Alzheimer's Disease and Related Dementias

Signs of Cognitive Decline

As we age, it is important to notice early signs of cognitive decline, which starts off as forgetfulness and, over time, develops into memory loss and a lack of ability to complete or perform everyday tasks. Here are 10 warning signs to look for with early-onset Alzheimer’s Disease and Related Dementias (ADRD)¹:

1. Persistent and worsening memory that disrupts daily life.
2. Challenges in planning or solving problems.
3. Difficulty in performing familiar tasks.
4. Confusion with time or location.
5. Trouble understanding visual images and spatial relationships.
6. Misplacing things and losing the ability to retrace steps.
7. Lack of ability to make sensible decisions and judgments.
8. Decreased or poor thinking ability and judgment.
9. Withdrawal from work and social activities.
10. Changes in personality and behavior.

Types of Dementia

Dementia is an umbrella term for the loss of memory and other thinking abilities that are severe enough to interfere with daily life. Here are some types of dementia²:

• Alzheimer’s Disease
• Vascular Dementia
• Lewy body Dementia
• Frontotemporal Dementia
• Huntington's Disease
• Mixed Dementia

Stages of Alzheimer’s Disease

Alzheimer's disease progresses in stages. Each stage provides a range of symptoms, and some stages may overlap, which may make it difficult to know which stage a person is in. The stages are³:

• Asymptomatic
  • No cognitive symptoms; possible changes in the brain.
• Mild Cognitive Impairment due to Alzheimer’s disease
  • Some symptoms of cognitive ability loss begin to appear.
• Early stage (mild)
  • Symptoms that tend to interfere with some daily activities of living.
• Middle stage (moderate)
  • More symptoms that interfere with many daily activities of living.
• Late stage (severe)
  • Symptoms interfere with most daily activities of living.

Getting the Diagnosis

If there are signs of ADRD, it is best to reach out to a doctor to express concern about a family member, loved one, or oneself for a full medical evaluation. Learning about or receiving a diagnosis of Alzheimer's disease or dementia can be difficult for both the recipient and their loved ones to process. It is a life-changing event, and a range of emotions will be expressed. It is important to get accurate information, resources, and support in order to know what to expect and what to do next after receiving the diagnosis. The provided checklist can help with next steps after an Alzheimer's diagnosis⁴:

• Having a conversation about the best approach for care or treatment.
• Making sure that regular medical care and appointments are being scheduled with a primary or specialist.
• Finding local services and support in the local community.
• Coordinating legal, financial, and long-term care planning with all concerned parties
• Plan to get help as needed for activities of daily living or day-to-day tasks. This encompasses the safety and lifestyle of the person with an ADRD diagnosis.
• Staying healthy and maintaining active lifestyles for both the loved one and caregiver(s).

Caregiver Support

Family and friends take on the role of caregivers to help support this loved one who has received a diagnosis. It is important that, as a trusted caregiver, they navigate both the care of themselves and their loved one.

• Look at local resources and support groups for the role of care activities.
• Apply to programs that you or a loved one are eligible for.
• Take care of both your physical and mental wellbeing.
• Take part in any advocacy and research opportunities.

Insight into the Future of Treatment for Alzheimer's Disease

With advances in both science and technology, research and drug advancements have been developed and approved by the Federal Drug Administration (FDA) to help lessen some symptoms temporarily or treat the underlying biology of the disease. Recently, a new Alzheimer's treatment called Leqembi has been approved for coverage for veterans in the early stages of Alzheimer’s disease by the Department of Veteran Affairs.⁵ They are the first major US insurer to agree to pay for the medicine following its accelerated approval in January 2023. Another experimental Alzheimer’s drug developed by Eli Lilly and Co. called donanemab has shown to slow cognitive decline by 35% in a late-stage trial compared to a placebo.⁶ The price of donanemab is expected to be in the same range as other similar therapies when it becomes available.⁶ While these developments in drugs and treatments for Alzheimer’s disease are still underway, every breakthrough helps current and future people with the disease.

Sources:

1. https://www.alz.org/alzheimers-dementia/10_signs
2. https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia
3. https://www.alz.org/alzheimers-dementia/stages
4. https://www.nia.nih.gov/health/next-steps-after-alzheimers-diagnosis
5. https://www.military.com/daily-news/2023/03/14/va-cover-new-drug-early-stage-alzheimers-disease.html#:~:text=The%20VA%20will%20cover%20Leqembi,country%20to%20endorse%20the%20treatment.
6. https://www.reuters.com/business/healthcare-pharmaceuticals/lilly-drug-slows-alzheimers-progression-by-35-trial-2023-05-03/