Alzheimer’s and the not easy coping of patients and close persons

Alzheimer’s Disease is a disease related to degeneration of the brain, which many people may be familiar with the name but still do not clearly understand what it is or how it truly affects life. This article will help explain more simply what causes Alzheimer’s disease, what factors should be cautioned, and how to take care appropriately for each stage of the disease.

Key Takeaways

• Alzheimer is a type of brain degeneration disease, affecting memory, thinking, reasoning, and behavior
• Symptoms begin from forgetting simple things such as names of close persons, places, or events, behavior changes, mood swings, and in the late stage will not be able to help oneself
• Risk factors are increasing age, genetics, family history, underlying diseases such as diabetes, high blood pressure, including lifestyle behaviors such as lack of exercise and insufficient sleep
• Diagnosis begins with history taking, physical examination, memory assessment, including laboratory tests and brain scans to differentiate other diseases with similar symptoms
• Although Alzheimer’s disease cannot be completely cured, symptoms can be slowed by medication, environmental care, brain stimulation, and continuous support from close persons

Getting to know ‘Alzheimer’s disease’, what is it?

Alzheimer’s Disease, or memory degeneration disease, is a disease caused by abnormal structure of brain cells, causing brain cells to gradually atrophy and deteriorate, directly affecting brain function, leading to dementia. It is commonly found in elderly aged 65 years and above

Alzheimer’s disease is related to accumulation of beta-amyloid protein (Beta-Amyloid) and tau protein (Tau) in the brain, which destroy nerve cells and interfere with communication between brain cells. As the disease progresses, patients will begin to have problems with memory, thinking, and behavior, causing confusion and forgetfulness

What are the symptoms of Alzheimer’s disease?

Alzheimer’s disease is a dementia that causes the brain to gradually lose function, affecting memory, thinking, and behavior. Symptoms start from slight abnormalities and gradually become more severe and may continuously affect daily life. Examples of commonly found symptoms are as follows

• Forgetting recent events such as forgetting conversations just spoken, asking the same questions repeatedly, forgetting appointments, or forgetting simple daily matters
• Forgetting names of close persons or familiar places, sometimes unable to recognize one’s own home or getting lost even in very familiar areas
• Placing items in the wrong place or unable to find them and misunderstanding that someone stole them, which is a behavior frequently found in Alzheimer’s patients
• Losing ability to think and make decisions, such as using objects incorrectly, forgetting how to do things that were routinely done, or unable to plan simple things as before
• Changes in mood and behavior, irritability, easily annoyed, aggressive, or suspicious of others; some may speak incoherently or misunderstand that people around intend to harm them
• Having sleep problems such as intermittent sleep, wandering at night, or insufficient rest
• Losing skills in performing daily activities such as bathing, dressing, or even handling simple objects becoming more difficult
• In severe stage, Alzheimer’s patients cannot help themselves and must depend on caregivers in all aspects of daily life

Risk factors that cause Alzheimer’s

The cause of Alzheimer’s disease cannot yet be clearly identified, but studies have found many risk factors that increase the chance of Alzheimer’s disease, especially in the elderly. Knowing and understanding related risks can help take care of health and reduce risk. The risk factors are as follows

• Increasing age, it is found that those aged over 65 years have progressively higher risk of Alzheimer’s disease, especially at age 85 years and above where patients significantly increase
• Genetics, if family members have Alzheimer’s, the risk increases, especially in cases with abnormalities of genes related to Apolipoprotein E (APOE e4) production
• Down syndrome, those with Down syndrome have a chance of developing Alzheimer’s disease earlier than general population by about 10–20 years due to abnormality of chromosome pair 21
• Female sex, it is found that biological females have slightly higher tendency than males, partly related to longer life expectancy
• History of severe head injury, those with history of severe head injury have increased risk
• Those with abnormal sleep, sleep apnea or chronic sleep problems may be risk factors affecting Alzheimer’s disease
• Lifestyle behaviors and chronic comorbidities such as lack of exercise, obesity, type 2 diabetes, high blood pressure, high cholesterol, smoking, and cerebrovascular disease

How is Alzheimer’s disease diagnosed?

Alzheimer’s disease has symptoms similar to many other conditions such as brain tumors compressing the temporal lobe which may also cause forgetfulness. Diagnosis therefore requires information from multiple aspects. The general diagnostic process consists of important steps as follows

• History taking and initial symptom assessment, the physician will ask for information from the patient and close relatives to assess behavior, memory, and changes occurring in daily life, including differentiating whether there are psychological factors or other physical diseases that may cause symptoms similar to Alzheimer’s disease
• Memory and cognitive assessment tests using standard tests such as Thai Mental State Examination (TMSE) and Montreal Cognitive Assessment (MoCA) to assess memory, calculation, language, and spatial skills, taking approximately 15–20 minutes
• Laboratory tests to differentiate other causes that may cause memory loss symptoms such as thyroid hormone abnormalities, deficiency of certain vitamins, or other diseases affecting brain function
• Genetic and biomarker testing, in some cases testing biomarkers from blood or cerebrospinal fluid or testing for genetic abnormalities may be performed to support more accurate diagnosis of Alzheimer’s disease
• Brain imaging using Magnetic Resonance Imaging (MRI) or FDG Brain PET Scan to observe abnormalities of brain structure, detect brain atrophy, and help accurately differentiate Alzheimer’s disease from other types of dementia

How can Alzheimer’s disease be treated?

Treatment of Alzheimer’s focuses on integrated care, both pharmacological and non-pharmacological, to help slow brain degeneration, reduce impact on daily life, and help patients have better quality of life. Treatment approaches are as follows

Non-pharmacological treatment

• Brain training and memory development using activities such as memory games, drawing, reading, or talking about past events to stimulate brain function and help maintain continuous brain use
• Support movement and physical therapy, regular exercise or simple activities such as walking in the house help promote body function and reduce chances of other complications
• Promote self-care, encourage patients to perform daily activities that they can still do by themselves such as dressing and eating to maintain basic abilities as long as possible
• Overall health care, consume all 5 food groups, control weight within standard range, get sufficient sleep, take care of dental health, hearing, and properly treat underlying diseases to prevent other health problems that may worsen symptoms

Pharmacological treatment

• Physicians may consider medications to help slow dementia symptoms to maintain neurotransmitter levels in the brain as long as possible such as Cholinesterase Inhibitor group and NMDA Receptor Antagonist
• Medications to control behavior and mood, used in cases where patients have agitation, anxiety, or behavioral and emotional problems to enable smoother coexistence with others

How to care for Alzheimer’s patients

Caring for Alzheimer’s patients is not only about physical assistance but also involves understanding patients’ behavior and emotions. Methods are as follows

• Understand the patient, caregivers should be aware that mood swings, aggression, or abnormal behaviors are direct results of the disease, not because the patient has bad intentions, to help reduce caregiver stress
• Avoid triggers of negative emotions, observe which factors cause dissatisfaction or aggressive behavior and avoid or resolve them
• Organize daily routines, doing the same things at the same time helps patients feel secure and reduces confusion
• Encourage and accept patient limitations, when patients cannot do something, do not scold or show disappointment but encourage and support them to do what they can
• Caregivers must take care of themselves, caregivers should have rest time and share burden by asking help from family members or professionals to prevent accumulated stress

Alzheimer’s, a disease that requires understanding in care

Alzheimer’s disease not only affects patients but also affects the mind and feelings of people around them, especially caregivers. Care therefore requires understanding, patience, and appropriate planning so that patients can live with quality of life and caregivers do not feel overly exhausted

If facing care of Alzheimer’s patients or having questions about proper treatment and care approaches, Neurology Center, Praram 9 Hospital is pleased to provide close care with a ready medical team, offering consultation, diagnosis, and appropriate treatment planning for each patient

For more information

• Facebook: Praram 9 Hospital International & Expats
• Line: @Praram9Hospital
• Tel. 1270

Frequently asked questions about Alzheimer’s

1. Is Alzheimer’s the same as dementia?

Not exactly the same. Dementia is a term for a group of symptoms related to brain degeneration affecting memory, thinking, and reasoning, while Alzheimer’s is one of the causes of dementia and is the most common

2. How should communication with Alzheimer’s patients be done?

Communication with Alzheimer’s patients should use simple, concise language and speak in a gentle tone. Speak one topic at a time, do not rush or repeat too frequently until causing pressure. Maintain eye contact and use body language to help enhance understanding. Importantly, have patience and understand that patients do not intend to forget or not understand

3. Can Alzheimer’s be completely cured?

Currently, Alzheimer’s disease cannot be completely cured. Existing treatments focus on slowing brain degeneration, controlling symptoms, and maintaining patient quality of life as long as possible

References

Alzheimer's disease. (2024, July 04). NHS. https://www.nhs.uk/conditions/alzheimers-disease/

Alzheimer’s Disease. (2025, February 19). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9164-alzheimers-disease

Jaime Herndon, MS, MPH, MFA. (2024, October 9). Alzheimer's Disease: Symptoms, Treatment, and Diagnosis. Healthline. https://www.healthline.com/health/alzheimers-disease