Alzheimer’s disease is a progressive disease that causes a continual decrease in cognitive functions (such as memory, language, planning, orientation, etc.) due to brain cell degeneration.

The first signs of Alzheimer’s disease often manifest themselves when people forget conversations or what has happened recently, but as the disease develops there is a serious memory impairment, with a subsequent decline in other mental functions, leading to the loss of the ability to live independently. Drugs are now available that can temporarily improve symptoms or delay the progression of the disease.

If you are concerned about your memory or other cognitive abilities or functions, it is very important that you consult a doctor who can give you a full check-up.

Symptoms of Alzheimer’s disease

With Alzheimer’s disease, the brain degenerates due to the death of neurons that generally initially affect memory, but this is not always the case. There are other forms of Alzheimer’s disease which are manifested with different impairments. When language is the main impairment, people notice that words fail them and that they cannot express themselves fluently (this is what is known as primary progressive aphasia).

Other people experience great difficulty in correctly perceiving what they see, even simulating blindness, known as posterior cortical atrophy. In both cases the pathology would probably be Alzheimer’s disease but with an atypical presentation. Therefore, although memory is not the main impairment, we still might be looking at a form of Alzheimer’s disease.

However, the main symptoms of Alzheimer’s disease are:

• Memory loss: Patients forget recent conversations or situations, repeat the same questions, forget names of familiar people or everyday objects, lose objects.
• Disorientation: This can be an early symptom. Initially there is usually confusion about which day of the month or which week it is, or even the time, and later when the disease progresses the person is totally disoriented in time, space and even as a person.
• Language: People have difficulty expressing themselves as they cannot find the right words, which they usually change to another that does not mean the same thing, and they have low language fluency. They may have problems with comprehension and difficulty naming objects, and in advanced stages there is no language communication.
• Impaired execution of activities: Apraxia is the inability to carry out a motor act without limited movement. For example, if a patient is asked to make gestures to indicate how he brushes his hair, although he can move his arm, pick up his comb and do the task, he is not able to plan the sequence of motor acts needed to do it.
• Impaired perception (agnosia): Difficulty or inability to perceive sensory information. Therefore, although the patient’s eyes work correctly, they cannot recognise objects or people, or they perceive them in a distorted way. Although their ears work, they cannot recognise sounds, and this also happens with smells.
• Difficulties in concentration and reasoning: People with Alzheimer’s disease develop difficulties in understanding abstract concepts, especially numbers and finances. They also have problems doing different tasks at the same time, as well as making everyday decisions.
• Personality changes: Alzheimer’s disease often causes alterations in the patient’s personality, as well as changes in family relationships and plans. The person can present depression, apathy and social isolation, as well as mood swings, distrustfulness and aggressiveness, or decreased inhibitions.
• Sleep rhythm disturbance: Patients can develop insomnia or sleep too much or with an altered rhythm.

Causes and risk factors

It is believed that the causes of Alzheimer’s disease are a combination of genetic, lifestyle and environmental factors. The risk of suffering from Alzheimer’s disease is greater if a first-degree relative has developed the disease, but heart problems and lifestyle risk factors can increase the chances of it appearing. Therefore, maintaining good brain health throughout our lives is important to prevent diseases like Alzheimer’s. The fact that the disease starts to develop years before the first symptoms can be detected is relevant.

• Learn more about how to keep your brain healthy throughout your life: Barcelona Brain Health Initiative

A higher percentage of people with Down syndrome develop Alzheimer’s disease.However, it is true that mild cognitive impairment can progress towards dementia due to Alzheimer’s disease. This is why it is important to make timely changes to our lifestyle and do memory training. It is important to differentiate between Alzheimer’s disease and mild cognitive impairment. The latter involves greater loss of memory and reasoning than what would be considered normal at a certain age, but does not bring about changes in personality or normal functioning in social situations.