections to resources and services, or missed chances for maintaining quality of life.
Overwhelmingly, caregivers would welcome dementia care navigator support and believe it would benefit both the person living with dementia and the caregiver.
Mapping a Better Future for Dementia Care Navigation (PDF) provides a comprehensive look at dementia care navigation, a holistic model of care that provides medical and social support for people living with dementia and their caregivers in order to alleviate stress, improve health outcomes and lower costs. Dementia care navigation emphasizes person-centered, evidence-based, culturally competent, empowered support throughout the dementia care journey. Support services include:

Caregiver education and training.

Care coordination, including scheduling appointments, coordinating diagnostic testing, and facilitation communication and referrals across specialities and organizations.

Connecting people living with dementia and caregivers to education and training, social services, and community support.

Management of chronic conditions, medication, symptoms and dementia-related behaviors.

Safety assessments.

Advance care planning.

Assistance with insurance and benefits.

The special report survey revealed three recommendations for health care systems to advance dementia care navigation efforts:

Seven in 10 dementia caregivers say that coordinating care is stressful.

More than 4 in 5 dementia caregivers (85%) say having access to a care navigator would influence their choice of dementia health care provider for the person they care for.

Three in 5 dementia caregivers (61%) believe that having a care navigator would improve quality of life for their care recipient, and 43% believe that a care navigator would improve the care recipient's overall health.

Three in 5 dementia caregivers say less stress (62%) and more peace of mind (62%) would be valuable outcomes of having a care navigator. More than half (56%) say having a care navigator could help them be better caregivers.

The special report national survey also found that 60% of health care workers believe that the U.S. health care system is not effectively helping patients and their families navigate dementia care.

1. Formalize the dementia care navigator role and increase navigator proficiency in dementia care.

2. Scale and expand access to dementia care navigation programs.

3. Create direct lines to dementia care navigators, such as a 24/7 helpline.

Health care delivery that includes dementia care navigation can improve the quality of life of those facing dementia and their caregivers, paving the way for a more sustainable, efficient and compassionate health care system. Learn more in Mapping a Better Future for Dementia Care Navigation (PDF) and view the special report infographic (PDF).

For more information about dementia care navigation, read the Dementia Care Navigation Guiding Principles, a national framework for dementia care navigation within or in collaboration with U.S. health systems, and consider participating in the Dementia Care Navigation Roundtable.

Read past special reports

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Read the 2024 report to understand the burden of Alzheimer's and dementia on individuals, caregivers, government and the nation's health care system.

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Galantamine- nausea, vommiting,

Aducanumab - Reduces number of plaques in brain - Imaging abnormalities

Memantine - Blocks toxic effects with excessive glutamate - dizziness, headache, constipation

Scientists still do not fully understand what directly cures alzheimers

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Treatment of Alzheimer's Disease

Alzheimer's disease is complex, and it is therefore unlikely that any one drug or other intervention will ever successfully treat it in all people living with the disease. Still, in recent years, scientists have made tremendous progress in better understanding Alzheimer's and in developing and testing new treatments, including several medications that are in late-stage clinical trials.

Several prescription drugs are already approved by the U.S. Food and Drug Administration (FDA) to help manage symptoms in people with Alzheimer's disease. And, on June 7, 2021, FDA provided accelerated approval for the newest medication, aducanumab, which helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimer's, although it has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.

Most medicines work best for people in the early or middle stages of Alzheimer's. However, it is important to understand that none of the medications available at this time will cure Alzheimer's.

Treatment for mild to moderate Alzheimer's

Treating the symptoms of Alzheimer's can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer's symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.

Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer's disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer's progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimer's may respond better to one drug versus another.

Medications that target the underlying causes of a disease are called disease-modifying drugs or therapies. Aducanumab is the only disease-modifying medication currently approved to treat Alzheimer's. This medication is a human antibody, or immunotherapy, that targets the protein beta-amyloid and helps to reduce amyloid plaques, which are brain lesions associated with Alzheimer's. Clinical studies to determine the effectiveness of aducanumab were conducted only in people with early-stage Alzheimer's or mild cognitive impairment. Researchers are continuing to study whether this medication works to affect a person's rate of cognitive decline over time.

Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimer's before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.

Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimer's as potential treatments.

Aducanumab was approved through the FDA's Accelerated Approval Program, which provides a path for earlier approval of drugs that treat certain serious conditions. This helps people living with the disease gain earlier access to the treatment. The approval of aducanumab was based on the ability of the drug to reduce amyloid in the brain. When using the accelerated approval pathway, drug companies are required to conduct additional studies to determine whether there is in fact clinical benefit after the drug is approved. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.

Treatment for moderate to severe Alzheimer's

A medication known as memantine, an N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer's disease. This drug's main effect is to decrease symptoms, which could enable some people to maintain certain daily functions a little longer than they would without the medication. For example, memantine may help a person in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both the person with Alzheimer's and caregivers.

Memantine is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.

The FDA has also approved donepezil, the rivastigmine patch, and a combination medication of memantine and donepezil for the treatment of moderate to severe Alzheimer's.

Drug Name

Drug Type and Use

How It Works

Common Side Effects

Drug Name

Delivery Method

For More Information

Aducanumab

Intravenous: Dose is determined by a person's weight; given over one hour every four weeks; most people will start with a lower dose and over a period of time increase the amount of medicine to reach the full prescription dose

Prescribing information (PDF, 343K)

Donepezil

Tablet: Once a day; dosage may be increased over time if well tolerated

Orally disintegrating tablet: Same dosing regimen as above

Prescribing information (PDF, 594K)

Rivastigmine

Capsule: Twice a day; dosage may be increased over time, at minimum two-week intervals, if well tolerated

Patch: Once a day; dosage amount may be increased over time, at minimum four-week intervals, if well tolerated

Prescribing information (PDF, 284K)

Memantine

Tablet: Once a day; dosage may be increased in amount and frequency (up to twice a day) if well tolerated

Oral solution: Same dosage as tablet

Extended-release capsule: Once a day; dosage may increase in amount over time, at minimum one-week intervals, if well tolerated

Prescribing information (PDF, 604K)

Manufactured combination of memantine and donepezil

Extended-release capsule: Once a day; initial dosage depends on whether the person is already on a stable dose of memantine and/or donepezil; dosage may increase over time, at minimum one-week intervals, if well tolerated

Prescribing information (PDF, 455K)

Galantamine

Tablet: Twice a day; dosing may increase over time, at minimum four-week intervals, if well tolerated

Extended-release capsule: Same dosage as tablet but taken once a day

Prescribing information (PDF, 1M)

Dosage and side effects of Alzheimer's disease medications

Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evidence that certain people may benefit from higher doses of Alzheimer's medications. However, the higher the dose, the more likely side effects will occur.

Patients should be monitored when a drug is started. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, allergic reactions, and loss of appetite. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor's instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.

Managing behavioral symptoms of Alzheimer's disease

Common behavioral symptoms of Alzheimer's include sleeplessness, wandering, agitation, anxiety, aggression, restlessness, and depression. Scientists are learning why these symptoms occur and are studying new treatments - drug and nondrug - to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimer's more comfortable and makes things easier for caregivers.

Experts agree that medicines to treat these behavior problems should be used only after other strategies that don't use medicine have been tried. Learn more about behavioral changes in people with Alzheimer's disease and ways to cope.

Medicines to be used with caution in people with Alzheimer's disease

There are some medicines, such as sleep aids, anti-anxiety drugs, anti-convulsants, and antipsychotics, that a person with Alzheimer's disease should take only:

After the doctor has explained all the risks and side effects of the medicine

After other, safer nonmedication options have not helped treat the problem

People living with Alzheimer's and their caregivers must watch closely for side effects from these medications.

Sleep aids are used to help people get to sleep and stay asleep. People with Alzheimer's should NOT use these drugs regularly because they make the person more confused and more likely to fall. There are lifestyle changes people can make to improve their sleep. Learn more about getting a good night's sleep.

Anti-anxiety drugs are used to treat agitation. These drugs can cause sleepiness, dizziness, falls, and confusion. For this reason, doctors recommend they should only be used for short periods of time.

Anti-convulsants are drugs sometimes used to treat severe aggression. Side effects may cause sleepiness, dizziness, mood swings, and confusion.

Antipsychotics are drugs used to treat paranoia, hallucinations, agitation, and aggression. Side effects of using these drugs can be serious, including increased risk of death in some older people with dementia. They should only be given to people with Alzheimer's when the doctor agrees that the symptoms are severe.

The future of Alzheimer's disease treatments

Alzheimer's disease research has developed to a point where scientists are exploring a variety of avenues to not only treat symptoms but also address underlying disease processes. In ongoing clinical trials, scientists are developing and testing several possible interventions, including immunization therapy, drug therapies, cognitive training, physical activity, and treatments for cardiovascular disease and diabetes.

Read about this topic in Spanish. Lea sobre este tema en español.

For more information about treating Alzheimer's

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov portal for information and resources on Alzheimer's and related dementias from across the federal government.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Treatment of Alzheimer's Disease

Alzheimer's disease is complex, and it is therefore unlikely that any one drug or other intervention will ever successfully treat it in all people living with the disease. Still, in recent years, scientists have made tremendous progress in better understanding Alzheimer's and in developing and testing new treatments, including several medications that are in late-stage clinical trials.

Several prescription drugs are already approved by the U.S. Food and Drug Administration (FDA) to help manage symptoms in people with Alzheimer's disease. And, on June 7, 2021, FDA provided accelerated approval for the newest medication, aducanumab, which helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimer's, although it has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.

Most medicines work best for people in the early or middle stages of Alzheimer's. However, it is important to understand that none of the medications available at this time will cure Alzheimer's.

Treatment for mild to moderate Alzheimer's

Treating the symptoms of Alzheimer's can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer's symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.

Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer's disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer's progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimer's may respond better to one drug versus another.

Medications that target the underlying causes of a disease are called disease-modifying drugs or therapies. Aducanumab is the only disease-modifying medication currently approved to treat Alzheimer's. This medication is a human antibody, or immunotherapy, that targets the protein beta-amyloid and helps to reduce amyloid plaques, which are brain lesions associated with Alzheimer's. Clinical studies to determine the effectiveness of aducanumab were conducted only in people with early-stage Alzheimer's or mild cognitive impairment. Researchers are continuing to study whether this medication works to affect a person's rate of cognitive decline over time.

Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimer's before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.

Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimer's as potential treatments.

Aducanumab was approved through the FDA's Accelerated Approval Program, which provides a path for earlier approval of drugs that treat certain serious conditions. This helps people living with the disease gain earlier access to the treatment. The approval of aducanumab was based on the ability of the drug to reduce amyloid in the brain. When using the accelerated approval pathway, drug companies are required to conduct additional studies to determine whether there is in fact clinical benefit after the drug is approved. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.

Treatment for moderate to severe Alzheimer's

A medication known as memantine, an N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer's disease. This drug's main effect is to decrease symptoms, which could enable some people to maintain certain daily functions a little longer than they would without the medication. For example, memantine may help a person in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both the person with Alzheimer's and caregivers.

Memantine is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.

The FDA has also approved donepezil, the rivastigmine patch, and a combination medication of memantine and donepezil for the treatment of moderate to severe Alzheimer's.

Drug Name

Drug Type and Use

How It Works

Common Side Effects

Drug Name

Delivery Method

For More Information

Aducanumab

Intravenous: Dose is determined by a person's weight; given over one hour every four weeks; most people will start with a lower dose and over a period of time increase the amount of medicine to reach the full prescription dose

Prescribing information (PDF, 343K)

Donepezil

Tablet: Once a day; dosage may be increased over time if well tolerated

Orally disintegrating tablet: Same dosing regimen as above

Prescribing information (PDF, 594K)

Rivastigmine

Capsule: Twice a day; dosage may be increased over time, at minimum two-week intervals, if well tolerated

Patch: Once a day; dosage amount may be increased over time, at minimum four-week intervals, if well tolerated

Prescribing information (PDF, 284K)

Memantine

Tablet: Once a day; dosage may be increased in amount and frequency (up to twice a day) if well tolerated

Oral solution: Same dosage as tablet

Extended-release capsule: Once a day; dosage may increase in amount over time, at minimum one-week intervals, if well tolerated

Prescribing information (PDF, 604K)

Manufactured combination of memantine and donepezil

Extended-release capsule: Once a day; initial dosage depends on whether the person is already on a stable dose of memantine and/or donepezil; dosage may increase over time, at minimum one-week intervals, if well tolerated

Prescribing information (PDF, 455K)

Galantamine

Tablet: Twice a day; dosing may increase over time, at minimum four-week intervals, if well tolerated

Extended-release capsule: Same dosage as tablet but taken once a day

Prescribing information (PDF, 1M)

Dosage and side effects of Alzheimer's disease medications

Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evidence that certain people may benefit from higher doses of Alzheimer's medications. However, the higher the dose, the more likely side effects will occur.

Patients should be monitored when a drug is started. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, allergic reactions, and loss of appetite. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor's instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.

Managing behavioral symptoms of Alzheimer's disease

Common behavioral symptoms of Alzheimer's include sleeplessness, wandering, agitation, anxiety, aggression, restlessness, and depression. Scientists are learning why these symptoms occur and are studying new treatments - drug and nondrug - to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimer's more comfortable and makes things easier for caregivers.

Experts agree that medicines to treat these behavior problems should be used only after other strategies that don't use medicine have been tried. Learn more about behavioral changes in people with Alzheimer's disease and ways to cope.

Medicines to be used with caution in people with Alzheimer's disease

There are some medicines, such as sleep aids, anti-anxiety drugs, anti-convulsants, and antipsychotics, that a person with Alzheimer's disease should take only:

After the doctor has explained all the risks and side effects of the medicine

After other, safer nonmedication options have not helped treat the problem

People living with Alzheimer's and their caregivers must watch closely for side effects from these medications.

Sleep aids are used to help people get to sleep and stay asleep. People with Alzheimer's should NOT use these drugs regularly because they make the person more confused and more likely to fall. There are lifestyle changes people can make to improve their sleep. Learn more about getting a good night's sleep.

Anti-anxiety drugs are used to treat agitation. These drugs can cause sleepiness, dizziness, falls, and confusion. For this reason, doctors recommend they should only be used for short periods of time.

Anti-convulsants are drugs sometimes used to treat severe aggression. Side effects may cause sleepiness, dizziness, mood swings, and confusion.

Antipsychotics are drugs used to treat paranoia, hallucinations, agitation, and aggression. Side effects of using these drugs can be serious, including increased risk of death in some older people with dementia. They should only be given to people with Alzheimer's when the doctor agrees that the symptoms are severe.

The future of Alzheimer's disease treatments

Alzheimer's disease research has developed to a point where scientists are exploring a variety of avenues to not only treat symptoms but also address underlying disease processes. In ongoing clinical trials, scientists are developing and testing several possible interventions, including immunization therapy, drug therapies, cognitive training, physical activity, and treatments for cardiovascular disease and diabetes.

Read about this topic in Spanish. Lea sobre este tema en español.

For more information about treating Alzheimer's

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov portal for information and resources on Alzheimer's and related dementias from across the federal government.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

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Treatment of Alzheimer's Disease Alzheimer's disease is complex, and it is therefore unlikely that any one drug or other intervention will ever successfully treat it in all people living with the disease. Still, in recent years, scientists have made tremendous progress in better understanding Alzheimer's and in developing and testing new treatments, including several medications that are in late-stage clinical trials.

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1.  Age related changes
2. Genetics

Environmental changes are believed to be related to alzheimers

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Español
Scientists don't yet fully understand what causes Alzheimer's disease in most people. The causes probably include a combination of age-related changes in the brain, along with genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of Alzheimer's disease may differ from person to person.

Alzheimer's disease is a progressive brain disease. It is characterized by changes in the brain -including amyloid plaques and neurofibrillary, or tau, tangles-that result in loss of neurons and their connections. These and other changes affect a person's ability to remember and think and, eventually, to live independently.

Aging and Alzheimer's risk

Older age does not cause Alzheimer's, but it is the most important known risk factor for the disease. The number of people with Alzheimer's disease doubles about every 5 years beyond age 65. About one-third of all people age 85 and older may have Alzheimer's disease.

Scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimer's damage. These age-related changes include atrophy (shrinking) of certain parts of the brain, inflammation, vascular damage, production of unstable molecules called free radicals, and breakdown of energy production within cells.

However, age is only one risk factor for Alzheimer's disease. Many people live into their 90s and beyond without ever developing dementia.

Clinical trials on Alzheimer's disease

Volunteers are needed for clinical trials that are exploring why some older adults get Alzheimer's disease. By joining one of these studies, you may learn more about the relationship between aging and Alzheimer's and contribute useful information to help other older adults in the future.

Genetics of Alzheimer's disease

Share this infographic and help spread the word about Alzheimer's genetics.

Many people worry about developing Alzheimer's disease, especially if a family member has had it. Having a family history of the disease does not mean for sure that you'll have it, too. But it may mean you are more likely to develop it.

People's genes, which are inherited from their biological parents, can affect how likely they are to develop Alzheimer's disease. Genetic risk factors are changes or differences in genes that can influence the chance of getting a disease. These risk factors are the reason some diseases run in families.

There are two types of Alzheimer's-early-onset and late-onset. Both types have a genetic component.

Late-Onset Alzheimer's

Early-Onset Alzheimer's

Signs first appear in a person's mid-60s

Signs first appear between a person's 30s and mid-60s

Most common type

Very rare

May involve a gene called APOE ɛ4

Usually caused by gene changes passed down from parent to child

Late-onset Alzheimer's disease

Most people with Alzheimer's have late-onset Alzheimer's disease, in which symptoms become apparent in their mid-60s. Researchers have not found a specific gene that directly causes the late-onset form of the disease. However, one genetic risk factor-having one form, or allele, of the apolipoprotein E (APOE) gene on chromosome 19-does increase a person's risk. APOE ɛ4 is called a risk-factor gene because it increases a person's risk of developing the disease. However, inheriting an APOE ɛ4 allele does not mean that a person will definitely develop Alzheimer's. Some people with an APOE ɛ4 allele never get the disease, and others who develop Alzheimer's do not have any APOE ɛ4 alleles.

Early-onset Alzheimer's disease

Early-onset Alzheimer's disease occurs between a person's 30s to mid-60s and represents less than 10 percent of all people with Alzheimer's. Some cases are caused by an inherited change in one of three genes. For other cases, research shows that other genetic components are involved. Researchers are working to identify additional genetic risk variants for early-onset Alzheimer's disease.

Read more about Alzheimer's disease genetics.

Health, environmental, and lifestyle factors that may contribute to Alzheimer's disease

Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimer's disease. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic diseases, such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimer's.

A nutritious diet, physical activity, social engagement, sleep, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimer's disease. Clinical trials are testing some of these possibilities.

Early-life factors may also play a role. For example, studies have linked higher levels of education with a decreased risk of dementia. There are also differences in dementia risk among racial groups and sexes-all of which are being studied to better understand the causes of Alzheimer's disease and to develop effective treatments and preventions for all people.

You may also be interested in

For more information about causes of Alzheimer's disease

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov website for information and resources on Alzheimer's and related dementias from across the federal government.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

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Aging and Alzheimer's risk

Older age does not cause Alzheimer's, but it is the most important known risk factor for the disease. The number of people with Alzheimer's disease doubles about every 5 years beyond age 65. About one-third of all people age 85 and older may have Alzheimer's disease.

Scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimer's damage. These age-related changes include atrophy (shrinking) of certain parts of the brain, inflammation, vascular damage, production of unstable molecules called free radicals, and breakdown of energy production within cells.

However, age is only one risk factor for Alzheimer's disease. Many people live into their 90s and beyond without ever developing dementia.

Genetics of Alzheimer's disease

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Many people worry about developing Alzheimer's disease, especially if a family member has had it. Having a family history of the disease does not mean for sure that you'll have it, too. But it may mean you are more likely to develop it.

People's genes, which are inherited from their biological parents, can affect how likely they are to develop Alzheimer's disease. Genetic risk factors are changes or differences in genes that can influence the chance of getting a disease. These risk factors are the reason some diseases run in families.

There are two types of Alzheimer's-early-onset and late-onset. Both types have a genetic component.

Late-Onset Alzheimer's

Early-Onset Alzheimer's

Signs first appear in a person's mid-60s

Signs first appear between a person's 30s and mid-60s

Most common type

Very rare

May involve a gene called APOE ɛ4

Usually caused by gene changes passed down from parent to child

Late-onset Alzheimer's disease

Most people with Alzheimer's have late-onset Alzheimer's disease, in which symptoms become apparent in their mid-60s. Researchers have not found a specific gene that directly causes the late-onset form of the disease. However, one genetic risk factor-having one form, or allele, of the apolipoprotein E (APOE) gene on chromosome 19-does increase a person's risk. APOE ɛ4 is called a risk-factor gene because it increases a person's risk of developing the disease. However, inheriting an APOE ɛ4 allele does not mean that a person will definitely develop Alzheimer's. Some people with an APOE ɛ4 allele never get the disease, and others who develop Alzheimer's do not have any APOE ɛ4 alleles.

Early-onset Alzheimer's disease

Early-onset Alzheimer's disease occurs between a person's 30s to mid-60s and represents less than 10 percent of all people with Alzheimer's. Some cases are caused by an inherited change in one of three genes. For other cases, research shows that other genetic components are involved. Researchers are working to identify additional genetic risk variants for early-onset Alzheimer's disease.

Read more about Alzheimer's disease genetics.

Health, environmental, and lifestyle factors that may contribute to Alzheimer's disease

Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimer's disease. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic diseases, such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimer's.

A nutritious diet, physical activity, social engagement, sleep, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimer's disease. Clinical trials are testing some of these possibilities.

Early-life factors may also play a role. For example, studies have linked higher levels of education with a decreased risk of dementia. There are also differences in dementia risk among racial groups and sexes-all of which are being studied to better understand the causes of Alzheimer's disease and to develop effective treatments and preventions for all people.

You may also be interested in

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov website for information and resources on Alzheimer's and related dementias from across the federal government.

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How does Alzheimer's disease affect the brain? Read how genetics, environment, and lifestyle play a role in developing early- or late-onset Alzheimer's.

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1. Increased Memory Loss
2. Confusion
3. Inability to learn new things
4.  Poor Judgement

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The symptoms of Alzheimer's can vary from one person to another. Memory problems are typically one of the first signs of the disease. Decline in non-memory aspects of cognition, such as finding the right word, trouble understanding visual images and spatial relationships, and impaired reasoning or judgment, may also signal the early stages of Alzheimer's. As the disease progresses, symptoms become more severe and include increased confusion and behavior changes.

For most people with Alzheimer's - those who have the late-onset variety - symptoms first appear in their mid-60s or later. When the disease develops before age 65, it's considered early-onset Alzheimer's, which can begin as early as a person's 30s, although this is rare.

Alzheimer's typically progresses clinically in several stages: preclinical, mild (sometimes called early-stage), moderate, and severe (sometimes called late-stage).

Preclinical Alzheimer's disease

Research suggests that the complex brain changes associated with Alzheimer's, such as the formation of amyloid plaques or tau tangles, start a decade or more before memory and thinking problems appear. This stage, in which changes in the brain appear before the onset of dementia, is called preclinical Alzheimer's. However, it's important to note that not everyone with these brain changes develops dementia.

Signs of Mild Alzheimer's disease

In mild Alzheimer's, a person may seem healthy but has more and more trouble making sense of the world around them. The realization that something is wrong often comes gradually to the person and their family. Problems can include:

Alzheimer's is often diagnosed at this stage.

Signs of moderate Alzheimer's disease

In this stage, more intensive supervision and care become necessary. These changes and increasing needs can be difficult for many spouses and families. Symptoms may include:

Share this infographic and help spread the word about what memory problems are normal and not.

Increased confusion and memory loss, such as forgetting events or personal history

Withdrawal from social activities

Inability to learn new things

Difficulty with language and problems with reading, writing, and working with numbers

Difficulty organizing thoughts and thinking logically

Shortened attention span

Problems coping with new situations

Changes in sleeping patterns, such as sleeping more during the day and being restless at night

Difficulty carrying out familiar, multistep tasks, such as getting dressed

Occasional problems recognizing family and friends

Hallucinations, delusions, and paranoia

Impulsive behavior, such as undressing at inappropriate times or places, or using vulgar language

Inappropriate emotional outbursts

Restlessness, agitation, anxiety, tearfulness, wandering - especially in the late afternoon or evening

Repetitive statements or movement, occasional muscle twitches

Signs of severe Alzheimer's disease

People with severe Alzheimer's cannot communicate and are completely dependent on others for their care. Near the end of life, the person may be in bed most or all of the time as their body shuts down. Symptoms often include:

Inability to communicate

No awareness of recent experiences or surroundings

Weight loss with little interest in eating

Seizures

General physical decline, including dental, skin, and foot problems

Difficulty swallowing

Groaning, moaning, or grunting

Increased sleeping

Loss of bowel and bladder control

A common cause of death for people with Alzheimer's is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.

While there is currently no cure for Alzheimer's, there are medicines approved by the U.S. Food and Drug Administration that may help treat the disease. There are also changes that can be made to the home environment and daily activities to help a person manage their changes in thinking.

Symptoms of mild cognitive impairment

Some people have a condition called mild cognitive impairment (MCI), which can be an early sign of Alzheimer's. However, not everyone with MCI will develop Alzheimer's. People with MCI can still take care of themselves and perform their normal activities. MCI memory problems may include:

Losing things often

Forgetting to go to events or appointments

Problems communicating because of difficulty finding words

When to visit the doctor for memory loss

If you, a family member, or friend has problems remembering recent events or thinking clearly, talk with a doctor. A doctor may ask questions and conduct various tests and procedures to see what might be causing the symptoms. A doctor may also refer you to a specialist, such as a neurologist, for further assessment. Learn more in How Is Alzheimer's Disease Diagnosed? If you or someone you know has recently been diagnosed with Alzheimer's, visit Next Steps After an Alzheimer's Diagnosis.

You also may be interested in participating in research on cognitive health, aging, and dementia. Learn more about volunteering for research to advance Alzheimer's treatments.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About the Signs of Alzheimer's Disease

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov website for information and resources on Alzheimer's and related dementias from across the federal government.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

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What Are the Signs of Alzheimer's Disease?

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Memory problems are typically one of the first signs of Alzheimer's disease. Learn about other common signs of mild, moderate, and severe Alzheimer's.