Alzheimer’s disease affects approximately 50 million people worldwide 

World Alzheimer’s Day is observed every year on 21 September. This annual commemoration shines a spotlight on dementia and Alzheimer’s disease which currently affects approximately 50 million people worldwide. Alzheimer’s Day is important for many reasons. Not only is dementia and Alzheimer’s disease likely to affect 131 million people by 2050 (World Health Organisation, 2021), it is a major cause of disability in adults, and one of the most costly long-term illnesses to society (World Alzheimer’s Report, 2021).

One way of addressing this international health concern is to stay informed with knowledge about the disease. In doing so, better support can be rendered to people living with dementia, their caregivers and families. Aptly, the theme for Alzheimer’s Day 2022 is “Know Dementia, Know Alzheimer’s”. In keeping with this theme, we have addressed a few commonly asked questions about dementia and Alzheimer’s disease.

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

Dementia is not a specific disease, but rather a broad term that is given to a set of complex symptoms that affect the brain. Dementia symptoms significantly affect one’s cognitive abilities and alter how one functions in everyday home, work and social life. Many diseases bring about a range of dementia symptoms, but the most common is Alzheimer’s disease, which accounts for 60-70% of all dementia cases (World Health Organisation, 2021). Alzheimer’s disease develops slowly over a long period, and permanent changes become evident in memory, language, thinking, behaviour and personality.

What are the causes of Alzheimer's disease?

Alzheimer’s disease is caused by specific proteins that destroy brain cells in two distinct ways. The Tau protein causes tangles within brain cells, and the beta-amyloid protein accumulates around brain cells. This destruction of brain cells causes the brain to shrink. Currently, it remains unclear as to what triggers the onset of Alzheimer’s disease, but old age is viewed as a major risk factor. It must be emphasised that Alzheimer’s disease is not part of the normal ageing process. Certain lifestyle factors are risk factors for developing Alzheimer’s disease, for example, smoking and cardiovascular disease (Alzheimer’s Disease International, 2022).

Is Alzheimer's disease hereditary?

Alzheimer's disease is not necessarily hereditary. This means that having one family member with Alzheimer’s disease does not imply that other family members will develop the disease. However, if a risk gene is inherited, one’s risk of developing Alzheimer’s Disease may be potentially higher (Alzheimer’s Research UK, 2022).

What are the early signs of Alzheimer's disease?

One of the earliest signs of Alzheimer’s disease may be memory difficulties. Early signs are noted in individuals repeating the same questions, re-telling the same information or having difficulty remembering the details of recent events. People who show early signs of Alzheimer’s disease may also struggle to find words they wish to use in a conversation, or remember how to complete routine tasks (for example, driving to the grocery store).

What are the stages of Alzheimer's disease?

In general, there is a progression of symptoms in three stages based on increasing severity; namely, mild, moderate and severe. In the mild stage, the early signs (as previously mentioned) become apparent gradually. The moderate stage is typically the longest. In this stage, changes in mood, personality and behaviour become most prominent. For example, persons with Alzheimer’s disease may appear depressed, withdrawn and disinterested in participating in activities that they previously enjoyed, such as socialising with friends or attending religious activities. In the severe stage, persons with Alzheimer’s disease become fully dependent on their caregivers to perform everyday tasks. A common symptom that cuts across all stages of Alzheimer’s disease is communication difficulty. This is due to challenges in initiating and maintaining conversations; and using language to effectively communicate feelings, preferences and pain.

Tips on how to prevent Alzheimer's disease

Simply put, Alzheimer’s disease cannot be prevented, especially considering that age, as well as genetics, are out of one’s control. Nonetheless, there are ways in which other risk factors can be reduced to prevent the likelihood of developing Alzheimer’s disease. These include:

·Maintaining a healthy body by eating healthily and reducing excessive alcohol consumption.

·Keeping one’s mind stimulated by staying socially connected with friends or community groups.

·Strengthening one’s cardiovascular health by controlling high blood pressure and diabetes, and maintaining optimal fitness levels.

While there are no definite way of preventing Alzheimer’s disease, medications may be used to manage some of the symptoms. On the other hand, psychosocial interventions (i.e., those that do not involve medication) are equally beneficial in helping an individual to live well with the disease.

Tips on howto communicate with a person who has Alzheimer’s disease

In this instance, research has shown that when persons with dementia and Alzheimer’s disease are supported in their daily conversations, their social and emotional well-being is likely to improve (Murray, Dada & May, 2022).

Conversations can be supported through augmentative and alternative communication (AAC) through the use of simple tools and communication aids (for example, picture gestures to indicate meal preference).  AAC is the term used to describe a wide range of techniques and tools that are used to support communication when a person’s natural speech is not sufficient for effective communication. There are a variety of AAC solutions that can be utilised in Dementia care.  A book has recently been written by Adele May, Shakila Dada and Janice Murray that explores the role of AAC in enhancing meaningful communication in persons living with dementia.

NB: A freely downloadable poster available at https://www.karger.com/Book/Home/283341 provides tips on how to support conversations with AAC in persons with dementia and Alzheimer’s disease.

Finally, non-profit organisations such as Alzheimer’s South Africa (https://alzheimers.org.za/) offer valuable caregiving tips and shared family experiences for post-diagnosis support.

For further reading, please consider the following:

Alzheimer’s Disease International (2022). Available at https://www.alzint.org/about/risk-factors-risk-reduction/

Alzheimer’s Research UK (2022). Available at https://www.alzheimersresearchuk.org/dementia-information/genes-and-dementia/

Murray, J., Dada, S., & May, A. (2022). Fast facts for healthcare professionals: Dementia and Augmentative and Alternative Communication: Supporting conversations. Karger Publishers: Germany. https://www.karger.com/Book/Toc/283341

World Alzheimer’s Report (2021). Available at https://www.alzint.org/resource/world-alzheimer-report-2021/

World Health Organisation (2021). Available at https://www.who.int/news-room/fact-sheets/detail/dementia

Authors:  Professor Shakila Dada, Centre for AAC, University of Pretoria & Dr Adele May, Stellenbosch University