Alzheimer’s

Alzheimer's diagnosis involves comprehensive evaluation including detailed medical history, cognitive testing, neurological examination, and often brain imaging (MRI or CT scan). There's no single definitive test—diagnosis is based on careful assessment of symptoms, ruling out other causes of cognitive decline (like thyroid problems or vitamin deficiencies), and evaluating the pattern and progression of memory and thinking problems. Our psychiatric evaluation includes standardized cognitive assessments and thorough review of how symptoms affect daily functioning.

Alzheimer's disease is caused by abnormal protein deposits in the brain—beta-amyloid plaques that form between nerve cells and tau tangles that form inside cells. These deposits damage and eventually kill brain cells, leading to the progressive symptoms of the disease. The exact trigger for these changes isn't fully understood, but age is the greatest risk factor. Genetics play a role—having the APOE-e4 gene variant increases risk, though many people with this gene never develop Alzheimer's, and many without it do. Cardiovascular health, education, and lifestyle factors also influence risk.

While there's currently no cure for Alzheimer's, treatments can help manage symptoms and, in some cases, slow progression. FDA-approved medications include cholinesterase inhibitors (donepezil, rivastigmine, galantamine) that help with memory and thinking, and memantine, which regulates glutamate activity. Newer disease-modifying therapies like lecanemab (Leqembi) target amyloid plaques directly and may slow decline in early-stage patients. Non-drug approaches include cognitive stimulation, structured routines, behavioral strategies, and careful management of other symptoms like depression, anxiety, or sleep problems.

Dementia is an umbrella term describing a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily life. It's not a specific disease but rather a syndrome with many possible causes. Alzheimer's disease is the most common cause of dementia, accounting for 60-80% of cases. Other types include vascular dementia (caused by reduced blood flow to the brain), Lewy body dementia, and frontotemporal dementia. Each type has different underlying causes, may progress differently, and may respond to different treatments—which is why accurate diagnosis matters.

Common medications include cholinesterase inhibitors—donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne)—which boost levels of a chemical messenger involved in memory and are used for mild to moderate stages. Memantine (Namenda) regulates glutamate and is used for moderate to severe Alzheimer's, sometimes combined with cholinesterase inhibitors. Newer treatments like lecanemab (Leqembi) and donanemab target amyloid plaques directly. Additional medications may address behavioral symptoms, sleep problems, depression, or agitation. Our providers at medication management appointments carefully select and monitor medications based on disease stage and individual response.

While Alzheimer's cannot be completely prevented with current knowledge, research suggests certain lifestyle factors may reduce risk or delay onset. The Lancet Commission on dementia prevention identifies modifiable risk factors including physical inactivity, smoking, excessive alcohol use, obesity, hypertension, diabetes, depression, social isolation, hearing loss, and air pollution. Protective factors include regular physical exercise, mental stimulation and lifelong learning, social engagement, heart-healthy diet (like the Mediterranean diet), quality sleep, and managing cardiovascular risk factors. Early detection through regular cognitive screening allows earlier intervention when treatments may be most effective.

Seek evaluation if memory problems are interfering with daily activities, if you or a loved one gets lost in familiar places, if there are noticeable personality or behavioral changes, if family members express concern about memory or judgment, or if you're experiencing difficulty with tasks that were previously routine (like managing finances or following recipes). Early evaluation is important because some causes of cognitive decline are treatable, and early Alzheimer's diagnosis allows earlier access to treatments, time for planning, and opportunity to participate in clinical trials. Don't dismiss concerns as "just normal aging"—call 430-288-5800 to schedule a consultation.