Don’t treat illness as “just getting forgetful with age”

Alzheimer’s disease is a brain degenerative disease with an insidious onset and gradual progression; it is the most common cause of dementia in old age. It is not a part of normal aging, but a pathological brain disease.

The core pathological features of Alzheimer's disease are the abnormal accumulation of beta-amyloid (Aβ) in the brain forming "senile plaques" and the hyperphosphorylation of tau protein leading to "neurofibrillary tangles," which in turn cause neuronal damage, synapse loss, and brain tissue atrophy, especially in the hippocampus and entorhinal cortex that are closely related to memory and cognitive functions.

As the disease progresses, patients experience memory decline, reduced thinking ability, changes in behavior and personality, and ultimately severe impairment of activities of daily living and social functioning. Therefore, patients often seek care in neurology, psychiatry, and geriatric departments.

Many people simply attribute memory decline to "being forgetful" (normal aging), considering it a natural consequence of getting older. However, Alzheimer's disease is fundamentally different from normal "forgetfulness." The key distinction is that normal aging does not significantly affect social functioning and independent living ability; Alzheimer's disease, on the other hand, leads to progressive functional decline until the patient can no longer care for themselves.

A definitive diagnosis requires professional examinations

When you notice that an elderly family member shows changes in memory, daily living abilities, personality, or behavior that people around them don’t understand, you should proactively take them to a specialized memory clinic for cognitive assessment and examinations, so they can receive a timely scientific diagnosis and treatment recommendations.

Doctors in memory clinics usually listen to family members’ detailed accounts of the condition and also have careful communication with the patient. They will then arrange for professionals to help the patient undergo assessments of neurocognitive function, psychiatric and behavioral symptoms, and activities of daily living, providing scientific evidence for diagnosis and differential diagnosis.

In addition, the patient will need to undergo some auxiliary tests. For example, MRI can determine whether there is brain atrophy and identify its location and characteristics. Hippocampal atrophy is the most typical finding in patients with Alzheimer’s disease. In recent years, biomarker testing, such as amyloid PET to assess amyloid burden, has increasingly been used for precise diagnosis of Alzheimer’s disease.

Which risk factors should be avoided to prevent it

Alzheimer's disease results from the combined effects of genetics, environment, and lifestyle. It can be divided into uncontrollable and controllable factors. According to The Lancet, about 45% of dementia cases can be prevented or delayed by intervening on modifiable risk factors. These modifiable risk factors include the following.

1 Lifestyle

Smoking, excessive alcohol consumption, and lack of exercise.

2 Cardiovascular disease-related factors

Hypertension, diabetes, obesity, and high low-density lipoprotein cholesterol.

3 Brain injury

History of traumatic brain injury.

4 Mental and psychological condition

Social isolation, depression.

5 Sensory functions

Uncorrected hearing loss and vision loss in middle age.

6 Education Level

Low education level.

Although there is currently no guaranteed way to prevent Alzheimer’s disease, numerous studies have confirmed that actively reducing controllable risk factors can significantly lower the risk of cognitive decline and prevent dementia. It is recommended to pay attention to brain health from early life and build a comprehensive management system integrating medical care and prevention, especially in the following five areas.

1. Adhere to scientific exercise: at least 150 minutes of moderate-intensity aerobic activity per week (such as brisk walking, swimming, etc.), combined with strength training.

2. Maintain a healthy lifestyle: quit smoking and limit alcohol, avoid exposure to secondhand smoke. Eat more vegetables, fruits, whole grains, nuts, fish, and olive oil; limit red meat, sugar, and processed foods.

3. Strengthen cognitive training: continuously learn new skills (such as musical instruments, languages, etc.), read, play chess, solve puzzles, participate in cognitive activation activities, and keep the brain active.

4. Actively participate socially: proactively expand your social circle, take part in community activities and volunteer work, maintain good interpersonal relationships, avoid loneliness, and keep a cheerful mood.

5. Actively manage health: control blood pressure, blood sugar, and blood lipids; protect hearing.

Treatment “three-pronged” approach — don’t be impatient

Currently there is no drug that can cure Alzheimer’s disease. Hoping for a “miracle injection,” a “magic dose,” or a panacea, or losing confidence in treatment and thinking “since it can’t be cured, might as well not treat it,” are all unscientific views.

Domestic and international Alzheimer’s disease diagnosis and treatment guidelines recommend a “three-pronged” treatment plan: first, adhere to appropriate medication to delay cognitive decline and alleviate neuropsychiatric symptoms; second, carry out scientific psychosocial interventions, increase social activities, and reduce behavioral problems; third, provide counseling and support for caregivers to improve the quality of home care.