By Beth Lawrence


Everyone has absentminded moments forgetting why they’ve walked into a room or being certain they left their keys on the hall table only to find them in a coat pocket. But when those moments come more frequently and are coupled with other concerning behaviors, it may portend something more ominous than absentmindedness.

November is National Alzheimer’s Disease Awareness month.

There are 180,000 North Carolinians facing the ravages of Alzheimer’s disease, according to the Alzheimer’s Association.

Some memory loss is a normal part of aging. Alzheimer’s is not. Alzheimer’s is more than memory loss; it is a progressively debilitating disease that physically alters the brain.

An example of normal aging might be you forget where you put your car keys,” said Denise Young, Alzheimer’s Association program manager. “But if you find yourself not knowing what those car keys are actually used for, then that might be an example of early signs of dementia … difficulty in completing familiar tasks, a person who might be an avid knitter, but they no longer are able to do that. Getting lost in familiar places is also a common thing.”

An individual or their family should be concerned when they are experiencing memory issues and at least one other item from the Alzheimer’s Association’s warning signs checklist. A primary care physician can help diagnose the disease or rule out another medical cause. They may also refer the patient to a specialist.

“Oftentimes people just assume it’s dementia,” Young said. “But more often than not it’s something else. There’s lots of things that can cause those symptoms of dementia that can be treated and reversed. So, it’s really important that if you notice any of those signs that you have a conversation with a physician.” 

Alzheimer’s interferes with the brain’s ability to nourish itself causing the brain to shrink and neurons (brain cells) to die off. These changes eventually affect every aspect of a victim’s life beyond memory from personality to motor skills.

Scientists still do not understand the causes of Alzheimer’s disease though it has been described in medical literature since the early 1900s.

Researchers believe changes in the brain created by Alzheimer’s are caused by genetic and environmental factors and/or a patient’s lifestyle such as diet, exercise, smoking and obesity, even previous head injuries.

Scientists do know that beta amyloid protein fragments build in the brain clumping together in plaques that interfere with communication between neurons. Tau proteins responsible for transporting nutrients in brain cells also change shape and form tangles disrupting nourishment to the brain.

Alzheimer’s is associated with memory because damage typically starts in the region of the brain responsible for memory.

Age is the most common factor in developing Alzheimer’s. The greater the age, the greater the risk of Alzheimer’s. However, early-onset cases have been diagnosed in people younger than 65.

Scientists do not fully understand the genetic link, but they do know the closer the familial relationship the greater the risk of developing the disease. For example, if a parent or sibling develops Alzheimer’s your risk of developing it is greater.

Other genetic factors are also being studied. Scientists have discovered that a variation of the apolipoprotein E gene, APOE e4, increases a person’s risk of Alzheimer’s, but not everyone who carries the gene develops the disease, according to the Mayo Clinic.

As the disease progresses, the brain atrophies, or wastes away. Symptoms progress, including confusion about events, time of day and location.

“They may have a really difficult time with anything that’s not happening right now,” Young said. “They might forget not just what time of day it is but what day of the week it is, what month it is. They may dress inappropriately for the season.”

Memory loss worsens and behavior and personality changes. Patients may become suspicious of family and caregivers. Eventually the patient loses control of balance and motor skills including difficulty speaking, swallowing, walking and performing everyday selfcare tasks.

The disease ultimately ends in death.

“Most people don’t really think about Alzheimer’s as being a brain disease, but it is a progressive brain disease that starts in the hippocampus, the area that controls your memory, which is the reason, for most people, that’s one of the first signs they have,” Young said. “Then it spreads until eventually it encompasses your entire brain including the brain stem which controls your basic bodily functions like breathing (and) your ability to swallow. So, it is a fatal brain disease.”

People sometimes stop visiting Alzheimer’s victims because the patient has changed and is not the person they once were. They may mistakenly think because the patient does not recognize them that their presence does not matter. It is important to continue to visit and show support anyway.

“The person that they were before the disease took over their brain is still in there,” Young said. “You can sing to them. You can read to them. They can still hear you. They still know that you are a person who is important to them and who cares for them. Your voice is very comforting particularly in those late stages.”

There are treatments to alleviate the symptoms of Alzheimer’s helping victims hold onto independence a while longer, but as of now there is no cure.