Overview
Alzheimer's disease is a progressive neurological disorder in which brain cells gradually die, impairing memory, thinking, and behavior. It is the most common cause of dementia (60-80%). It is estimated that about 600,000 people in our country have Alzheimer's disease.
The disease begins and progresses insidiously over years. There is no cure; however, early diagnosis can slow its progression.
Symptoms (By Stages)
Early stage:
- Short-term memory loss (forgetting newly learned information)
- Repeating the same question
- Getting lost in familiar places
- Misplacing items
- Difficulty making decisions
- Personality changes (withdrawal, depression)
Middle stage:
- Significant memory loss (difficulty recognizing family members)
- Difficulty with speech and reading-writing
- Loss of time and place orientation
- Need for help with daily tasks like bathing and dressing
- Hallucinations, paranoia
- Disrupted sleep pattern
- Behavioral changes (aggression, agitation)
Advanced stage:
- Loss of speech ability
- Complete dependence on care
- Swallowing difficulty
- Loss of bladder and bowel control
- Bedridden
Causes
The exact cause is unknown; it is thought that buildup of amyloid plaques and tau tangles in the brain causes neurons to die.
Risk Factors
- Advanced age (over 65)
- Family history
- Genetic factors: APOE-e4 gene
- Down syndrome
- Mild cognitive impairment
- History of head trauma
- Cardiovascular diseases
- Diabetes
- High blood pressure, high cholesterol
- Obesity
- Sedentary lifestyle
- Social isolation, depression
- Low educational level
- Smoking, excessive alcohol
Complications
- Falls, fractures
- Aspiration pneumonia
- Bedsores
- Malnutrition, weight loss
- Infections
- Accidents
- Caregiver burnout
When to See a Doctor
- If your family has noticed memory and behavioral changes in you
- If you experience short-term memory loss
- If you have difficulty performing familiar tasks
- If you have lost time and place orientation
- If you have difficulty making decisions
- If there are personality changes
Diagnosis and Treatment
Diagnosis:
- Detailed neurological examination
- Cognitive tests (MMSE, MoCA)
- Brain MRI or CT
- PET imaging
- CSF (cerebrospinal fluid) analysis
- Genetic testing
- Exclusion of other causes of dementia
Treatment:
Medications (do not stop the disease, but slow symptoms):
- Cholinesterase inhibitors: donepezil, rivastigmine, galantamine
- NMDA receptor antagonist: memantine
- New biological agents: lecanemab, donanemab (amyloid-targeted)
Supportive treatments:
- Antidepressants, antipsychotics for behavioral problems
- Sleep regulators
- Cognitive rehabilitation
- Music, art therapy
- Family and caregiver support
Prevention
There is no definitive prevention method, but risk can be reduced:
- Stay mentally active (reading, puzzles, learning new things)
- Exercise regularly
- Eat a healthy (Mediterranean) diet
- Maintain social connections
- Get enough quality sleep
- Protect heart health (control blood pressure, sugar, cholesterol)
- Quit smoking, limit alcohol
- Avoid head trauma (use a helmet)
- Treat hearing problems
- Manage stress